|
CHG RADEX TOE MINIMUM 2 VIEWS
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 73660
|
| Min. Negotiated Rate |
$26.18 |
| Max. Negotiated Rate |
$48.43 |
| Rate for Payer: Aetna Commercial |
$35.08
|
| Rate for Payer: Aetna Commercial |
$35.08
|
| Rate for Payer: Aetna Commercial |
$35.08
|
| Rate for Payer: Aetna Medicare |
$27.23
|
| Rate for Payer: Aetna Medicare |
$27.23
|
| Rate for Payer: Aetna Medicare |
$27.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.08
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$26.18
|
| Rate for Payer: BCBS MAPPO |
$26.18
|
| Rate for Payer: BCBS MAPPO |
$26.18
|
| Rate for Payer: BCN Medicare Advantage |
$26.18
|
| Rate for Payer: BCN Medicare Advantage |
$26.18
|
| Rate for Payer: BCN Medicare Advantage |
$26.18
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.18
|
| Rate for Payer: Healthscope Commercial |
$48.43
|
| Rate for Payer: Healthscope Commercial |
$48.43
|
| Rate for Payer: Healthscope Commercial |
$41.89
|
| Rate for Payer: Healthscope Commercial |
$41.89
|
| Rate for Payer: Healthscope Commercial |
$48.43
|
| Rate for Payer: Healthscope Commercial |
$41.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.90
|
| Rate for Payer: Nomi Health Commercial |
$31.42
|
| Rate for Payer: Nomi Health Commercial |
$31.42
|
| Rate for Payer: Nomi Health Commercial |
$31.42
|
| Rate for Payer: PACE SWMI |
$26.18
|
| Rate for Payer: PACE SWMI |
$26.18
|
| Rate for Payer: PACE SWMI |
$26.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$26.18
|
| Rate for Payer: Priority Health Medicare |
$26.18
|
| Rate for Payer: Priority Health Medicare |
$26.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.18
|
| Rate for Payer: UHC Medicare Advantage |
$26.18
|
| Rate for Payer: UHC Medicare Advantage |
$26.18
|
| Rate for Payer: UHC Medicare Advantage |
$26.18
|
|
|
CHG RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 73092
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$52.41 |
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.96
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Healthscope Commercial |
$45.33
|
| Rate for Payer: Healthscope Commercial |
$52.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
|
|
CHG RADEX WRIST 2 VIEWS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 73100
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$56.22 |
| Rate for Payer: Aetna Commercial |
$40.72
|
| Rate for Payer: Aetna Commercial |
$40.72
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.72
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$30.39
|
| Rate for Payer: BCBS MAPPO |
$30.39
|
| Rate for Payer: BCN Medicare Advantage |
$30.39
|
| Rate for Payer: BCN Medicare Advantage |
$30.39
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$40.72
|
| Rate for Payer: Cofinity Commercial |
$40.72
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.39
|
| Rate for Payer: Healthscope Commercial |
$56.22
|
| Rate for Payer: Healthscope Commercial |
$56.22
|
| Rate for Payer: Healthscope Commercial |
$48.62
|
| Rate for Payer: Healthscope Commercial |
$48.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$36.47
|
| Rate for Payer: Nomi Health Commercial |
$36.47
|
| Rate for Payer: PACE SWMI |
$30.39
|
| Rate for Payer: PACE SWMI |
$30.39
|
| Rate for Payer: PHP Medicare Advantage |
$30.39
|
| Rate for Payer: PHP Medicare Advantage |
$30.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$30.39
|
| Rate for Payer: Priority Health Medicare |
$30.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.39
|
| Rate for Payer: UHC Medicare Advantage |
$30.39
|
| Rate for Payer: UHC Medicare Advantage |
$30.39
|
|
|
CHG RADEX WRIST COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 73110
|
| Min. Negotiated Rate |
$37.20 |
| Max. Negotiated Rate |
$68.82 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.85
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Healthscope Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$59.52
|
| Rate for Payer: Healthscope Commercial |
$59.52
|
| Rate for Payer: Healthscope Commercial |
$68.82
|
| Rate for Payer: Healthscope Commercial |
$59.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.40
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$37.20
|
| Rate for Payer: Priority Health Medicare |
$37.20
|
| Rate for Payer: Priority Health Medicare |
$37.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.20
|
| Rate for Payer: UHC Medicare Advantage |
$37.20
|
| Rate for Payer: UHC Medicare Advantage |
$37.20
|
| Rate for Payer: UHC Medicare Advantage |
$37.20
|
|
|
CHG RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 77431
|
| Min. Negotiated Rate |
$84.80 |
| Max. Negotiated Rate |
$190.96 |
| Rate for Payer: Aetna Commercial |
$138.31
|
| Rate for Payer: Aetna Medicare |
$107.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.31
|
| Rate for Payer: BCBS Complete |
$84.80
|
| Rate for Payer: BCBS MAPPO |
$103.22
|
| Rate for Payer: BCN Medicare Advantage |
$103.22
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$148.64
|
| Rate for Payer: Cofinity Commercial |
$138.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.22
|
| Rate for Payer: Healthscope Commercial |
$165.15
|
| Rate for Payer: Healthscope Commercial |
$190.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.80
|
| Rate for Payer: Nomi Health Commercial |
$123.86
|
| Rate for Payer: PACE SWMI |
$103.22
|
| Rate for Payer: PHP Medicare Advantage |
$103.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.80
|
| Rate for Payer: Priority Health Medicare |
$103.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.22
|
| Rate for Payer: UHC Medicare Advantage |
$103.22
|
|
|
CHG RADIATION TREATMENT DELIVERY >=1 MEV COMPLEX
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 77412
|
| Min. Negotiated Rate |
$221.20 |
| Max. Negotiated Rate |
$359.45 |
| Rate for Payer: Aetna Medicare |
$276.50
|
| Rate for Payer: BCBS Complete |
$221.20
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$359.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.45
|
|
|
CHG RADIATION TREATMENT DELIVERY >=1 MEV SIMPLE
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
HCPCS 77402
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$235.30 |
| Rate for Payer: Aetna Medicare |
$181.00
|
| Rate for Payer: BCBS Complete |
$144.80
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.30
|
|
|
CHG RADIATION TREATMENT MANAGEMENT 5 TREATMENTS
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 77427
|
| Min. Negotiated Rate |
$144.00 |
| Max. Negotiated Rate |
$338.92 |
| Rate for Payer: Aetna Commercial |
$245.49
|
| Rate for Payer: Aetna Medicare |
$190.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.49
|
| Rate for Payer: BCBS Complete |
$144.00
|
| Rate for Payer: BCBS MAPPO |
$183.20
|
| Rate for Payer: BCN Medicare Advantage |
$183.20
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$263.81
|
| Rate for Payer: Cofinity Commercial |
$245.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.20
|
| Rate for Payer: Healthscope Commercial |
$338.92
|
| Rate for Payer: Healthscope Commercial |
$293.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.00
|
| Rate for Payer: Nomi Health Commercial |
$219.84
|
| Rate for Payer: PACE SWMI |
$183.20
|
| Rate for Payer: PHP Medicare Advantage |
$183.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.00
|
| Rate for Payer: Priority Health Medicare |
$183.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.20
|
| Rate for Payer: UHC Medicare Advantage |
$183.20
|
|
|
CHG RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTAGE
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 77401
|
| Min. Negotiated Rate |
$36.33 |
| Max. Negotiated Rate |
$67.21 |
| Rate for Payer: Aetna Commercial |
$48.68
|
| Rate for Payer: Aetna Medicare |
$37.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.68
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$36.33
|
| Rate for Payer: BCN Medicare Advantage |
$36.33
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$52.32
|
| Rate for Payer: Cofinity Commercial |
$48.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.33
|
| Rate for Payer: Healthscope Commercial |
$58.13
|
| Rate for Payer: Healthscope Commercial |
$67.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.15
|
| Rate for Payer: Nomi Health Commercial |
$43.60
|
| Rate for Payer: PACE SWMI |
$36.33
|
| Rate for Payer: PHP Medicare Advantage |
$36.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$36.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.33
|
| Rate for Payer: UHC Medicare Advantage |
$36.33
|
|
|
CHG RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 70110
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$73.06 |
| Rate for Payer: Aetna Commercial |
$52.92
|
| Rate for Payer: Aetna Medicare |
$41.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.92
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$39.49
|
| Rate for Payer: BCN Medicare Advantage |
$39.49
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$56.87
|
| Rate for Payer: Cofinity Commercial |
$52.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.49
|
| Rate for Payer: Healthscope Commercial |
$73.06
|
| Rate for Payer: Healthscope Commercial |
$63.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.25
|
| Rate for Payer: Nomi Health Commercial |
$47.39
|
| Rate for Payer: PACE SWMI |
$39.49
|
| Rate for Payer: PHP Medicare Advantage |
$39.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.25
|
| Rate for Payer: Priority Health Medicare |
$39.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$39.49
|
|
|
CHG RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 75989
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$188.59 |
| Rate for Payer: Aetna Commercial |
$136.60
|
| Rate for Payer: Aetna Medicare |
$106.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.60
|
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: BCBS MAPPO |
$101.94
|
| Rate for Payer: BCN Medicare Advantage |
$101.94
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$146.79
|
| Rate for Payer: Cofinity Commercial |
$136.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.94
|
| Rate for Payer: Healthscope Commercial |
$163.10
|
| Rate for Payer: Healthscope Commercial |
$188.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.15
|
| Rate for Payer: Nomi Health Commercial |
$122.33
|
| Rate for Payer: PACE SWMI |
$101.94
|
| Rate for Payer: PHP Medicare Advantage |
$101.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health Medicare |
$101.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.94
|
| Rate for Payer: UHC Medicare Advantage |
$101.94
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 74018
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$36.46
|
| Rate for Payer: Aetna Medicare |
$28.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$27.21
|
| Rate for Payer: BCN Medicare Advantage |
$27.21
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$39.18
|
| Rate for Payer: Cofinity Commercial |
$36.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.21
|
| Rate for Payer: Healthscope Commercial |
$43.54
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Nomi Health Commercial |
$32.65
|
| Rate for Payer: PACE SWMI |
$27.21
|
| Rate for Payer: PHP Medicare Advantage |
$27.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Medicare |
$27.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.21
|
| Rate for Payer: UHC Medicare Advantage |
$27.21
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 74019
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$62.05 |
| Rate for Payer: Aetna Commercial |
$44.94
|
| Rate for Payer: Aetna Commercial |
$44.94
|
| Rate for Payer: Aetna Medicare |
$34.88
|
| Rate for Payer: Aetna Medicare |
$34.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.94
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$33.54
|
| Rate for Payer: BCBS MAPPO |
$33.54
|
| Rate for Payer: BCN Medicare Advantage |
$33.54
|
| Rate for Payer: BCN Medicare Advantage |
$33.54
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.54
|
| Rate for Payer: Healthscope Commercial |
$62.05
|
| Rate for Payer: Healthscope Commercial |
$62.05
|
| Rate for Payer: Healthscope Commercial |
$53.66
|
| Rate for Payer: Healthscope Commercial |
$53.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.95
|
| Rate for Payer: Nomi Health Commercial |
$40.25
|
| Rate for Payer: Nomi Health Commercial |
$40.25
|
| Rate for Payer: PACE SWMI |
$33.54
|
| Rate for Payer: PACE SWMI |
$33.54
|
| Rate for Payer: PHP Medicare Advantage |
$33.54
|
| Rate for Payer: PHP Medicare Advantage |
$33.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$33.54
|
| Rate for Payer: Priority Health Medicare |
$33.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.54
|
| Rate for Payer: UHC Medicare Advantage |
$33.54
|
| Rate for Payer: UHC Medicare Advantage |
$33.54
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 74021
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$71.54 |
| Rate for Payer: Aetna Commercial |
$51.82
|
| Rate for Payer: Aetna Medicare |
$40.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.82
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$38.67
|
| Rate for Payer: BCN Medicare Advantage |
$38.67
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$55.68
|
| Rate for Payer: Cofinity Commercial |
$51.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.67
|
| Rate for Payer: Healthscope Commercial |
$61.87
|
| Rate for Payer: Healthscope Commercial |
$71.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$46.40
|
| Rate for Payer: PACE SWMI |
$38.67
|
| Rate for Payer: PHP Medicare Advantage |
$38.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$38.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.67
|
| Rate for Payer: UHC Medicare Advantage |
$38.67
|
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 73565
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$66.58 |
| Rate for Payer: Aetna Commercial |
$48.23
|
| Rate for Payer: Aetna Commercial |
$48.23
|
| Rate for Payer: Aetna Commercial |
$48.23
|
| Rate for Payer: Aetna Medicare |
$37.43
|
| Rate for Payer: Aetna Medicare |
$37.43
|
| Rate for Payer: Aetna Medicare |
$37.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.23
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$35.99
|
| Rate for Payer: BCBS MAPPO |
$35.99
|
| Rate for Payer: BCBS MAPPO |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$35.99
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.99
|
| Rate for Payer: Healthscope Commercial |
$57.58
|
| Rate for Payer: Healthscope Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$57.58
|
| Rate for Payer: Healthscope Commercial |
$57.58
|
| Rate for Payer: Healthscope Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$66.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.65
|
| Rate for Payer: Nomi Health Commercial |
$43.19
|
| Rate for Payer: Nomi Health Commercial |
$43.19
|
| Rate for Payer: Nomi Health Commercial |
$43.19
|
| Rate for Payer: PACE SWMI |
$35.99
|
| Rate for Payer: PACE SWMI |
$35.99
|
| Rate for Payer: PACE SWMI |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$35.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$35.99
|
| Rate for Payer: Priority Health Medicare |
$35.99
|
| Rate for Payer: Priority Health Medicare |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$35.99
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 71046
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$56.55 |
| Rate for Payer: Aetna Commercial |
$40.96
|
| Rate for Payer: Aetna Medicare |
$31.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.96
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$30.57
|
| Rate for Payer: BCN Medicare Advantage |
$30.57
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$44.02
|
| Rate for Payer: Cofinity Commercial |
$40.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.57
|
| Rate for Payer: Healthscope Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$48.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.70
|
| Rate for Payer: Nomi Health Commercial |
$36.68
|
| Rate for Payer: PACE SWMI |
$30.57
|
| Rate for Payer: PHP Medicare Advantage |
$30.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Medicare |
$30.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.57
|
| Rate for Payer: UHC Medicare Advantage |
$30.57
|
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 71047
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$70.45 |
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Medicare |
$39.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.03
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCN Medicare Advantage |
$38.08
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$54.84
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.08
|
| Rate for Payer: Healthscope Commercial |
$60.93
|
| Rate for Payer: Healthscope Commercial |
$70.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.85
|
| Rate for Payer: Nomi Health Commercial |
$45.70
|
| Rate for Payer: PACE SWMI |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$38.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Medicare |
$38.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.08
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 71045
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$43.79 |
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.08
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Healthscope Commercial |
$43.79
|
| Rate for Payer: Healthscope Commercial |
$43.79
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Healthscope Commercial |
$37.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$83.95 |
| Rate for Payer: Aetna Commercial |
$60.81
|
| Rate for Payer: Aetna Medicare |
$47.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.81
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$45.38
|
| Rate for Payer: BCN Medicare Advantage |
$45.38
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$65.35
|
| Rate for Payer: Cofinity Commercial |
$60.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.38
|
| Rate for Payer: Healthscope Commercial |
$72.61
|
| Rate for Payer: Healthscope Commercial |
$83.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Nomi Health Commercial |
$54.46
|
| Rate for Payer: PACE SWMI |
$45.38
|
| Rate for Payer: PHP Medicare Advantage |
$45.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$45.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.38
|
| Rate for Payer: UHC Medicare Advantage |
$45.38
|
|
|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 73600
|
| Min. Negotiated Rate |
$28.92 |
| Max. Negotiated Rate |
$53.50 |
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Healthscope Commercial |
$53.50
|
| Rate for Payer: Healthscope Commercial |
$53.50
|
| Rate for Payer: Healthscope Commercial |
$46.27
|
| Rate for Payer: Healthscope Commercial |
$46.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.20
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$28.92
|
| Rate for Payer: Priority Health Medicare |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 70030
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$40.01
|
| Rate for Payer: Aetna Medicare |
$31.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$29.86
|
| Rate for Payer: BCN Medicare Advantage |
$29.86
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$40.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.86
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Healthscope Commercial |
$47.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.95
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PACE SWMI |
$29.86
|
| Rate for Payer: PHP Medicare Advantage |
$29.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$29.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.86
|
| Rate for Payer: UHC Medicare Advantage |
$29.86
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73551
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$49.69 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$27.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.99
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$26.86
|
| Rate for Payer: BCN Medicare Advantage |
$26.86
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$38.68
|
| Rate for Payer: Cofinity Commercial |
$35.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.86
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Healthscope Commercial |
$49.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: PACE SWMI |
$26.86
|
| Rate for Payer: PHP Medicare Advantage |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$26.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.86
|
| Rate for Payer: UHC Medicare Advantage |
$26.86
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$25.20 |
| Max. Negotiated Rate |
$59.61 |
| Rate for Payer: Aetna Commercial |
$43.17
|
| Rate for Payer: Aetna Commercial |
$43.17
|
| Rate for Payer: Aetna Medicare |
$33.51
|
| Rate for Payer: Aetna Medicare |
$33.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.40
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$32.22
|
| Rate for Payer: BCBS MAPPO |
$32.22
|
| Rate for Payer: BCN Medicare Advantage |
$32.22
|
| Rate for Payer: BCN Medicare Advantage |
$32.22
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.22
|
| Rate for Payer: Healthscope Commercial |
$59.61
|
| Rate for Payer: Healthscope Commercial |
$59.61
|
| Rate for Payer: Healthscope Commercial |
$51.55
|
| Rate for Payer: Healthscope Commercial |
$51.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.00
|
| Rate for Payer: Nomi Health Commercial |
$38.66
|
| Rate for Payer: Nomi Health Commercial |
$38.66
|
| Rate for Payer: PACE SWMI |
$32.22
|
| Rate for Payer: PACE SWMI |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Medicare |
$32.22
|
| Rate for Payer: Priority Health Medicare |
$32.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.22
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
Both
|
$78.00
|
|
|
Service Code
|
HCPCS 73620
|
| Min. Negotiated Rate |
$25.68 |
| Max. Negotiated Rate |
$50.70 |
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: BCBS Complete |
$31.20
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$47.51
|
| Rate for Payer: Healthscope Commercial |
$47.51
|
| Rate for Payer: Healthscope Commercial |
$41.09
|
| Rate for Payer: Healthscope Commercial |
$41.09
|
| Rate for Payer: Healthscope Commercial |
$47.51
|
| Rate for Payer: Healthscope Commercial |
$41.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$85.00
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$30.69 |
| Max. Negotiated Rate |
$56.78 |
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: Healthscope Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$56.78
|
| Rate for Payer: Healthscope Commercial |
$49.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.30
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
|
