|
CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 70498
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$44,424.00 |
| Rate for Payer: Aetna Commercial |
$340.08
|
| Rate for Payer: Aetna Medicare |
$263.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.46
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$253.79
|
| Rate for Payer: BCN Commercial |
$419.28
|
| Rate for Payer: BCN Medicare Advantage |
$253.79
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$365.46
|
| Rate for Payer: Cofinity Commercial |
$340.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.79
|
| Rate for Payer: Healthscope Commercial |
$469.51
|
| Rate for Payer: Healthscope Commercial |
$406.06
|
| Rate for Payer: Mclaren Medicaid |
$52.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.48
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,424.00
|
| Rate for Payer: Nomi Health Commercial |
$304.55
|
| Rate for Payer: PACE SWMI |
$253.79
|
| Rate for Payer: PHP Medicare Advantage |
$253.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.25
|
| Rate for Payer: Priority Health Medicare |
$253.79
|
| Rate for Payer: Priority Health Narrow Network |
$435.25
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$540.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.79
|
| Rate for Payer: UHC Exchange |
$540.24
|
| Rate for Payer: UHC Medicare Advantage |
$253.79
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 72191
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$44,734.00 |
| Rate for Payer: Aetna Commercial |
$374.50
|
| Rate for Payer: Aetna Medicare |
$290.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.45
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$279.48
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$279.48
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$402.45
|
| Rate for Payer: Cofinity Commercial |
$374.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.48
|
| Rate for Payer: Healthscope Commercial |
$517.04
|
| Rate for Payer: Healthscope Commercial |
$447.17
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.45
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,734.00
|
| Rate for Payer: Nomi Health Commercial |
$335.38
|
| Rate for Payer: PACE SWMI |
$279.48
|
| Rate for Payer: PHP Medicare Advantage |
$279.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$480.92
|
| Rate for Payer: Priority Health Medicare |
$279.48
|
| Rate for Payer: Priority Health Narrow Network |
$480.92
|
| Rate for Payer: Priority Health SBD |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$591.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.48
|
| Rate for Payer: UHC Exchange |
$591.29
|
| Rate for Payer: UHC Medicare Advantage |
$279.48
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG CT ANGIOGRAPHY UPPER EXTREMITY
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 73206
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$44,734.00 |
| Rate for Payer: Aetna Commercial |
$365.93
|
| Rate for Payer: Aetna Medicare |
$284.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.24
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$273.08
|
| Rate for Payer: BCN Commercial |
$453.00
|
| Rate for Payer: BCN Medicare Advantage |
$273.08
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$393.24
|
| Rate for Payer: Cofinity Commercial |
$365.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.08
|
| Rate for Payer: Healthscope Commercial |
$505.20
|
| Rate for Payer: Healthscope Commercial |
$436.93
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.73
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,734.00
|
| Rate for Payer: Nomi Health Commercial |
$327.70
|
| Rate for Payer: PACE SWMI |
$273.08
|
| Rate for Payer: PHP Medicare Advantage |
$273.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.12
|
| Rate for Payer: Priority Health Medicare |
$273.08
|
| Rate for Payer: Priority Health Narrow Network |
$469.12
|
| Rate for Payer: Priority Health SBD |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.08
|
| Rate for Payer: UHC Exchange |
$548.55
|
| Rate for Payer: UHC Medicare Advantage |
$273.08
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG CT CERVICAL SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72126
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$29,860.00 |
| Rate for Payer: Aetna Commercial |
$208.06
|
| Rate for Payer: Aetna Medicare |
$161.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.59
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$155.27
|
| Rate for Payer: BCN Commercial |
$256.07
|
| Rate for Payer: BCN Medicare Advantage |
$155.27
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$223.59
|
| Rate for Payer: Cofinity Commercial |
$208.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.27
|
| Rate for Payer: Healthscope Commercial |
$287.25
|
| Rate for Payer: Healthscope Commercial |
$248.43
|
| Rate for Payer: Mclaren Medicaid |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.03
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,860.00
|
| Rate for Payer: Nomi Health Commercial |
$186.32
|
| Rate for Payer: PACE SWMI |
$155.27
|
| Rate for Payer: PHP Medicare Advantage |
$155.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.38
|
| Rate for Payer: Priority Health Medicare |
$155.27
|
| Rate for Payer: Priority Health Narrow Network |
$266.38
|
| Rate for Payer: Priority Health SBD |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$438.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.27
|
| Rate for Payer: UHC Exchange |
$438.90
|
| Rate for Payer: UHC Medicare Advantage |
$155.27
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
CHG CT CERVICAL SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72125
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$22,932.00 |
| Rate for Payer: Aetna Commercial |
$160.79
|
| Rate for Payer: Aetna Medicare |
$124.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.79
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.99
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$119.99
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$172.79
|
| Rate for Payer: Cofinity Commercial |
$160.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.99
|
| Rate for Payer: Healthscope Commercial |
$221.98
|
| Rate for Payer: Healthscope Commercial |
$191.98
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.99
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,932.00
|
| Rate for Payer: Nomi Health Commercial |
$143.99
|
| Rate for Payer: PACE SWMI |
$119.99
|
| Rate for Payer: PHP Medicare Advantage |
$119.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.30
|
| Rate for Payer: Priority Health Medicare |
$119.99
|
| Rate for Payer: Priority Health Narrow Network |
$205.30
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.99
|
| Rate for Payer: UHC Exchange |
$310.29
|
| Rate for Payer: UHC Medicare Advantage |
$119.99
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72127
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$34,898.00 |
| Rate for Payer: Aetna Commercial |
$241.94
|
| Rate for Payer: Aetna Medicare |
$187.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.99
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$180.55
|
| Rate for Payer: BCN Commercial |
$300.05
|
| Rate for Payer: BCN Medicare Advantage |
$180.55
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$259.99
|
| Rate for Payer: Cofinity Commercial |
$241.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.55
|
| Rate for Payer: Healthscope Commercial |
$334.02
|
| Rate for Payer: Healthscope Commercial |
$288.88
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.58
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,898.00
|
| Rate for Payer: Nomi Health Commercial |
$216.66
|
| Rate for Payer: PACE SWMI |
$180.55
|
| Rate for Payer: PHP Medicare Advantage |
$180.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.07
|
| Rate for Payer: Priority Health Medicare |
$180.55
|
| Rate for Payer: Priority Health Narrow Network |
$312.07
|
| Rate for Payer: Priority Health SBD |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$513.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.55
|
| Rate for Payer: UHC Exchange |
$513.00
|
| Rate for Payer: UHC Medicare Advantage |
$180.55
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
|
CHG CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 74263
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$115,567.00 |
| Rate for Payer: Aetna Commercial |
$864.31
|
| Rate for Payer: Aetna Medicare |
$670.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.81
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$645.01
|
| Rate for Payer: BCN Commercial |
$1,004.72
|
| Rate for Payer: BCN Medicare Advantage |
$645.01
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$928.81
|
| Rate for Payer: Cofinity Commercial |
$864.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.01
|
| Rate for Payer: Healthscope Commercial |
$1,032.02
|
| Rate for Payer: Healthscope Commercial |
$1,193.27
|
| Rate for Payer: Mclaren Medicaid |
$71.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.26
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115,567.00
|
| Rate for Payer: Nomi Health Commercial |
$774.01
|
| Rate for Payer: PACE SWMI |
$645.01
|
| Rate for Payer: PHP Medicare Advantage |
$645.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.81
|
| Rate for Payer: Priority Health Medicare |
$645.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.81
|
| Rate for Payer: Priority Health SBD |
$164.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$645.01
|
| Rate for Payer: UHC Medicare Advantage |
$645.01
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 74262
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$50,675.00 |
| Rate for Payer: Aetna Commercial |
$566.24
|
| Rate for Payer: Aetna Medicare |
$439.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.50
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$422.57
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$422.57
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$608.50
|
| Rate for Payer: Cofinity Commercial |
$566.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.57
|
| Rate for Payer: Healthscope Commercial |
$781.75
|
| Rate for Payer: Healthscope Commercial |
$676.11
|
| Rate for Payer: Mclaren Medicaid |
$75.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.70
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50,675.00
|
| Rate for Payer: Nomi Health Commercial |
$507.08
|
| Rate for Payer: PACE SWMI |
$422.57
|
| Rate for Payer: PHP Medicare Advantage |
$422.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.04
|
| Rate for Payer: Priority Health Medicare |
$422.57
|
| Rate for Payer: Priority Health Narrow Network |
$737.04
|
| Rate for Payer: Priority Health SBD |
$180.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$422.57
|
| Rate for Payer: UHC Medicare Advantage |
$422.57
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$37,775.00 |
| Rate for Payer: Aetna Commercial |
$504.66
|
| Rate for Payer: Aetna Commercial |
$504.66
|
| Rate for Payer: Aetna Medicare |
$391.67
|
| Rate for Payer: Aetna Medicare |
$391.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.66
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS MAPPO |
$376.61
|
| Rate for Payer: BCBS MAPPO |
$376.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Medicare Advantage |
$376.61
|
| Rate for Payer: BCN Medicare Advantage |
$376.61
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$504.66
|
| Rate for Payer: Cofinity Commercial |
$542.32
|
| Rate for Payer: Cofinity Commercial |
$504.66
|
| Rate for Payer: Cofinity Commercial |
$542.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.61
|
| Rate for Payer: Healthscope Commercial |
$602.58
|
| Rate for Payer: Healthscope Commercial |
$696.73
|
| Rate for Payer: Healthscope Commercial |
$696.73
|
| Rate for Payer: Healthscope Commercial |
$602.58
|
| Rate for Payer: Mclaren Medicaid |
$72.42
|
| Rate for Payer: Mclaren Medicaid |
$72.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.44
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,775.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37,775.00
|
| Rate for Payer: Nomi Health Commercial |
$451.93
|
| Rate for Payer: Nomi Health Commercial |
$451.93
|
| Rate for Payer: PACE SWMI |
$376.61
|
| Rate for Payer: PACE SWMI |
$376.61
|
| Rate for Payer: PHP Medicare Advantage |
$376.61
|
| Rate for Payer: PHP Medicare Advantage |
$376.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.92
|
| Rate for Payer: Priority Health Medicare |
$376.61
|
| Rate for Payer: Priority Health Medicare |
$376.61
|
| Rate for Payer: Priority Health Narrow Network |
$654.92
|
| Rate for Payer: Priority Health Narrow Network |
$654.92
|
| Rate for Payer: Priority Health SBD |
$172.46
|
| Rate for Payer: Priority Health SBD |
$172.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.61
|
| Rate for Payer: UHC Medicare Advantage |
$376.61
|
| Rate for Payer: UHC Medicare Advantage |
$376.61
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
|
|
CHG CT GUIDANCE &MONITORING VISC TISS ABLATION
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 77013
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$86,252.00 |
| Rate for Payer: Aetna Commercial |
$620.14
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.14
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCN Commercial |
$711.03
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86,252.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.78
|
| Rate for Payer: Priority Health Narrow Network |
$765.78
|
| Rate for Payer: Priority Health SBD |
$275.61
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
CHG CT GUIDANCE NEEDLE PLACEMENT
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 77012
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$24,485.00 |
| Rate for Payer: Aetna Commercial |
$156.07
|
| Rate for Payer: Aetna Medicare |
$121.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.72
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$116.47
|
| Rate for Payer: BCBS Trust/PPO |
$801.43
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: BCN Medicare Advantage |
$116.47
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$167.72
|
| Rate for Payer: Cofinity Commercial |
$156.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.47
|
| Rate for Payer: Healthscope Commercial |
$215.47
|
| Rate for Payer: Healthscope Commercial |
$186.35
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.29
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,485.00
|
| Rate for Payer: Nomi Health Commercial |
$139.76
|
| Rate for Payer: PACE SWMI |
$116.47
|
| Rate for Payer: PHP Medicare Advantage |
$116.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.03
|
| Rate for Payer: Priority Health Medicare |
$116.47
|
| Rate for Payer: Priority Health Narrow Network |
$214.03
|
| Rate for Payer: Priority Health SBD |
$105.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.47
|
| Rate for Payer: UHC Exchange |
$389.14
|
| Rate for Payer: UHC Medicare Advantage |
$116.47
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
|
CHG CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 77014
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$20,572.00 |
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.20
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.13
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Healthscope Commercial |
$173.38
|
| Rate for Payer: Healthscope Commercial |
$200.47
|
| Rate for Payer: Healthscope Commercial |
$173.38
|
| Rate for Payer: Healthscope Commercial |
$200.47
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,572.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,572.00
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.26
|
| Rate for Payer: Priority Health Medicare |
$108.36
|
| Rate for Payer: Priority Health Medicare |
$108.36
|
| Rate for Payer: Priority Health Narrow Network |
$184.26
|
| Rate for Payer: Priority Health Narrow Network |
$184.26
|
| Rate for Payer: Priority Health SBD |
$68.26
|
| Rate for Payer: Priority Health SBD |
$68.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Exchange |
$204.34
|
| Rate for Payer: UHC Exchange |
$204.34
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
CHG CT GUIDANCE STEREOTACTIC LOCALIZATION
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 77011
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$38,090.00 |
| Rate for Payer: Aetna Commercial |
$263.82
|
| Rate for Payer: Aetna Commercial |
$263.82
|
| Rate for Payer: Aetna Medicare |
$204.76
|
| Rate for Payer: Aetna Medicare |
$204.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.82
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS MAPPO |
$196.88
|
| Rate for Payer: BCBS MAPPO |
$196.88
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Medicare Advantage |
$196.88
|
| Rate for Payer: BCN Medicare Advantage |
$196.88
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$283.51
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Cofinity Commercial |
$283.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.88
|
| Rate for Payer: Healthscope Commercial |
$315.01
|
| Rate for Payer: Healthscope Commercial |
$364.23
|
| Rate for Payer: Healthscope Commercial |
$315.01
|
| Rate for Payer: Healthscope Commercial |
$364.23
|
| Rate for Payer: Mclaren Medicaid |
$38.98
|
| Rate for Payer: Mclaren Medicaid |
$38.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.72
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,090.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38,090.00
|
| Rate for Payer: Nomi Health Commercial |
$236.26
|
| Rate for Payer: Nomi Health Commercial |
$236.26
|
| Rate for Payer: PACE SWMI |
$196.88
|
| Rate for Payer: PACE SWMI |
$196.88
|
| Rate for Payer: PHP Medicare Advantage |
$196.88
|
| Rate for Payer: PHP Medicare Advantage |
$196.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.81
|
| Rate for Payer: Priority Health Medicare |
$196.88
|
| Rate for Payer: Priority Health Medicare |
$196.88
|
| Rate for Payer: Priority Health Narrow Network |
$340.81
|
| Rate for Payer: Priority Health Narrow Network |
$340.81
|
| Rate for Payer: Priority Health SBD |
$93.41
|
| Rate for Payer: Priority Health SBD |
$93.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$581.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.88
|
| Rate for Payer: UHC Exchange |
$581.94
|
| Rate for Payer: UHC Exchange |
$581.94
|
| Rate for Payer: UHC Medicare Advantage |
$196.88
|
| Rate for Payer: UHC Medicare Advantage |
$196.88
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
|
|
CHG CT HEAD/BRAIN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 70460
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$26,190.00 |
| Rate for Payer: Aetna Commercial |
$183.63
|
| Rate for Payer: Aetna Medicare |
$142.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.34
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$137.04
|
| Rate for Payer: BCN Commercial |
$224.30
|
| Rate for Payer: BCN Medicare Advantage |
$137.04
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$197.34
|
| Rate for Payer: Cofinity Commercial |
$183.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.04
|
| Rate for Payer: Healthscope Commercial |
$253.52
|
| Rate for Payer: Healthscope Commercial |
$219.26
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.89
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,190.00
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: PACE SWMI |
$137.04
|
| Rate for Payer: PHP Medicare Advantage |
$137.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.04
|
| Rate for Payer: Priority Health Medicare |
$137.04
|
| Rate for Payer: Priority Health Narrow Network |
$234.04
|
| Rate for Payer: Priority Health SBD |
$81.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$333.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.04
|
| Rate for Payer: UHC Exchange |
$333.13
|
| Rate for Payer: UHC Medicare Advantage |
$137.04
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 70450
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$18,794.00 |
| Rate for Payer: Aetna Commercial |
$132.18
|
| Rate for Payer: Aetna Medicare |
$102.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.04
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$98.64
|
| Rate for Payer: BCN Commercial |
$160.77
|
| Rate for Payer: BCN Medicare Advantage |
$98.64
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$142.04
|
| Rate for Payer: Cofinity Commercial |
$132.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.64
|
| Rate for Payer: Healthscope Commercial |
$182.48
|
| Rate for Payer: Healthscope Commercial |
$157.82
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.57
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,794.00
|
| Rate for Payer: Nomi Health Commercial |
$118.37
|
| Rate for Payer: PACE SWMI |
$98.64
|
| Rate for Payer: PHP Medicare Advantage |
$98.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.33
|
| Rate for Payer: Priority Health Medicare |
$98.64
|
| Rate for Payer: Priority Health Narrow Network |
$167.33
|
| Rate for Payer: Priority Health SBD |
$61.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$272.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.64
|
| Rate for Payer: UHC Exchange |
$272.25
|
| Rate for Payer: UHC Medicare Advantage |
$98.64
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
|
|
CHG CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 70470
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$30,787.00 |
| Rate for Payer: Aetna Commercial |
$214.29
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.28
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$159.92
|
| Rate for Payer: BCN Commercial |
$263.88
|
| Rate for Payer: BCN Medicare Advantage |
$159.92
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$230.28
|
| Rate for Payer: Cofinity Commercial |
$214.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.92
|
| Rate for Payer: Healthscope Commercial |
$295.85
|
| Rate for Payer: Healthscope Commercial |
$255.87
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.92
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,787.00
|
| Rate for Payer: Nomi Health Commercial |
$191.90
|
| Rate for Payer: PACE SWMI |
$159.92
|
| Rate for Payer: PHP Medicare Advantage |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.09
|
| Rate for Payer: Priority Health Medicare |
$159.92
|
| Rate for Payer: Priority Health Narrow Network |
$274.09
|
| Rate for Payer: Priority Health SBD |
$91.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.92
|
| Rate for Payer: UHC Exchange |
$407.14
|
| Rate for Payer: UHC Medicare Advantage |
$159.92
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
CHG CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 75572
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$40,135.00 |
| Rate for Payer: Aetna Commercial |
$281.92
|
| Rate for Payer: Aetna Medicare |
$218.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.96
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$210.39
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$210.39
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$302.96
|
| Rate for Payer: Cofinity Commercial |
$281.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.39
|
| Rate for Payer: Healthscope Commercial |
$336.62
|
| Rate for Payer: Healthscope Commercial |
$389.22
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.91
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,135.00
|
| Rate for Payer: Nomi Health Commercial |
$252.47
|
| Rate for Payer: PACE SWMI |
$210.39
|
| Rate for Payer: PHP Medicare Advantage |
$210.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.28
|
| Rate for Payer: Priority Health Medicare |
$210.39
|
| Rate for Payer: Priority Health Narrow Network |
$359.28
|
| Rate for Payer: Priority Health SBD |
$124.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.39
|
| Rate for Payer: UHC Medicare Advantage |
$210.39
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
CHG CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 75571
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$17,536.00 |
| Rate for Payer: Aetna Commercial |
$123.63
|
| Rate for Payer: Aetna Medicare |
$95.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.85
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$92.26
|
| Rate for Payer: BCN Commercial |
$151.00
|
| Rate for Payer: BCN Medicare Advantage |
$92.26
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$132.85
|
| Rate for Payer: Cofinity Commercial |
$123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.26
|
| Rate for Payer: Healthscope Commercial |
$170.68
|
| Rate for Payer: Healthscope Commercial |
$147.62
|
| Rate for Payer: Mclaren Medicaid |
$17.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.87
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,536.00
|
| Rate for Payer: Nomi Health Commercial |
$110.71
|
| Rate for Payer: PACE SWMI |
$92.26
|
| Rate for Payer: PHP Medicare Advantage |
$92.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.57
|
| Rate for Payer: Priority Health Medicare |
$92.26
|
| Rate for Payer: Priority Health Narrow Network |
$157.57
|
| Rate for Payer: Priority Health SBD |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.26
|
| Rate for Payer: UHC Medicare Advantage |
$92.26
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
|
|
CHG CT LIMITED/LOCALIZED FOLLOW UP STUDY
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 76380
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$22,329.00 |
| Rate for Payer: Aetna Commercial |
$161.62
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.68
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$173.68
|
| Rate for Payer: Cofinity Commercial |
$161.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Healthscope Commercial |
$223.13
|
| Rate for Payer: Healthscope Commercial |
$192.98
|
| Rate for Payer: Mclaren Medicaid |
$28.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,329.00
|
| Rate for Payer: Nomi Health Commercial |
$144.73
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.34
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Narrow Network |
$206.34
|
| Rate for Payer: Priority Health SBD |
$68.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Exchange |
$199.86
|
| Rate for Payer: UHC Medicare Advantage |
$120.61
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
|
|
CHG CT LOWER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 73701
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$29,495.00 |
| Rate for Payer: Aetna Commercial |
$205.46
|
| Rate for Payer: Aetna Medicare |
$159.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.80
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$153.33
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: BCN Medicare Advantage |
$153.33
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$205.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.33
|
| Rate for Payer: Healthscope Commercial |
$283.66
|
| Rate for Payer: Healthscope Commercial |
$245.33
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.00
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,495.00
|
| Rate for Payer: Nomi Health Commercial |
$184.00
|
| Rate for Payer: PACE SWMI |
$153.33
|
| Rate for Payer: PHP Medicare Advantage |
$153.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.29
|
| Rate for Payer: Priority Health Medicare |
$153.33
|
| Rate for Payer: Priority Health Narrow Network |
$263.29
|
| Rate for Payer: Priority Health SBD |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$381.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.33
|
| Rate for Payer: UHC Exchange |
$381.42
|
| Rate for Payer: UHC Medicare Advantage |
$153.33
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
CHG CT LOWER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 73700
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$22,876.00 |
| Rate for Payer: Aetna Commercial |
$160.40
|
| Rate for Payer: Aetna Medicare |
$124.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.37
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.70
|
| Rate for Payer: BCN Commercial |
$195.96
|
| Rate for Payer: BCN Medicare Advantage |
$119.70
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$172.37
|
| Rate for Payer: Cofinity Commercial |
$160.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.70
|
| Rate for Payer: Healthscope Commercial |
$221.44
|
| Rate for Payer: Healthscope Commercial |
$191.52
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.68
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,876.00
|
| Rate for Payer: Nomi Health Commercial |
$143.64
|
| Rate for Payer: PACE SWMI |
$119.70
|
| Rate for Payer: PHP Medicare Advantage |
$119.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$204.27
|
| Rate for Payer: Priority Health Medicare |
$119.70
|
| Rate for Payer: Priority Health Narrow Network |
$204.27
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.70
|
| Rate for Payer: UHC Exchange |
$286.42
|
| Rate for Payer: UHC Medicare Advantage |
$119.70
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT LOWER EXTREMITY W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 73702
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$34,474.00 |
| Rate for Payer: Aetna Commercial |
$240.05
|
| Rate for Payer: Aetna Medicare |
$186.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.96
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$179.14
|
| Rate for Payer: BCN Commercial |
$296.63
|
| Rate for Payer: BCN Medicare Advantage |
$179.14
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$257.96
|
| Rate for Payer: Cofinity Commercial |
$240.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.14
|
| Rate for Payer: Healthscope Commercial |
$331.41
|
| Rate for Payer: Healthscope Commercial |
$286.62
|
| Rate for Payer: Mclaren Medicaid |
$36.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.10
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,474.00
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: PACE SWMI |
$179.14
|
| Rate for Payer: PHP Medicare Advantage |
$179.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.47
|
| Rate for Payer: Priority Health Medicare |
$179.14
|
| Rate for Payer: Priority Health Narrow Network |
$308.47
|
| Rate for Payer: Priority Health SBD |
$87.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.14
|
| Rate for Payer: UHC Exchange |
$419.42
|
| Rate for Payer: UHC Medicare Advantage |
$179.14
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
CHG CT LUMBAR SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72132
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$29,916.00 |
| Rate for Payer: Aetna Commercial |
$208.85
|
| Rate for Payer: Aetna Medicare |
$162.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.44
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$155.86
|
| Rate for Payer: BCN Commercial |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$155.86
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$224.44
|
| Rate for Payer: Cofinity Commercial |
$208.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.86
|
| Rate for Payer: Healthscope Commercial |
$288.34
|
| Rate for Payer: Healthscope Commercial |
$249.38
|
| Rate for Payer: Mclaren Medicaid |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.65
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29,916.00
|
| Rate for Payer: Nomi Health Commercial |
$187.03
|
| Rate for Payer: PACE SWMI |
$155.86
|
| Rate for Payer: PHP Medicare Advantage |
$155.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.90
|
| Rate for Payer: Priority Health Medicare |
$155.86
|
| Rate for Payer: Priority Health Narrow Network |
$266.90
|
| Rate for Payer: Priority Health SBD |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$452.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.86
|
| Rate for Payer: UHC Exchange |
$452.47
|
| Rate for Payer: UHC Medicare Advantage |
$155.86
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
CHG CT LUMBAR SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72131
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$22,820.00 |
| Rate for Payer: Aetna Commercial |
$160.01
|
| Rate for Payer: Aetna Medicare |
$124.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.95
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.41
|
| Rate for Payer: BCN Commercial |
$195.47
|
| Rate for Payer: BCN Medicare Advantage |
$119.41
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$171.95
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.41
|
| Rate for Payer: Healthscope Commercial |
$220.91
|
| Rate for Payer: Healthscope Commercial |
$191.06
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.38
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,820.00
|
| Rate for Payer: Nomi Health Commercial |
$143.29
|
| Rate for Payer: PACE SWMI |
$119.41
|
| Rate for Payer: PHP Medicare Advantage |
$119.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.76
|
| Rate for Payer: Priority Health Medicare |
$119.41
|
| Rate for Payer: Priority Health Narrow Network |
$203.76
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.41
|
| Rate for Payer: UHC Exchange |
$310.41
|
| Rate for Payer: UHC Medicare Advantage |
$119.41
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72133
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$35,010.00 |
| Rate for Payer: Aetna Commercial |
$242.34
|
| Rate for Payer: Aetna Medicare |
$188.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.42
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$180.85
|
| Rate for Payer: BCN Commercial |
$301.02
|
| Rate for Payer: BCN Medicare Advantage |
$180.85
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$260.42
|
| Rate for Payer: Cofinity Commercial |
$242.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.85
|
| Rate for Payer: Healthscope Commercial |
$334.57
|
| Rate for Payer: Healthscope Commercial |
$289.36
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.89
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35,010.00
|
| Rate for Payer: Nomi Health Commercial |
$217.02
|
| Rate for Payer: PACE SWMI |
$180.85
|
| Rate for Payer: PHP Medicare Advantage |
$180.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.57
|
| Rate for Payer: Priority Health Medicare |
$180.85
|
| Rate for Payer: Priority Health Narrow Network |
$312.57
|
| Rate for Payer: Priority Health SBD |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.85
|
| Rate for Payer: UHC Exchange |
$547.65
|
| Rate for Payer: UHC Medicare Advantage |
$180.85
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
