|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$67.78 |
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Healthscope Commercial |
$67.78
|
| Rate for Payer: Healthscope Commercial |
$67.78
|
| Rate for Payer: Healthscope Commercial |
$58.62
|
| Rate for Payer: Healthscope Commercial |
$58.62
|
| Rate for Payer: Healthscope Commercial |
$67.78
|
| Rate for Payer: Healthscope Commercial |
$58.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70100
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$64.51 |
| Rate for Payer: Aetna Commercial |
$46.73
|
| Rate for Payer: Aetna Medicare |
$36.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.73
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$34.87
|
| Rate for Payer: BCN Medicare Advantage |
$34.87
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$50.21
|
| Rate for Payer: Cofinity Commercial |
$46.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.87
|
| Rate for Payer: Healthscope Commercial |
$64.51
|
| Rate for Payer: Healthscope Commercial |
$55.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$41.84
|
| Rate for Payer: PACE SWMI |
$34.87
|
| Rate for Payer: PHP Medicare Advantage |
$34.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Medicare |
$34.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.87
|
| Rate for Payer: UHC Medicare Advantage |
$34.87
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 70360
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$52.52 |
| Rate for Payer: Aetna Commercial |
$38.04
|
| Rate for Payer: Aetna Medicare |
$29.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.04
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$28.39
|
| Rate for Payer: BCN Medicare Advantage |
$28.39
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Cofinity Commercial |
$38.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.39
|
| Rate for Payer: Healthscope Commercial |
$45.42
|
| Rate for Payer: Healthscope Commercial |
$52.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Nomi Health Commercial |
$34.07
|
| Rate for Payer: PACE SWMI |
$28.39
|
| Rate for Payer: PHP Medicare Advantage |
$28.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$28.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.39
|
|
|
CHG RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPLETE
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 77075
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$165.63 |
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna Medicare |
$93.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.97
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$89.53
|
| Rate for Payer: BCN Medicare Advantage |
$89.53
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$128.92
|
| Rate for Payer: Cofinity Commercial |
$119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.53
|
| Rate for Payer: Healthscope Commercial |
$143.25
|
| Rate for Payer: Healthscope Commercial |
$165.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.05
|
| Rate for Payer: Nomi Health Commercial |
$107.44
|
| Rate for Payer: PACE SWMI |
$89.53
|
| Rate for Payer: PHP Medicare Advantage |
$89.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health Medicare |
$89.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.53
|
| Rate for Payer: UHC Medicare Advantage |
$89.53
|
|
|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 72170
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$47.01 |
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.05
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Healthscope Commercial |
$40.66
|
| Rate for Payer: Healthscope Commercial |
$47.01
|
| Rate for Payer: Healthscope Commercial |
$40.66
|
| Rate for Payer: Healthscope Commercial |
$40.66
|
| Rate for Payer: Healthscope Commercial |
$47.01
|
| Rate for Payer: Healthscope Commercial |
$47.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.25
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health Medicare |
$25.41
|
| Rate for Payer: Priority Health Medicare |
$25.41
|
| Rate for Payer: Priority Health Medicare |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
|
|
CHG RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72200
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$56.28 |
| Rate for Payer: Aetna Commercial |
$40.76
|
| Rate for Payer: Aetna Medicare |
$31.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$30.42
|
| Rate for Payer: BCN Medicare Advantage |
$30.42
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$43.80
|
| Rate for Payer: Cofinity Commercial |
$40.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.42
|
| Rate for Payer: Healthscope Commercial |
$48.67
|
| Rate for Payer: Healthscope Commercial |
$56.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.95
|
| Rate for Payer: Nomi Health Commercial |
$36.50
|
| Rate for Payer: PACE SWMI |
$30.42
|
| Rate for Payer: PHP Medicare Advantage |
$30.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$30.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.42
|
| Rate for Payer: UHC Medicare Advantage |
$30.42
|
|
|
CHG RADIOLOGIC EXAMINATION SKULL 4< VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 70250
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$60.14 |
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.56
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Healthscope Commercial |
$60.14
|
| Rate for Payer: Healthscope Commercial |
$60.14
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Healthscope Commercial |
$52.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Medicare |
$32.51
|
| Rate for Payer: Priority Health Medicare |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
|
|
CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 73590
|
| Min. Negotiated Rate |
$28.62 |
| Max. Negotiated Rate |
$54.60 |
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Healthscope Commercial |
$52.95
|
| Rate for Payer: Healthscope Commercial |
$52.95
|
| Rate for Payer: Healthscope Commercial |
$45.79
|
| Rate for Payer: Healthscope Commercial |
$45.79
|
| Rate for Payer: Healthscope Commercial |
$52.95
|
| Rate for Payer: Healthscope Commercial |
$45.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.05
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
|
|
CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 73564
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$78.90 |
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.15
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Complete |
$45.20
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Healthscope Commercial |
$78.90
|
| Rate for Payer: Healthscope Commercial |
$78.90
|
| Rate for Payer: Healthscope Commercial |
$68.24
|
| Rate for Payer: Healthscope Commercial |
$68.24
|
| Rate for Payer: Healthscope Commercial |
$78.90
|
| Rate for Payer: Healthscope Commercial |
$68.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.00
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health Medicare |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
|
|
CHG RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 72190
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$70.34 |
| Rate for Payer: Aetna Commercial |
$50.95
|
| Rate for Payer: Aetna Commercial |
$50.95
|
| Rate for Payer: Aetna Medicare |
$39.54
|
| Rate for Payer: Aetna Medicare |
$39.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.75
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Healthscope Commercial |
$70.34
|
| Rate for Payer: Healthscope Commercial |
$70.34
|
| Rate for Payer: Healthscope Commercial |
$60.83
|
| Rate for Payer: Healthscope Commercial |
$60.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.45
|
| Rate for Payer: Nomi Health Commercial |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$45.62
|
| Rate for Payer: PACE SWMI |
$38.02
|
| Rate for Payer: PACE SWMI |
$38.02
|
| Rate for Payer: PHP Medicare Advantage |
$38.02
|
| Rate for Payer: PHP Medicare Advantage |
$38.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$38.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$38.02
|
|
|
CHG RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 72202
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$65.86 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.26
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Healthscope Commercial |
$65.86
|
| Rate for Payer: Healthscope Commercial |
$65.86
|
| Rate for Payer: Healthscope Commercial |
$56.96
|
| Rate for Payer: Healthscope Commercial |
$56.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.00
|
| Rate for Payer: Nomi Health Commercial |
$42.72
|
| Rate for Payer: Nomi Health Commercial |
$42.72
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Medicare |
$35.60
|
| Rate for Payer: Priority Health Medicare |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
|
|
CHG RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 70260
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$74.85 |
| Rate for Payer: Aetna Commercial |
$54.22
|
| Rate for Payer: Aetna Medicare |
$42.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.22
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS MAPPO |
$40.46
|
| Rate for Payer: BCN Medicare Advantage |
$40.46
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$54.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.46
|
| Rate for Payer: Healthscope Commercial |
$74.85
|
| Rate for Payer: Healthscope Commercial |
$64.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.35
|
| Rate for Payer: Nomi Health Commercial |
$48.55
|
| Rate for Payer: PACE SWMI |
$40.46
|
| Rate for Payer: PHP Medicare Advantage |
$40.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health Medicare |
$40.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.46
|
| Rate for Payer: UHC Medicare Advantage |
$40.46
|
|
|
CHG RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 74250
|
| Min. Negotiated Rate |
$94.40 |
| Max. Negotiated Rate |
$201.35 |
| Rate for Payer: Aetna Commercial |
$145.85
|
| Rate for Payer: Aetna Medicare |
$113.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.85
|
| Rate for Payer: BCBS Complete |
$94.40
|
| Rate for Payer: BCBS MAPPO |
$108.84
|
| Rate for Payer: BCN Medicare Advantage |
$108.84
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$156.73
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.84
|
| Rate for Payer: Healthscope Commercial |
$174.14
|
| Rate for Payer: Healthscope Commercial |
$201.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.40
|
| Rate for Payer: Nomi Health Commercial |
$130.61
|
| Rate for Payer: PACE SWMI |
$108.84
|
| Rate for Payer: PHP Medicare Advantage |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health Medicare |
$108.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.84
|
| Rate for Payer: UHC Medicare Advantage |
$108.84
|
|
|
CHG RADN RX DELIVERY COMPLX 11-19 MEV
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 77414
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$308.75 |
| Rate for Payer: Aetna Medicare |
$237.50
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$308.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
|
|
CHG RADN RX DELIVERY COMPLX 6-10 MEV
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 77413
|
| Min. Negotiated Rate |
$168.80 |
| Max. Negotiated Rate |
$274.30 |
| Rate for Payer: Aetna Medicare |
$211.00
|
| Rate for Payer: BCBS Complete |
$168.80
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$274.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
|
|
CHG RADN RX DELIVERY SIMPLE 11-19 MEV
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 77404
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
|
|
CHG RADN RX DELIVERY SIMPLE 6-10 MEV
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 77403
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,1 CHANNEL
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 77785
|
| Min. Negotiated Rate |
$123.60 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna Medicare |
$228.00
|
| Rate for Payer: BCBS Complete |
$182.40
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.40
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,2-12 CHANNEL
|
Professional
|
Both
|
$682.00
|
|
|
Service Code
|
HCPCS 77786
|
| Min. Negotiated Rate |
$272.80 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Medicare |
$341.00
|
| Rate for Payer: Aetna Medicare |
$502.50
|
| Rate for Payer: BCBS Complete |
$402.00
|
| Rate for Payer: BCBS Complete |
$272.80
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$653.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$443.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.25
|
|
|
CHG REPAIR,ILIAC ANRYSM/PSEUDO/AV MALF/TRAUMA W/ ENDOPROSTHESIS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 75954
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$143.00 |
| Rate for Payer: Aetna Medicare |
$110.00
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 77293
|
| Min. Negotiated Rate |
$330.40 |
| Max. Negotiated Rate |
$670.75 |
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.10
|
| Rate for Payer: BCBS Complete |
$247.20
|
| Rate for Payer: BCBS Complete |
$330.40
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Healthscope Commercial |
$580.11
|
| Rate for Payer: Healthscope Commercial |
$580.11
|
| Rate for Payer: Healthscope Commercial |
$670.75
|
| Rate for Payer: Healthscope Commercial |
$670.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$536.90
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health Medicare |
$362.57
|
| Rate for Payer: Priority Health Medicare |
$362.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.57
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
|
|
CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 78803
|
| Min. Negotiated Rate |
$34.80 |
| Max. Negotiated Rate |
$559.85 |
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.51
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Complete |
$279.60
|
| Rate for Payer: BCBS Complete |
$244.80
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Healthscope Commercial |
$559.85
|
| Rate for Payer: Healthscope Commercial |
$559.85
|
| Rate for Payer: Healthscope Commercial |
$484.19
|
| Rate for Payer: Healthscope Commercial |
$484.19
|
| Rate for Payer: Healthscope Commercial |
$559.85
|
| Rate for Payer: Healthscope Commercial |
$484.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$397.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.35
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health Medicare |
$302.62
|
| Rate for Payer: Priority Health Medicare |
$302.62
|
| Rate for Payer: Priority Health Medicare |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
|
|
CHG RP THERAPY INTRAVENOUS ADMINISTRATION
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 79101
|
| Min. Negotiated Rate |
$134.80 |
| Max. Negotiated Rate |
$342.55 |
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.11
|
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: BCBS Complete |
$117.20
|
| Rate for Payer: BCBS MAPPO |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$134.80
|
| Rate for Payer: BCN Medicare Advantage |
$134.80
|
| Rate for Payer: BCN Medicare Advantage |
$134.80
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$180.63
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$180.63
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.80
|
| Rate for Payer: Healthscope Commercial |
$249.38
|
| Rate for Payer: Healthscope Commercial |
$249.38
|
| Rate for Payer: Healthscope Commercial |
$215.68
|
| Rate for Payer: Healthscope Commercial |
$215.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.45
|
| Rate for Payer: Nomi Health Commercial |
$161.76
|
| Rate for Payer: Nomi Health Commercial |
$161.76
|
| Rate for Payer: PACE SWMI |
$134.80
|
| Rate for Payer: PACE SWMI |
$134.80
|
| Rate for Payer: PHP Medicare Advantage |
$134.80
|
| Rate for Payer: PHP Medicare Advantage |
$134.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health Medicare |
$134.80
|
| Rate for Payer: Priority Health Medicare |
$134.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.80
|
|
|
CHG RP THERAPY ORAL ADMINISTRATION
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 79005
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$231.23 |
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.99
|
| Rate for Payer: BCBS Complete |
$104.00
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Healthscope Commercial |
$231.23
|
| Rate for Payer: Healthscope Commercial |
$231.23
|
| Rate for Payer: Healthscope Commercial |
$199.98
|
| Rate for Payer: Healthscope Commercial |
$199.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.75
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.99
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
|
|
CHG SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 76831
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$190.90 |
| Rate for Payer: Aetna Commercial |
$138.27
|
| Rate for Payer: Aetna Medicare |
$107.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.27
|
| Rate for Payer: BCBS Complete |
$96.00
|
| Rate for Payer: BCBS MAPPO |
$103.19
|
| Rate for Payer: BCN Medicare Advantage |
$103.19
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$148.59
|
| Rate for Payer: Cofinity Commercial |
$138.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.19
|
| Rate for Payer: Healthscope Commercial |
$190.90
|
| Rate for Payer: Healthscope Commercial |
$165.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.00
|
| Rate for Payer: Nomi Health Commercial |
$123.83
|
| Rate for Payer: PACE SWMI |
$103.19
|
| Rate for Payer: PHP Medicare Advantage |
$103.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health Medicare |
$103.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.19
|
| Rate for Payer: UHC Medicare Advantage |
$103.19
|
|
