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Phenothiazine Level Test

Montana rates for HCPCS 84022

Measures how much phenothiazine medicine is present in a sample. Phenothiazines are an older family of drugs used for psychosis, severe nausea and agitation, and the result helps a prescriber judge whether the amount in the body is about right or too high.

Rates data updated October 2026.

How much does Phenothiazine Level Test cost?

$31.62

Typical facility fee. In Montana, October 2026.

Insurers have agreed to pay about $31.62 for this service. Most negotiated rates run $27.54 to $36.31.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 3 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $36 · 10th to 90th $22 to $36Professionalmedian $28 · 10th to 90th $25 to $30
facility $36professional $28

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None
Typical Low
$24.55
Median
$24.55
Typical High
$30.20
MountainHealth Co-op
Setting
Facility
Modifier
None
Typical Low
$31.62
Median
$36.31
Typical High
$36.31
MountainHealth Co-op
Setting
Professional
Modifier
None
Typical Low
$27.54
Median
$27.54
Typical High
$27.54
Providence
Setting
Facility
Modifier
None
Typical Low
$22.39
Median
$22.39
Typical High
$22.39

Where Montana sits

The same service costs 3.0 times more in South Dakota than in Alaska. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Montana· 8th of 50

$31.62

SD $40.74AK $13.80

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.