|
CHG TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 77306
|
| Min. Negotiated Rate |
$137.23 |
| Max. Negotiated Rate |
$257.40 |
| Rate for Payer: Aetna Commercial |
$183.89
|
| Rate for Payer: Aetna Commercial |
$183.89
|
| Rate for Payer: Aetna Medicare |
$142.72
|
| Rate for Payer: Aetna Medicare |
$142.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.61
|
| Rate for Payer: BCBS Complete |
$158.40
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: BCBS MAPPO |
$137.23
|
| Rate for Payer: BCBS MAPPO |
$137.23
|
| Rate for Payer: BCN Medicare Advantage |
$137.23
|
| Rate for Payer: BCN Medicare Advantage |
$137.23
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cofinity Commercial |
$183.89
|
| Rate for Payer: Cofinity Commercial |
$197.61
|
| Rate for Payer: Cofinity Commercial |
$183.89
|
| Rate for Payer: Cofinity Commercial |
$197.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.23
|
| Rate for Payer: Healthscope Commercial |
$253.88
|
| Rate for Payer: Healthscope Commercial |
$253.88
|
| Rate for Payer: Healthscope Commercial |
$219.57
|
| Rate for Payer: Healthscope Commercial |
$219.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.45
|
| Rate for Payer: Nomi Health Commercial |
$164.68
|
| Rate for Payer: Nomi Health Commercial |
$164.68
|
| Rate for Payer: PACE SWMI |
$137.23
|
| Rate for Payer: PACE SWMI |
$137.23
|
| Rate for Payer: PHP Medicare Advantage |
$137.23
|
| Rate for Payer: PHP Medicare Advantage |
$137.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.40
|
| Rate for Payer: Priority Health Medicare |
$137.23
|
| Rate for Payer: Priority Health Medicare |
$137.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.23
|
| Rate for Payer: UHC Medicare Advantage |
$137.23
|
| Rate for Payer: UHC Medicare Advantage |
$137.23
|
|
|
CHG THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 74283
|
| Min. Negotiated Rate |
$110.80 |
| Max. Negotiated Rate |
$437.15 |
| Rate for Payer: Aetna Commercial |
$316.64
|
| Rate for Payer: Aetna Medicare |
$245.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.64
|
| Rate for Payer: BCBS Complete |
$110.80
|
| Rate for Payer: BCBS MAPPO |
$236.30
|
| Rate for Payer: BCN Medicare Advantage |
$236.30
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$340.27
|
| Rate for Payer: Cofinity Commercial |
$316.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.30
|
| Rate for Payer: Healthscope Commercial |
$437.15
|
| Rate for Payer: Healthscope Commercial |
$378.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.05
|
| Rate for Payer: Nomi Health Commercial |
$283.56
|
| Rate for Payer: PACE SWMI |
$236.30
|
| Rate for Payer: PHP Medicare Advantage |
$236.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.05
|
| Rate for Payer: Priority Health Medicare |
$236.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.30
|
| Rate for Payer: UHC Medicare Advantage |
$236.30
|
|
|
CHG THERAPEUTIC RADIOLOGY PORT IMAGE(S)
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 77417
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$27.03 |
| Rate for Payer: Aetna Commercial |
$19.58
|
| Rate for Payer: Aetna Medicare |
$15.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.58
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$14.61
|
| Rate for Payer: BCN Medicare Advantage |
$14.61
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$21.04
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.61
|
| Rate for Payer: Healthscope Commercial |
$23.38
|
| Rate for Payer: Healthscope Commercial |
$27.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.10
|
| Rate for Payer: Nomi Health Commercial |
$17.53
|
| Rate for Payer: PACE SWMI |
$14.61
|
| Rate for Payer: PHP Medicare Advantage |
$14.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$14.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.61
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 77263
|
| Min. Negotiated Rate |
$120.80 |
| Max. Negotiated Rate |
$298.52 |
| Rate for Payer: Aetna Commercial |
$216.22
|
| Rate for Payer: Aetna Medicare |
$167.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.22
|
| Rate for Payer: BCBS Complete |
$120.80
|
| Rate for Payer: BCBS MAPPO |
$161.36
|
| Rate for Payer: BCN Medicare Advantage |
$161.36
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Cofinity Commercial |
$216.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.36
|
| Rate for Payer: Healthscope Commercial |
$298.52
|
| Rate for Payer: Healthscope Commercial |
$258.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.30
|
| Rate for Payer: Nomi Health Commercial |
$193.63
|
| Rate for Payer: PACE SWMI |
$161.36
|
| Rate for Payer: PHP Medicare Advantage |
$161.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.30
|
| Rate for Payer: Priority Health Medicare |
$161.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.36
|
| Rate for Payer: UHC Medicare Advantage |
$161.36
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 77262
|
| Min. Negotiated Rate |
$80.80 |
| Max. Negotiated Rate |
$191.49 |
| Rate for Payer: Aetna Commercial |
$138.70
|
| Rate for Payer: Aetna Medicare |
$107.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.70
|
| Rate for Payer: BCBS Complete |
$80.80
|
| Rate for Payer: BCBS MAPPO |
$103.51
|
| Rate for Payer: BCN Medicare Advantage |
$103.51
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$149.05
|
| Rate for Payer: Cofinity Commercial |
$138.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.51
|
| Rate for Payer: Healthscope Commercial |
$165.62
|
| Rate for Payer: Healthscope Commercial |
$191.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.30
|
| Rate for Payer: Nomi Health Commercial |
$124.21
|
| Rate for Payer: PACE SWMI |
$103.51
|
| Rate for Payer: PHP Medicare Advantage |
$103.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health Medicare |
$103.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.51
|
| Rate for Payer: UHC Medicare Advantage |
$103.51
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 77261
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$123.43 |
| Rate for Payer: Aetna Commercial |
$89.40
|
| Rate for Payer: Aetna Medicare |
$69.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.40
|
| Rate for Payer: BCBS Complete |
$54.00
|
| Rate for Payer: BCBS MAPPO |
$66.72
|
| Rate for Payer: BCN Medicare Advantage |
$66.72
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Cofinity Commercial |
$89.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.72
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Healthscope Commercial |
$123.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.75
|
| Rate for Payer: Nomi Health Commercial |
$80.06
|
| Rate for Payer: PACE SWMI |
$66.72
|
| Rate for Payer: PHP Medicare Advantage |
$66.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.75
|
| Rate for Payer: Priority Health Medicare |
$66.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.72
|
| Rate for Payer: UHC Medicare Advantage |
$66.72
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX
|
Professional
|
Both
|
$964.00
|
|
|
Service Code
|
HCPCS 77290
|
| Min. Negotiated Rate |
$385.60 |
| Max. Negotiated Rate |
$730.42 |
| Rate for Payer: Aetna Commercial |
$529.06
|
| Rate for Payer: Aetna Commercial |
$529.06
|
| Rate for Payer: Aetna Medicare |
$410.61
|
| Rate for Payer: Aetna Medicare |
$410.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.06
|
| Rate for Payer: BCBS Complete |
$321.20
|
| Rate for Payer: BCBS Complete |
$385.60
|
| Rate for Payer: BCBS MAPPO |
$394.82
|
| Rate for Payer: BCBS MAPPO |
$394.82
|
| Rate for Payer: BCN Medicare Advantage |
$394.82
|
| Rate for Payer: BCN Medicare Advantage |
$394.82
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cofinity Commercial |
$529.06
|
| Rate for Payer: Cofinity Commercial |
$529.06
|
| Rate for Payer: Cofinity Commercial |
$568.54
|
| Rate for Payer: Cofinity Commercial |
$568.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.82
|
| Rate for Payer: Healthscope Commercial |
$730.42
|
| Rate for Payer: Healthscope Commercial |
$730.42
|
| Rate for Payer: Healthscope Commercial |
$631.71
|
| Rate for Payer: Healthscope Commercial |
$631.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$626.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$521.95
|
| Rate for Payer: Nomi Health Commercial |
$473.78
|
| Rate for Payer: Nomi Health Commercial |
$473.78
|
| Rate for Payer: PACE SWMI |
$394.82
|
| Rate for Payer: PACE SWMI |
$394.82
|
| Rate for Payer: PHP Medicare Advantage |
$394.82
|
| Rate for Payer: PHP Medicare Advantage |
$394.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$626.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Medicare |
$394.82
|
| Rate for Payer: Priority Health Medicare |
$394.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.82
|
| Rate for Payer: UHC Medicare Advantage |
$394.82
|
| Rate for Payer: UHC Medicare Advantage |
$394.82
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 77285
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$733.77 |
| Rate for Payer: Aetna Commercial |
$531.48
|
| Rate for Payer: Aetna Medicare |
$412.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.48
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS MAPPO |
$396.63
|
| Rate for Payer: BCN Medicare Advantage |
$396.63
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$571.15
|
| Rate for Payer: Cofinity Commercial |
$531.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.63
|
| Rate for Payer: Healthscope Commercial |
$634.61
|
| Rate for Payer: Healthscope Commercial |
$733.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.10
|
| Rate for Payer: Nomi Health Commercial |
$475.96
|
| Rate for Payer: PACE SWMI |
$396.63
|
| Rate for Payer: PHP Medicare Advantage |
$396.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health Medicare |
$396.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.63
|
| Rate for Payer: UHC Medicare Advantage |
$396.63
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 77280
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$442.82 |
| Rate for Payer: Aetna Commercial |
$320.74
|
| Rate for Payer: Aetna Commercial |
$320.74
|
| Rate for Payer: Aetna Medicare |
$248.93
|
| Rate for Payer: Aetna Medicare |
$248.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: BCBS Complete |
$177.60
|
| Rate for Payer: BCBS Complete |
$206.00
|
| Rate for Payer: BCBS MAPPO |
$239.36
|
| Rate for Payer: BCBS MAPPO |
$239.36
|
| Rate for Payer: BCN Medicare Advantage |
$239.36
|
| Rate for Payer: BCN Medicare Advantage |
$239.36
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cofinity Commercial |
$320.74
|
| Rate for Payer: Cofinity Commercial |
$320.74
|
| Rate for Payer: Cofinity Commercial |
$344.68
|
| Rate for Payer: Cofinity Commercial |
$344.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.36
|
| Rate for Payer: Healthscope Commercial |
$442.82
|
| Rate for Payer: Healthscope Commercial |
$442.82
|
| Rate for Payer: Healthscope Commercial |
$382.98
|
| Rate for Payer: Healthscope Commercial |
$382.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$334.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.60
|
| Rate for Payer: Nomi Health Commercial |
$287.23
|
| Rate for Payer: Nomi Health Commercial |
$287.23
|
| Rate for Payer: PACE SWMI |
$239.36
|
| Rate for Payer: PACE SWMI |
$239.36
|
| Rate for Payer: PHP Medicare Advantage |
$239.36
|
| Rate for Payer: PHP Medicare Advantage |
$239.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$334.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Medicare |
$239.36
|
| Rate for Payer: Priority Health Medicare |
$239.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.36
|
| Rate for Payer: UHC Medicare Advantage |
$239.36
|
| Rate for Payer: UHC Medicare Advantage |
$239.36
|
|
|
CHG TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 88233
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$260.35 |
| Rate for Payer: Aetna Commercial |
$188.58
|
| Rate for Payer: Aetna Medicare |
$146.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.58
|
| Rate for Payer: BCBS Complete |
$119.60
|
| Rate for Payer: BCBS MAPPO |
$140.73
|
| Rate for Payer: BCN Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$202.65
|
| Rate for Payer: Cofinity Commercial |
$188.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.73
|
| Rate for Payer: Healthscope Commercial |
$260.35
|
| Rate for Payer: Healthscope Commercial |
$225.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.35
|
| Rate for Payer: Nomi Health Commercial |
$168.88
|
| Rate for Payer: PACE SWMI |
$140.73
|
| Rate for Payer: PHP Medicare Advantage |
$140.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health Medicare |
$140.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.73
|
| Rate for Payer: UHC Medicare Advantage |
$140.73
|
|
|
CHG TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 87220
|
| Min. Negotiated Rate |
$4.27 |
| Max. Negotiated Rate |
$14.30 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.72
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$6.15
|
| Rate for Payer: Cofinity Commercial |
$5.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$6.83
|
| Rate for Payer: Healthscope Commercial |
$7.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.30
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
|
|
CHG TRANSCATHETER EMBOLIZATION ANY METH RS&I
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 75894
|
| Min. Negotiated Rate |
$143.60 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: BCBS Complete |
$143.60
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
|
|
CHG TRANSCATHETER INFUSION OTHER THAN THROMBOLYSIS
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 75896
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$184.60 |
| Rate for Payer: Aetna Medicare |
$142.00
|
| Rate for Payer: BCBS Complete |
$113.60
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.60
|
|
|
CHG TRANSFERASE ALANINE AMINO ALT SGPT
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 84460
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: Aetna Medicare |
$5.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.10
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.10
|
| Rate for Payer: Cofinity Commercial |
$7.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$9.80
|
| Rate for Payer: Healthscope Commercial |
$8.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Nomi Health Commercial |
$6.36
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.30
|
|
|
CHG TRANSFERASE ASPARTATE AMINO AST SGOT
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 84450
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$9.58 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.94
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$8.29
|
| Rate for Payer: Healthscope Commercial |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.10
|
| Rate for Payer: Nomi Health Commercial |
$6.22
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 77334
|
| Min. Negotiated Rate |
$115.71 |
| Max. Negotiated Rate |
$214.06 |
| Rate for Payer: Aetna Commercial |
$155.05
|
| Rate for Payer: Aetna Commercial |
$155.05
|
| Rate for Payer: Aetna Medicare |
$120.34
|
| Rate for Payer: Aetna Medicare |
$120.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.05
|
| Rate for Payer: BCBS Complete |
$73.20
|
| Rate for Payer: BCBS Complete |
$116.40
|
| Rate for Payer: BCBS MAPPO |
$115.71
|
| Rate for Payer: BCBS MAPPO |
$115.71
|
| Rate for Payer: BCN Medicare Advantage |
$115.71
|
| Rate for Payer: BCN Medicare Advantage |
$115.71
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$155.05
|
| Rate for Payer: Cofinity Commercial |
$155.05
|
| Rate for Payer: Cofinity Commercial |
$166.62
|
| Rate for Payer: Cofinity Commercial |
$166.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.71
|
| Rate for Payer: Healthscope Commercial |
$214.06
|
| Rate for Payer: Healthscope Commercial |
$214.06
|
| Rate for Payer: Healthscope Commercial |
$185.14
|
| Rate for Payer: Healthscope Commercial |
$185.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.95
|
| Rate for Payer: Nomi Health Commercial |
$138.85
|
| Rate for Payer: Nomi Health Commercial |
$138.85
|
| Rate for Payer: PACE SWMI |
$115.71
|
| Rate for Payer: PACE SWMI |
$115.71
|
| Rate for Payer: PHP Medicare Advantage |
$115.71
|
| Rate for Payer: PHP Medicare Advantage |
$115.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.95
|
| Rate for Payer: Priority Health Medicare |
$115.71
|
| Rate for Payer: Priority Health Medicare |
$115.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.71
|
| Rate for Payer: UHC Medicare Advantage |
$115.71
|
| Rate for Payer: UHC Medicare Advantage |
$115.71
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 77333
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$228.68 |
| Rate for Payer: Aetna Commercial |
$165.64
|
| Rate for Payer: Aetna Commercial |
$165.64
|
| Rate for Payer: Aetna Medicare |
$128.55
|
| Rate for Payer: Aetna Medicare |
$128.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.00
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS Complete |
$64.40
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCN Medicare Advantage |
$123.61
|
| Rate for Payer: BCN Medicare Advantage |
$123.61
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cofinity Commercial |
$165.64
|
| Rate for Payer: Cofinity Commercial |
$178.00
|
| Rate for Payer: Cofinity Commercial |
$165.64
|
| Rate for Payer: Cofinity Commercial |
$178.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.61
|
| Rate for Payer: Healthscope Commercial |
$228.68
|
| Rate for Payer: Healthscope Commercial |
$228.68
|
| Rate for Payer: Healthscope Commercial |
$197.78
|
| Rate for Payer: Healthscope Commercial |
$197.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.65
|
| Rate for Payer: Nomi Health Commercial |
$148.33
|
| Rate for Payer: Nomi Health Commercial |
$148.33
|
| Rate for Payer: PACE SWMI |
$123.61
|
| Rate for Payer: PACE SWMI |
$123.61
|
| Rate for Payer: PHP Medicare Advantage |
$123.61
|
| Rate for Payer: PHP Medicare Advantage |
$123.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Medicare |
$123.61
|
| Rate for Payer: Priority Health Medicare |
$123.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.61
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 77332
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$69.91 |
| Rate for Payer: Aetna Commercial |
$50.64
|
| Rate for Payer: Aetna Commercial |
$50.64
|
| Rate for Payer: Aetna Medicare |
$39.30
|
| Rate for Payer: Aetna Medicare |
$39.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.42
|
| Rate for Payer: BCBS Complete |
$39.60
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: BCBS MAPPO |
$37.79
|
| Rate for Payer: BCBS MAPPO |
$37.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.79
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$50.64
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Cofinity Commercial |
$50.64
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$60.46
|
| Rate for Payer: Healthscope Commercial |
$60.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.75
|
| Rate for Payer: Nomi Health Commercial |
$45.35
|
| Rate for Payer: Nomi Health Commercial |
$45.35
|
| Rate for Payer: PACE SWMI |
$37.79
|
| Rate for Payer: PACE SWMI |
$37.79
|
| Rate for Payer: PHP Medicare Advantage |
$37.79
|
| Rate for Payer: PHP Medicare Advantage |
$37.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.79
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
|
|
CHG ULTRASONIC GUIDANCE INTRAOPERATIVE
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 76998
|
| Min. Negotiated Rate |
$118.00 |
| Max. Negotiated Rate |
$191.75 |
| Rate for Payer: Aetna Medicare |
$147.50
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
|
|
CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 76981
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$176.73 |
| Rate for Payer: Aetna Commercial |
$128.01
|
| Rate for Payer: Aetna Medicare |
$99.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.56
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS MAPPO |
$95.53
|
| Rate for Payer: BCN Medicare Advantage |
$95.53
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$137.56
|
| Rate for Payer: Cofinity Commercial |
$128.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.53
|
| Rate for Payer: Healthscope Commercial |
$176.73
|
| Rate for Payer: Healthscope Commercial |
$152.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.35
|
| Rate for Payer: Nomi Health Commercial |
$114.64
|
| Rate for Payer: PACE SWMI |
$95.53
|
| Rate for Payer: PHP Medicare Advantage |
$95.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health Medicare |
$95.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.53
|
| Rate for Payer: UHC Medicare Advantage |
$95.53
|
|
|
CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 76800
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$304.94 |
| Rate for Payer: Aetna Commercial |
$220.87
|
| Rate for Payer: Aetna Medicare |
$171.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.36
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$164.83
|
| Rate for Payer: BCN Medicare Advantage |
$164.83
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$220.87
|
| Rate for Payer: Cofinity Commercial |
$237.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.83
|
| Rate for Payer: Healthscope Commercial |
$263.73
|
| Rate for Payer: Healthscope Commercial |
$304.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.15
|
| Rate for Payer: Nomi Health Commercial |
$197.80
|
| Rate for Payer: PACE SWMI |
$164.83
|
| Rate for Payer: PHP Medicare Advantage |
$164.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$164.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.83
|
| Rate for Payer: UHC Medicare Advantage |
$164.83
|
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 76496
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
|
|
CHG URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 78740
|
| Min. Negotiated Rate |
$186.91 |
| Max. Negotiated Rate |
$345.78 |
| Rate for Payer: Aetna Commercial |
$250.46
|
| Rate for Payer: Aetna Medicare |
$194.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.46
|
| Rate for Payer: BCBS Complete |
$194.00
|
| Rate for Payer: BCBS MAPPO |
$186.91
|
| Rate for Payer: BCN Medicare Advantage |
$186.91
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$250.46
|
| Rate for Payer: Cofinity Commercial |
$269.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.91
|
| Rate for Payer: Healthscope Commercial |
$345.78
|
| Rate for Payer: Healthscope Commercial |
$299.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.25
|
| Rate for Payer: Nomi Health Commercial |
$224.29
|
| Rate for Payer: PACE SWMI |
$186.91
|
| Rate for Payer: PHP Medicare Advantage |
$186.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health Medicare |
$186.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.91
|
| Rate for Payer: UHC Medicare Advantage |
$186.91
|
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 74450
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$72.80 |
| Rate for Payer: Aetna Medicare |
$56.00
|
| Rate for Payer: BCBS Complete |
$44.80
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 74455
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$167.79 |
| Rate for Payer: Aetna Commercial |
$121.54
|
| Rate for Payer: Aetna Medicare |
$94.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.54
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$90.70
|
| Rate for Payer: BCN Medicare Advantage |
$90.70
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$130.61
|
| Rate for Payer: Cofinity Commercial |
$121.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.70
|
| Rate for Payer: Healthscope Commercial |
$167.79
|
| Rate for Payer: Healthscope Commercial |
$145.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.45
|
| Rate for Payer: Nomi Health Commercial |
$108.84
|
| Rate for Payer: PACE SWMI |
$90.70
|
| Rate for Payer: PHP Medicare Advantage |
$90.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$90.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.70
|
| Rate for Payer: UHC Medicare Advantage |
$90.70
|
|
