|
CHG THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 77262
|
| Min. Negotiated Rate |
$69.86 |
| Max. Negotiated Rate |
$19,064.00 |
| Rate for Payer: Aetna Commercial |
$138.70
|
| Rate for Payer: Aetna Medicare |
$107.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.05
|
| Rate for Payer: BCBS Complete |
$73.35
|
| Rate for Payer: BCBS MAPPO |
$103.51
|
| Rate for Payer: BCBS Trust/PPO |
$381.96
|
| Rate for Payer: BCN Commercial |
$156.86
|
| 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 |
$191.49
|
| Rate for Payer: Healthscope Commercial |
$165.62
|
| Rate for Payer: Mclaren Medicaid |
$69.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.69
|
| Rate for Payer: Meridian Medicaid |
$73.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,064.00
|
| 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 Choice Medicaid |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.79
|
| Rate for Payer: Priority Health Medicare |
$103.51
|
| Rate for Payer: Priority Health Narrow Network |
$165.79
|
| Rate for Payer: Priority Health SBD |
$165.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.51
|
| Rate for Payer: UHC Exchange |
$165.29
|
| Rate for Payer: UHC Medicare Advantage |
$103.51
|
| Rate for Payer: UHCCP Medicaid |
$69.86
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 77261
|
| Min. Negotiated Rate |
$45.16 |
| Max. Negotiated Rate |
$12,456.00 |
| Rate for Payer: Aetna Commercial |
$89.40
|
| Rate for Payer: Aetna Medicare |
$69.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.08
|
| Rate for Payer: BCBS Complete |
$47.42
|
| Rate for Payer: BCBS MAPPO |
$66.72
|
| Rate for Payer: BCBS Trust/PPO |
$984.75
|
| Rate for Payer: BCN Commercial |
$102.62
|
| 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 |
$123.43
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Mclaren Medicaid |
$45.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.06
|
| Rate for Payer: Meridian Medicaid |
$47.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,456.00
|
| 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 Choice Medicaid |
$45.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.30
|
| Rate for Payer: Priority Health Medicare |
$66.72
|
| Rate for Payer: Priority Health Narrow Network |
$108.30
|
| Rate for Payer: Priority Health SBD |
$237.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.72
|
| Rate for Payer: UHC Exchange |
$109.62
|
| Rate for Payer: UHC Medicare Advantage |
$66.72
|
| Rate for Payer: UHCCP Medicaid |
$45.16
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX
|
Professional
|
Both
|
$964.00
|
|
|
Service Code
|
HCPCS 77290
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$76,176.00 |
| 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 |
$55.46
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS MAPPO |
$394.82
|
| Rate for Payer: BCBS MAPPO |
$394.82
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCN Commercial |
$661.67
|
| Rate for Payer: BCN Commercial |
$661.67
|
| 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 |
$568.54
|
| Rate for Payer: Cofinity Commercial |
$529.06
|
| Rate for Payer: Cofinity Commercial |
$529.06
|
| 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 |
$631.71
|
| Rate for Payer: Healthscope Commercial |
$730.42
|
| Rate for Payer: Healthscope Commercial |
$631.71
|
| Rate for Payer: Healthscope Commercial |
$730.42
|
| Rate for Payer: Mclaren Medicaid |
$52.82
|
| Rate for Payer: Mclaren Medicaid |
$52.82
|
| 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: Meridian Medicaid |
$55.46
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,176.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76,176.00
|
| 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 Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| 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 HMO/PPO/Tiered Network |
$689.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.31
|
| Rate for Payer: Priority Health Medicare |
$394.82
|
| Rate for Payer: Priority Health Medicare |
$394.82
|
| Rate for Payer: Priority Health Narrow Network |
$689.31
|
| Rate for Payer: Priority Health Narrow Network |
$689.31
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$399.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.82
|
| Rate for Payer: UHC Exchange |
$399.15
|
| Rate for Payer: UHC Exchange |
$399.15
|
| Rate for Payer: UHC Medicare Advantage |
$394.82
|
| Rate for Payer: UHC Medicare Advantage |
$394.82
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 77285
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$74,036.00 |
| Rate for Payer: Aetna Commercial |
$531.48
|
| Rate for Payer: Aetna Medicare |
$412.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.15
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$396.63
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$645.54
|
| 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 |
$733.77
|
| Rate for Payer: Healthscope Commercial |
$634.61
|
| Rate for Payer: Mclaren Medicaid |
$36.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.46
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,036.00
|
| 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 Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.04
|
| Rate for Payer: Priority Health Medicare |
$396.63
|
| Rate for Payer: Priority Health Narrow Network |
$679.04
|
| Rate for Payer: Priority Health SBD |
$86.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.63
|
| Rate for Payer: UHC Exchange |
$297.68
|
| Rate for Payer: UHC Medicare Advantage |
$396.63
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE
|
Professional
|
Both
|
$515.00
|
|
|
Service Code
|
HCPCS 77280
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$45,274.00 |
| 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 |
$25.27
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$239.36
|
| Rate for Payer: BCBS MAPPO |
$239.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.32
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Commercial |
$394.36
|
| 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 |
$344.68
|
| Rate for Payer: Cofinity Commercial |
$320.74
|
| Rate for Payer: Cofinity Commercial |
$320.74
|
| 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 |
$382.98
|
| Rate for Payer: Healthscope Commercial |
$442.82
|
| Rate for Payer: Healthscope Commercial |
$382.98
|
| Rate for Payer: Healthscope Commercial |
$442.82
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$24.07
|
| 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: Meridian Medicaid |
$25.27
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,274.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45,274.00
|
| 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 Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| 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 HMO/PPO/Tiered Network |
$414.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.71
|
| Rate for Payer: Priority Health Medicare |
$239.36
|
| Rate for Payer: Priority Health Medicare |
$239.36
|
| Rate for Payer: Priority Health Narrow Network |
$414.71
|
| Rate for Payer: Priority Health Narrow Network |
$414.71
|
| Rate for Payer: Priority Health SBD |
$57.48
|
| Rate for Payer: Priority Health SBD |
$57.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.36
|
| Rate for Payer: UHC Exchange |
$187.91
|
| Rate for Payer: UHC Exchange |
$187.91
|
| Rate for Payer: UHC Medicare Advantage |
$239.36
|
| Rate for Payer: UHC Medicare Advantage |
$239.36
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
|
|
CHG TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 88233
|
| Min. Negotiated Rate |
$105.55 |
| Max. Negotiated Rate |
$21,110.00 |
| Rate for Payer: Aetna Commercial |
$188.58
|
| Rate for Payer: Aetna Medicare |
$146.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.65
|
| Rate for Payer: BCBS Complete |
$119.60
|
| Rate for Payer: BCBS MAPPO |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: BCN Commercial |
$105.55
|
| 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 |
$225.17
|
| Rate for Payer: Healthscope Commercial |
$260.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,110.00
|
| 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 HMO/PPO/Tiered Network |
$218.18
|
| Rate for Payer: Priority Health Medicare |
$140.73
|
| Rate for Payer: Priority Health Narrow Network |
$218.18
|
| Rate for Payer: Priority Health SBD |
$218.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.73
|
| Rate for Payer: UHC Exchange |
$163.28
|
| 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 |
$3.20 |
| Max. Negotiated Rate |
$4,124.97 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.15
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4,124.97
|
| Rate for Payer: BCN Commercial |
$3.20
|
| 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 |
$641.00
|
| 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 HMO/PPO/Tiered Network |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: Priority Health SBD |
$4.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$8.63
|
| 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 |
$45.58 |
| Max. Negotiated Rate |
$169,142.00 |
| Rate for Payer: Aetna Commercial |
$1,126.65
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.65
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$393.58
|
| Rate for Payer: BCN Commercial |
$1,451.37
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Mclaren Medicaid |
$45.58
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169,142.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,546.97
|
| Rate for Payer: Priority Health Narrow Network |
$1,546.97
|
| Rate for Payer: Priority Health SBD |
$108.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,080.86
|
| Rate for Payer: UHC Exchange |
$1,080.86
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
|
|
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 |
$1.08 |
| Max. Negotiated Rate |
$1,976.37 |
| 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: BCBS Trust/PPO |
$1,976.37
|
| Rate for Payer: BCN Commercial |
$1.08
|
| 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 |
$7.63
|
| Rate for Payer: Cofinity Commercial |
$7.10
|
| 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 |
$5.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$795.00
|
| 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 HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: Priority Health SBD |
$5.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Exchange |
$7.72
|
| 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 |
$1.08 |
| Max. Negotiated Rate |
$2,972.74 |
| 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: BCBS Trust/PPO |
$2,972.74
|
| Rate for Payer: BCN Commercial |
$1.08
|
| 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 |
$9.58
|
| Rate for Payer: Healthscope Commercial |
$8.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$777.00
|
| 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 HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: Priority Health SBD |
$5.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.65
|
| 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 |
$38.77 |
| Max. Negotiated Rate |
$21,402.00 |
| 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) |
$155.05
|
| 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) |
$166.62
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS MAPPO |
$115.71
|
| Rate for Payer: BCBS MAPPO |
$115.71
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCN Commercial |
$217.82
|
| Rate for Payer: BCN Commercial |
$217.82
|
| 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 |
$166.62
|
| Rate for Payer: Cofinity Commercial |
$155.05
|
| 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 |
$185.14
|
| Rate for Payer: Healthscope Commercial |
$185.14
|
| Rate for Payer: Healthscope Commercial |
$214.06
|
| Rate for Payer: Mclaren Medicaid |
$38.77
|
| Rate for Payer: Mclaren Medicaid |
$38.77
|
| 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: Meridian Medicaid |
$40.71
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,402.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,402.00
|
| 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 Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| 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 HMO/PPO/Tiered Network |
$193.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.49
|
| Rate for Payer: Priority Health Medicare |
$115.71
|
| Rate for Payer: Priority Health Medicare |
$115.71
|
| Rate for Payer: Priority Health Narrow Network |
$193.49
|
| Rate for Payer: Priority Health Narrow Network |
$193.49
|
| Rate for Payer: Priority Health SBD |
$92.39
|
| Rate for Payer: Priority Health SBD |
$92.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.71
|
| Rate for Payer: UHC Exchange |
$273.60
|
| Rate for Payer: UHC Exchange |
$273.60
|
| Rate for Payer: UHC Medicare Advantage |
$115.71
|
| Rate for Payer: UHC Medicare Advantage |
$115.71
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 77333
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$23,351.00 |
| 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) |
$178.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.64
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCN Commercial |
$75.81
|
| Rate for Payer: BCN Commercial |
$75.81
|
| 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 |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$178.00
|
| Rate for Payer: Cofinity Commercial |
$165.64
|
| 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 |
$197.78
|
| Rate for Payer: Healthscope Commercial |
$228.68
|
| Rate for Payer: Healthscope Commercial |
$197.78
|
| Rate for Payer: Healthscope Commercial |
$228.68
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| 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: Meridian Medicaid |
$26.84
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,351.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,351.00
|
| 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 Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.95
|
| Rate for Payer: Priority Health Medicare |
$123.61
|
| Rate for Payer: Priority Health Medicare |
$123.61
|
| Rate for Payer: Priority Health Narrow Network |
$210.95
|
| Rate for Payer: Priority Health Narrow Network |
$210.95
|
| Rate for Payer: Priority Health SBD |
$60.06
|
| Rate for Payer: Priority Health SBD |
$60.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.61
|
| Rate for Payer: UHC Exchange |
$130.57
|
| Rate for Payer: UHC Exchange |
$130.57
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 77332
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$6,610.00 |
| 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) |
$54.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.64
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS MAPPO |
$37.79
|
| Rate for Payer: BCBS MAPPO |
$37.79
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCN Commercial |
$118.27
|
| Rate for Payer: BCN Commercial |
$118.27
|
| 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 |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Cofinity Commercial |
$50.64
|
| 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 |
$60.46
|
| Rate for Payer: Healthscope Commercial |
$69.91
|
| Rate for Payer: Healthscope Commercial |
$60.46
|
| Rate for Payer: Healthscope Commercial |
$69.91
|
| Rate for Payer: Mclaren Medicaid |
$15.34
|
| Rate for Payer: Mclaren Medicaid |
$15.34
|
| 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: Meridian Medicaid |
$16.11
|
| Rate for Payer: Meridian Medicaid |
$16.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,610.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,610.00
|
| 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 Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health SBD |
$36.44
|
| Rate for Payer: Priority Health SBD |
$36.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.79
|
| Rate for Payer: UHC Exchange |
$88.01
|
| Rate for Payer: UHC Exchange |
$88.01
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: UHCCP Medicaid |
$15.34
|
| Rate for Payer: UHCCP Medicaid |
$15.34
|
|
|
CHG ULTRASONIC GUIDANCE INTRAOPERATIVE
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 76998
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$10,910.00 |
| Rate for Payer: Aetna Commercial |
$74.11
|
| Rate for Payer: Aetna Medicare |
$147.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.11
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$125.74
|
| Rate for Payer: BCN Commercial |
$266.33
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Mclaren Medicaid |
$29.61
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,910.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.83
|
| Rate for Payer: Priority Health Narrow Network |
$70.83
|
| Rate for Payer: Priority Health SBD |
$70.83
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
|
|
CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 76981
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$17,764.00 |
| 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 |
$19.02
|
| Rate for Payer: BCBS MAPPO |
$95.53
|
| Rate for Payer: BCN Commercial |
$152.96
|
| 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: Mclaren Medicaid |
$18.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.31
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,764.00
|
| 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 Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.65
|
| Rate for Payer: Priority Health Medicare |
$95.53
|
| Rate for Payer: Priority Health Narrow Network |
$160.65
|
| Rate for Payer: Priority Health SBD |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.53
|
| Rate for Payer: UHC Medicare Advantage |
$95.53
|
| Rate for Payer: UHCCP Medicaid |
$18.11
|
|
|
CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 76800
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$26,923.00 |
| 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 |
$42.04
|
| Rate for Payer: BCBS MAPPO |
$164.83
|
| Rate for Payer: BCBS Trust/PPO |
$337.06
|
| Rate for Payer: BCN Commercial |
$229.68
|
| 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 |
$237.36
|
| Rate for Payer: Cofinity Commercial |
$220.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.83
|
| Rate for Payer: Healthscope Commercial |
$304.94
|
| Rate for Payer: Healthscope Commercial |
$263.73
|
| Rate for Payer: Mclaren Medicaid |
$40.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.07
|
| Rate for Payer: Meridian Medicaid |
$42.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26,923.00
|
| 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 Choice Medicaid |
$40.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.38
|
| Rate for Payer: Priority Health Medicare |
$164.83
|
| Rate for Payer: Priority Health Narrow Network |
$266.38
|
| Rate for Payer: Priority Health SBD |
$94.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.83
|
| Rate for Payer: UHC Exchange |
$130.00
|
| Rate for Payer: UHC Medicare Advantage |
$164.83
|
| Rate for Payer: UHCCP Medicaid |
$40.04
|
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 76496
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$11,533.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.70
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,533.00
|
| 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 |
$17.04 |
| Max. Negotiated Rate |
$34,267.00 |
| Rate for Payer: Aetna Commercial |
$250.46
|
| Rate for Payer: Aetna Medicare |
$194.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.15
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$186.91
|
| Rate for Payer: BCBS Trust/PPO |
$581.13
|
| Rate for Payer: BCN Commercial |
$298.09
|
| 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 |
$299.06
|
| Rate for Payer: Healthscope Commercial |
$345.78
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.26
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,267.00
|
| 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 Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.86
|
| Rate for Payer: Priority Health Medicare |
$186.91
|
| Rate for Payer: Priority Health Narrow Network |
$323.86
|
| Rate for Payer: Priority Health SBD |
$40.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.91
|
| Rate for Payer: UHC Exchange |
$120.06
|
| Rate for Payer: UHC Medicare Advantage |
$186.91
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 74450
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$11,615.00 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: Aetna Medicare |
$56.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.77
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$238.97
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,615.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.66
|
| Rate for Payer: Priority Health Narrow Network |
$102.66
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.67
|
| Rate for Payer: UHC Exchange |
$79.67
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 74455
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$17,703.00 |
| Rate for Payer: Aetna Commercial |
$121.54
|
| Rate for Payer: Aetna Medicare |
$94.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.61
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$90.70
|
| Rate for Payer: BCBS Trust/PPO |
$60.70
|
| Rate for Payer: BCN Commercial |
$153.93
|
| 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 |
$167.80
|
| Rate for Payer: Healthscope Commercial |
$145.12
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.24
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,703.00
|
| 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 Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.14
|
| Rate for Payer: Priority Health Medicare |
$90.70
|
| Rate for Payer: Priority Health Narrow Network |
$160.14
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.70
|
| Rate for Payer: UHC Exchange |
$84.95
|
| Rate for Payer: UHC Medicare Advantage |
$90.70
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
|
|
CHG URINALYSIS MICROSCOPIC ONLY
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 81015
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$2,074.63 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.63
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Cofinity Commercial |
$4.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$4.88
|
| Rate for Payer: Healthscope Commercial |
$5.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$458.00
|
| Rate for Payer: Nomi Health Commercial |
$3.66
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.00
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$3.00
|
| Rate for Payer: Priority Health SBD |
$3.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Exchange |
$4.75
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
|
|
CHG URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81005
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$2,140.67 |
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.12
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.67
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$3.47
|
| Rate for Payer: Healthscope Commercial |
$4.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.00
|
| Rate for Payer: Nomi Health Commercial |
$2.60
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$2.33
|
| Rate for Payer: Priority Health SBD |
$2.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.39
|
| Rate for Payer: UHC Medicare Advantage |
$2.17
|
|
|
CHG URINARY BLADDER RESIDUAL STUDY
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 78730
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$11,428.00 |
| Rate for Payer: Aetna Commercial |
$78.87
|
| Rate for Payer: Aetna Medicare |
$61.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.76
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$58.86
|
| Rate for Payer: BCBS Trust/PPO |
$512.98
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.86
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$84.76
|
| Rate for Payer: Cofinity Commercial |
$78.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.86
|
| Rate for Payer: Healthscope Commercial |
$94.18
|
| Rate for Payer: Healthscope Commercial |
$108.89
|
| Rate for Payer: Mclaren Medicaid |
$4.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.80
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,428.00
|
| Rate for Payer: Nomi Health Commercial |
$70.63
|
| Rate for Payer: PACE SWMI |
$58.86
|
| Rate for Payer: PHP Medicare Advantage |
$58.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.22
|
| Rate for Payer: Priority Health Medicare |
$58.86
|
| Rate for Payer: Priority Health Narrow Network |
$105.22
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.86
|
| Rate for Payer: UHC Exchange |
$97.20
|
| Rate for Payer: UHC Medicare Advantage |
$58.86
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
|
|
CHG URINE ALBUMIN SEMIQUANTITATIVE
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82044
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$3,544.36 |
| Rate for Payer: Aetna Commercial |
$8.35
|
| Rate for Payer: Aetna Medicare |
$6.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.97
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$6.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,544.36
|
| Rate for Payer: BCN Commercial |
$4.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.23
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$8.97
|
| Rate for Payer: Cofinity Commercial |
$8.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.23
|
| Rate for Payer: Healthscope Commercial |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$9.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$935.00
|
| Rate for Payer: Nomi Health Commercial |
$7.48
|
| Rate for Payer: PACE SWMI |
$6.23
|
| Rate for Payer: PHP Medicare Advantage |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.32
|
| Rate for Payer: Priority Health Medicare |
$6.23
|
| Rate for Payer: Priority Health Narrow Network |
$6.32
|
| Rate for Payer: Priority Health SBD |
$6.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.23
|
| Rate for Payer: UHC Exchange |
$4.02
|
| Rate for Payer: UHC Medicare Advantage |
$6.23
|
|
