|
CHG URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 81025
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$2,329.80 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.40
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,329.80
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$13.78
|
| Rate for Payer: Healthscope Commercial |
$15.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,292.00
|
| Rate for Payer: Nomi Health Commercial |
$10.33
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.65
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$8.65
|
| Rate for Payer: Priority Health SBD |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Exchange |
$9.90
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
|
|
CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 81000
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$2,458.18 |
| Rate for Payer: Aetna Commercial |
$5.39
|
| Rate for Payer: Aetna Medicare |
$4.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.79
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cofinity Commercial |
$5.79
|
| Rate for Payer: Cofinity Commercial |
$5.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$6.43
|
| Rate for Payer: Healthscope Commercial |
$7.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$603.00
|
| Rate for Payer: Nomi Health Commercial |
$4.82
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.99
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow Network |
$3.99
|
| Rate for Payer: Priority Health SBD |
$3.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.02
|
| Rate for Payer: UHC Exchange |
$9.97
|
| Rate for Payer: UHC Medicare Advantage |
$4.02
|
|
|
CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 81001
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$3,145.50 |
| Rate for Payer: Aetna Commercial |
$4.25
|
| Rate for Payer: Aetna Medicare |
$3.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.56
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,145.50
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Cofinity Commercial |
$4.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
| Rate for Payer: Healthscope Commercial |
$5.07
|
| Rate for Payer: Healthscope Commercial |
$5.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$476.00
|
| Rate for Payer: Nomi Health Commercial |
$3.80
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow Network |
$3.33
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.17
|
| Rate for Payer: UHC Exchange |
$9.75
|
| Rate for Payer: UHC Medicare Advantage |
$3.17
|
|
|
CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81003
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$1,827.92 |
| Rate for Payer: Aetna Commercial |
$3.02
|
| Rate for Payer: Aetna Medicare |
$2.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.24
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.92
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.24
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$3.60
|
| Rate for Payer: Healthscope Commercial |
$4.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.00
|
| Rate for Payer: Nomi Health Commercial |
$2.70
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| 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 |
$2.25
|
| 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) |
$4.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
| Rate for Payer: UHC Exchange |
$4.08
|
| Rate for Payer: UHC Medicare Advantage |
$2.25
|
|
|
CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 81002
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$2,102.11 |
| Rate for Payer: Aetna Commercial |
$4.66
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.01
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.11
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$5.01
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$6.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$522.00
|
| Rate for Payer: Nomi Health Commercial |
$4.18
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$3.33
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.48
|
| Rate for Payer: UHC Exchange |
$7.85
|
| Rate for Payer: UHC Medicare Advantage |
$3.48
|
|
|
CHG UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 74400
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$23,110.00 |
| Rate for Payer: Aetna Commercial |
$159.11
|
| Rate for Payer: Aetna Commercial |
$159.11
|
| Rate for Payer: Aetna Medicare |
$123.49
|
| Rate for Payer: Aetna Medicare |
$123.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.11
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$118.74
|
| Rate for Payer: BCBS MAPPO |
$118.74
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$200.36
|
| Rate for Payer: BCN Commercial |
$200.36
|
| Rate for Payer: BCN Medicare Advantage |
$118.74
|
| Rate for Payer: BCN Medicare Advantage |
$118.74
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$170.99
|
| Rate for Payer: Cofinity Commercial |
$159.11
|
| Rate for Payer: Cofinity Commercial |
$159.11
|
| Rate for Payer: Cofinity Commercial |
$170.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.74
|
| Rate for Payer: Healthscope Commercial |
$189.98
|
| Rate for Payer: Healthscope Commercial |
$219.67
|
| Rate for Payer: Healthscope Commercial |
$189.98
|
| Rate for Payer: Healthscope Commercial |
$219.67
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Mclaren Medicaid |
$14.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.68
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,110.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,110.00
|
| Rate for Payer: Nomi Health Commercial |
$142.49
|
| Rate for Payer: Nomi Health Commercial |
$142.49
|
| Rate for Payer: PACE SWMI |
$118.74
|
| Rate for Payer: PACE SWMI |
$118.74
|
| Rate for Payer: PHP Medicare Advantage |
$118.74
|
| Rate for Payer: PHP Medicare Advantage |
$118.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.86
|
| Rate for Payer: Priority Health Medicare |
$118.74
|
| Rate for Payer: Priority Health Medicare |
$118.74
|
| Rate for Payer: Priority Health Narrow Network |
$207.86
|
| Rate for Payer: Priority Health Narrow Network |
$207.86
|
| Rate for Payer: Priority Health SBD |
$35.42
|
| Rate for Payer: Priority Health SBD |
$35.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.74
|
| Rate for Payer: UHC Exchange |
$111.95
|
| Rate for Payer: UHC Exchange |
$111.95
|
| Rate for Payer: UHC Medicare Advantage |
$118.74
|
| Rate for Payer: UHC Medicare Advantage |
$118.74
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
CHG UROGRAPHY RETROGRADE WITH/WO KUB
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 74420
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$13,149.00 |
| Rate for Payer: Aetna Commercial |
$94.75
|
| Rate for Payer: Aetna Medicare |
$73.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.75
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$70.71
|
| Rate for Payer: BCBS Trust/PPO |
$978.41
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$70.71
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$94.75
|
| Rate for Payer: Cofinity Commercial |
$101.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.71
|
| Rate for Payer: Healthscope Commercial |
$130.81
|
| Rate for Payer: Healthscope Commercial |
$113.14
|
| Rate for Payer: Mclaren Medicaid |
$15.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.25
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,149.00
|
| Rate for Payer: Nomi Health Commercial |
$84.85
|
| Rate for Payer: PACE SWMI |
$70.71
|
| Rate for Payer: PHP Medicare Advantage |
$70.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.10
|
| Rate for Payer: Priority Health Medicare |
$70.71
|
| Rate for Payer: Priority Health Narrow Network |
$120.10
|
| Rate for Payer: Priority Health SBD |
$36.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.71
|
| Rate for Payer: UHC Exchange |
$129.35
|
| Rate for Payer: UHC Medicare Advantage |
$70.71
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
|
|
CHG US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 76706
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$18,187.00 |
| Rate for Payer: Aetna Commercial |
$128.93
|
| Rate for Payer: Aetna Medicare |
$100.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.56
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$96.22
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: BCN Medicare Advantage |
$96.22
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$138.56
|
| Rate for Payer: Cofinity Commercial |
$128.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.22
|
| Rate for Payer: Healthscope Commercial |
$178.01
|
| Rate for Payer: Healthscope Commercial |
$153.95
|
| Rate for Payer: Mclaren Medicaid |
$16.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.03
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,187.00
|
| Rate for Payer: Nomi Health Commercial |
$115.46
|
| Rate for Payer: PACE SWMI |
$96.22
|
| Rate for Payer: PHP Medicare Advantage |
$96.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.24
|
| Rate for Payer: Priority Health Medicare |
$96.22
|
| Rate for Payer: Priority Health Narrow Network |
$164.24
|
| Rate for Payer: Priority Health SBD |
$39.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.22
|
| Rate for Payer: UHC Medicare Advantage |
$96.22
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 76700
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$19,994.00 |
| Rate for Payer: Aetna Commercial |
$140.43
|
| Rate for Payer: Aetna Medicare |
$108.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.43
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$104.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,008.07
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Medicare Advantage |
$104.80
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$150.91
|
| Rate for Payer: Cofinity Commercial |
$140.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.80
|
| Rate for Payer: Healthscope Commercial |
$167.68
|
| Rate for Payer: Healthscope Commercial |
$193.88
|
| Rate for Payer: Mclaren Medicaid |
$24.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.04
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19,994.00
|
| Rate for Payer: Nomi Health Commercial |
$125.76
|
| Rate for Payer: PACE SWMI |
$104.80
|
| Rate for Payer: PHP Medicare Advantage |
$104.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.12
|
| Rate for Payer: Priority Health Medicare |
$104.80
|
| Rate for Payer: Priority Health Narrow Network |
$179.12
|
| Rate for Payer: Priority Health SBD |
$57.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.80
|
| Rate for Payer: UHC Exchange |
$128.25
|
| Rate for Payer: UHC Medicare Advantage |
$104.80
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE LIMITED
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 76705
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$15,097.00 |
| Rate for Payer: Aetna Commercial |
$105.39
|
| Rate for Payer: Aetna Commercial |
$105.39
|
| Rate for Payer: Aetna Medicare |
$81.80
|
| Rate for Payer: Aetna Medicare |
$81.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.39
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCBS MAPPO |
$78.65
|
| Rate for Payer: BCBS MAPPO |
$78.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.65
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Medicare Advantage |
$78.65
|
| Rate for Payer: BCN Medicare Advantage |
$78.65
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$113.26
|
| Rate for Payer: Cofinity Commercial |
$105.39
|
| Rate for Payer: Cofinity Commercial |
$105.39
|
| Rate for Payer: Cofinity Commercial |
$113.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.65
|
| Rate for Payer: Healthscope Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$145.50
|
| Rate for Payer: Healthscope Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$145.50
|
| Rate for Payer: Mclaren Medicaid |
$17.68
|
| Rate for Payer: Mclaren Medicaid |
$17.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.58
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,097.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,097.00
|
| Rate for Payer: Nomi Health Commercial |
$94.38
|
| Rate for Payer: Nomi Health Commercial |
$94.38
|
| Rate for Payer: PACE SWMI |
$78.65
|
| Rate for Payer: PACE SWMI |
$78.65
|
| Rate for Payer: PHP Medicare Advantage |
$78.65
|
| Rate for Payer: PHP Medicare Advantage |
$78.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.96
|
| Rate for Payer: Priority Health Medicare |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$78.65
|
| Rate for Payer: Priority Health Narrow Network |
$133.96
|
| Rate for Payer: Priority Health Narrow Network |
$133.96
|
| Rate for Payer: Priority Health SBD |
$42.09
|
| Rate for Payer: Priority Health SBD |
$42.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.65
|
| Rate for Payer: UHC Exchange |
$107.86
|
| Rate for Payer: UHC Exchange |
$107.86
|
| Rate for Payer: UHC Medicare Advantage |
$78.65
|
| Rate for Payer: UHC Medicare Advantage |
$78.65
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
|
|
CHG US, BREAST(S), REAL TIME
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 76645
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Medicare |
$75.00
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
|
|
CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 76604
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$9,817.00 |
| Rate for Payer: Aetna Commercial |
$71.44
|
| Rate for Payer: Aetna Medicare |
$55.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.77
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$53.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,617.20
|
| Rate for Payer: BCN Commercial |
$83.07
|
| Rate for Payer: BCN Medicare Advantage |
$53.31
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$76.77
|
| Rate for Payer: Cofinity Commercial |
$71.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.31
|
| Rate for Payer: Healthscope Commercial |
$98.62
|
| Rate for Payer: Healthscope Commercial |
$85.30
|
| Rate for Payer: Mclaren Medicaid |
$17.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.98
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,817.00
|
| Rate for Payer: Nomi Health Commercial |
$63.97
|
| Rate for Payer: PACE SWMI |
$53.31
|
| Rate for Payer: PHP Medicare Advantage |
$53.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.76
|
| Rate for Payer: Priority Health Medicare |
$53.31
|
| Rate for Payer: Priority Health Narrow Network |
$87.76
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.31
|
| Rate for Payer: UHC Exchange |
$106.69
|
| Rate for Payer: UHC Medicare Advantage |
$53.31
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
|
|
CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 76936
|
| Min. Negotiated Rate |
$59.21 |
| Max. Negotiated Rate |
$44,464.00 |
| Rate for Payer: Aetna Commercial |
$315.24
|
| Rate for Payer: Aetna Medicare |
$244.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.76
|
| Rate for Payer: BCBS Complete |
$62.17
|
| Rate for Payer: BCBS MAPPO |
$235.25
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$379.21
|
| Rate for Payer: BCN Medicare Advantage |
$235.25
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$338.76
|
| Rate for Payer: Cofinity Commercial |
$315.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.25
|
| Rate for Payer: Healthscope Commercial |
$435.21
|
| Rate for Payer: Healthscope Commercial |
$376.40
|
| Rate for Payer: Mclaren Medicaid |
$59.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.01
|
| Rate for Payer: Meridian Medicaid |
$62.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44,464.00
|
| Rate for Payer: Nomi Health Commercial |
$282.30
|
| Rate for Payer: PACE SWMI |
$235.25
|
| Rate for Payer: PHP Medicare Advantage |
$235.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.86
|
| Rate for Payer: Priority Health Medicare |
$235.25
|
| Rate for Payer: Priority Health Narrow Network |
$400.86
|
| Rate for Payer: Priority Health SBD |
$141.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.25
|
| Rate for Payer: UHC Exchange |
$375.57
|
| Rate for Payer: UHC Medicare Advantage |
$235.25
|
| Rate for Payer: UHCCP Medicaid |
$59.21
|
|
|
CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 76881
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$9,486.00 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Medicare |
$52.17
|
| Rate for Payer: Aetna Medicare |
$52.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$50.16
|
| Rate for Payer: BCBS MAPPO |
$50.16
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$50.16
|
| Rate for Payer: BCN Medicare Advantage |
$50.16
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$67.21
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Cofinity Commercial |
$67.21
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.16
|
| Rate for Payer: Healthscope Commercial |
$80.26
|
| Rate for Payer: Healthscope Commercial |
$92.80
|
| Rate for Payer: Healthscope Commercial |
$92.80
|
| Rate for Payer: Healthscope Commercial |
$80.26
|
| Rate for Payer: Mclaren Medicaid |
$27.26
|
| Rate for Payer: Mclaren Medicaid |
$27.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.67
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,486.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,486.00
|
| Rate for Payer: Nomi Health Commercial |
$60.19
|
| Rate for Payer: Nomi Health Commercial |
$60.19
|
| Rate for Payer: PACE SWMI |
$50.16
|
| Rate for Payer: PACE SWMI |
$50.16
|
| Rate for Payer: PHP Medicare Advantage |
$50.16
|
| Rate for Payer: PHP Medicare Advantage |
$50.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health Medicare |
$50.16
|
| Rate for Payer: Priority Health Medicare |
$50.16
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health SBD |
$65.70
|
| Rate for Payer: Priority Health SBD |
$65.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.16
|
| Rate for Payer: UHC Medicare Advantage |
$50.16
|
| Rate for Payer: UHC Medicare Advantage |
$50.16
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 76813
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$20,252.00 |
| Rate for Payer: Aetna Commercial |
$139.27
|
| Rate for Payer: Aetna Medicare |
$108.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.66
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$103.93
|
| Rate for Payer: BCBS Trust/PPO |
$675.17
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: BCN Medicare Advantage |
$103.93
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$149.66
|
| Rate for Payer: Cofinity Commercial |
$139.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.93
|
| Rate for Payer: Healthscope Commercial |
$192.27
|
| Rate for Payer: Healthscope Commercial |
$166.29
|
| Rate for Payer: Mclaren Medicaid |
$35.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.13
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,252.00
|
| Rate for Payer: Nomi Health Commercial |
$124.72
|
| Rate for Payer: PACE SWMI |
$103.93
|
| Rate for Payer: PHP Medicare Advantage |
$103.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$103.93
|
| Rate for Payer: Priority Health Narrow Network |
$178.10
|
| Rate for Payer: Priority Health SBD |
$85.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.93
|
| Rate for Payer: UHC Exchange |
$151.18
|
| Rate for Payer: UHC Medicare Advantage |
$103.93
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 76814
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$13,016.00 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$70.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.82
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$67.93
|
| Rate for Payer: BCBS Trust/PPO |
$696.30
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$67.93
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Cofinity Commercial |
$91.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.93
|
| Rate for Payer: Healthscope Commercial |
$125.67
|
| Rate for Payer: Healthscope Commercial |
$108.69
|
| Rate for Payer: Mclaren Medicaid |
$29.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.33
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,016.00
|
| Rate for Payer: Nomi Health Commercial |
$81.52
|
| Rate for Payer: PACE SWMI |
$67.93
|
| Rate for Payer: PHP Medicare Advantage |
$67.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.46
|
| Rate for Payer: Priority Health Medicare |
$67.93
|
| Rate for Payer: Priority Health Narrow Network |
$114.46
|
| Rate for Payer: Priority Health SBD |
$71.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.93
|
| Rate for Payer: UHC Exchange |
$102.42
|
| Rate for Payer: UHC Medicare Advantage |
$67.93
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
|
|
CHG US GUIDANCE AMNIOCENTESIS IMG S&I
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 76946
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$5,672.00 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$194.41
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$30.73
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| Rate for Payer: Cofinity Commercial |
$41.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.73
|
| Rate for Payer: Healthscope Commercial |
$56.85
|
| Rate for Payer: Healthscope Commercial |
$49.17
|
| Rate for Payer: Mclaren Medicaid |
$11.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.27
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,672.00
|
| Rate for Payer: Nomi Health Commercial |
$36.88
|
| Rate for Payer: PACE SWMI |
$30.73
|
| Rate for Payer: PHP Medicare Advantage |
$30.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.33
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: Priority Health Narrow Network |
$51.33
|
| Rate for Payer: Priority Health SBD |
$27.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.73
|
| Rate for Payer: UHC Exchange |
$85.20
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
|
|
CHG US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 76965
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$16,281.00 |
| Rate for Payer: Aetna Commercial |
$118.67
|
| Rate for Payer: Aetna Commercial |
$118.67
|
| Rate for Payer: Aetna Medicare |
$92.10
|
| Rate for Payer: Aetna Medicare |
$92.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.67
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$88.56
|
| Rate for Payer: BCBS MAPPO |
$88.56
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Medicare Advantage |
$88.56
|
| Rate for Payer: BCN Medicare Advantage |
$88.56
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$127.53
|
| Rate for Payer: Cofinity Commercial |
$118.67
|
| Rate for Payer: Cofinity Commercial |
$118.67
|
| Rate for Payer: Cofinity Commercial |
$127.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.56
|
| Rate for Payer: Healthscope Commercial |
$141.70
|
| Rate for Payer: Healthscope Commercial |
$163.84
|
| Rate for Payer: Healthscope Commercial |
$141.70
|
| Rate for Payer: Healthscope Commercial |
$163.84
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Mclaren Medicaid |
$43.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.99
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,281.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,281.00
|
| Rate for Payer: Nomi Health Commercial |
$106.27
|
| Rate for Payer: Nomi Health Commercial |
$106.27
|
| Rate for Payer: PACE SWMI |
$88.56
|
| Rate for Payer: PACE SWMI |
$88.56
|
| Rate for Payer: PHP Medicare Advantage |
$88.56
|
| Rate for Payer: PHP Medicare Advantage |
$88.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.25
|
| Rate for Payer: Priority Health Medicare |
$88.56
|
| Rate for Payer: Priority Health Medicare |
$88.56
|
| Rate for Payer: Priority Health Narrow Network |
$145.25
|
| Rate for Payer: Priority Health Narrow Network |
$145.25
|
| Rate for Payer: Priority Health SBD |
$102.66
|
| Rate for Payer: Priority Health SBD |
$102.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.56
|
| Rate for Payer: UHC Exchange |
$355.86
|
| Rate for Payer: UHC Exchange |
$355.86
|
| Rate for Payer: UHC Medicare Advantage |
$88.56
|
| Rate for Payer: UHC Medicare Advantage |
$88.56
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
|
|
CHG US GUIDANCE NEEDLE PLACEMENT IMG S&I
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 76942
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$10,084.00 |
| Rate for Payer: Aetna Commercial |
$72.94
|
| Rate for Payer: Aetna Commercial |
$72.94
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.94
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$78.38
|
| Rate for Payer: Cofinity Commercial |
$72.94
|
| Rate for Payer: Cofinity Commercial |
$72.94
|
| Rate for Payer: Cofinity Commercial |
$78.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Healthscope Commercial |
$87.09
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Healthscope Commercial |
$87.09
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,084.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,084.00
|
| Rate for Payer: Nomi Health Commercial |
$65.32
|
| Rate for Payer: Nomi Health Commercial |
$65.32
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.31
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Narrow Network |
$89.31
|
| Rate for Payer: Priority Health Narrow Network |
$89.31
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Exchange |
$158.18
|
| Rate for Payer: UHC Exchange |
$158.18
|
| Rate for Payer: UHC Medicare Advantage |
$54.43
|
| Rate for Payer: UHC Medicare Advantage |
$54.43
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
CHG US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 76941
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$20,408.00 |
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: Aetna Medicare |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.84
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS Trust/PPO |
$145.81
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,408.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.65
|
| Rate for Payer: Priority Health Narrow Network |
$179.65
|
| Rate for Payer: Priority Health SBD |
$97.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.13
|
| Rate for Payer: UHC Exchange |
$141.13
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
CHG US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 76882
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$7,427.00 |
| Rate for Payer: Aetna Commercial |
$79.44
|
| Rate for Payer: Aetna Commercial |
$79.44
|
| Rate for Payer: Aetna Medicare |
$61.65
|
| Rate for Payer: Aetna Medicare |
$61.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.44
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS MAPPO |
$59.28
|
| Rate for Payer: BCBS MAPPO |
$59.28
|
| Rate for Payer: BCBS Trust/PPO |
$884.90
|
| Rate for Payer: BCBS Trust/PPO |
$884.90
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$59.28
|
| Rate for Payer: BCN Medicare Advantage |
$59.28
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$85.36
|
| Rate for Payer: Cofinity Commercial |
$85.36
|
| Rate for Payer: Cofinity Commercial |
$79.44
|
| Rate for Payer: Cofinity Commercial |
$79.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.28
|
| Rate for Payer: Healthscope Commercial |
$94.85
|
| Rate for Payer: Healthscope Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$94.85
|
| Rate for Payer: Mclaren Medicaid |
$20.87
|
| Rate for Payer: Mclaren Medicaid |
$20.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.24
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,427.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,427.00
|
| Rate for Payer: Nomi Health Commercial |
$71.14
|
| Rate for Payer: Nomi Health Commercial |
$71.14
|
| Rate for Payer: PACE SWMI |
$59.28
|
| Rate for Payer: PACE SWMI |
$59.28
|
| Rate for Payer: PHP Medicare Advantage |
$59.28
|
| Rate for Payer: PHP Medicare Advantage |
$59.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.53
|
| Rate for Payer: Priority Health Medicare |
$59.28
|
| Rate for Payer: Priority Health Medicare |
$59.28
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health SBD |
$49.79
|
| Rate for Payer: Priority Health SBD |
$49.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.28
|
| Rate for Payer: UHC Medicare Advantage |
$59.28
|
| Rate for Payer: UHC Medicare Advantage |
$59.28
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
|
|
CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 76857
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$8,415.00 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna Medicare |
$47.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.10
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$45.90
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$71.35
|
| Rate for Payer: BCN Medicare Advantage |
$45.90
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$61.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.90
|
| Rate for Payer: Healthscope Commercial |
$84.92
|
| Rate for Payer: Healthscope Commercial |
$73.44
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.20
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,415.00
|
| Rate for Payer: Nomi Health Commercial |
$55.08
|
| Rate for Payer: PACE SWMI |
$45.90
|
| Rate for Payer: PHP Medicare Advantage |
$45.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health Medicare |
$45.90
|
| Rate for Payer: Priority Health Narrow Network |
$75.97
|
| Rate for Payer: Priority Health SBD |
$35.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.90
|
| Rate for Payer: UHC Exchange |
$105.71
|
| Rate for Payer: UHC Medicare Advantage |
$45.90
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
CHG US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 76856
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$18,095.00 |
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: Aetna Medicare |
$98.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.71
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$94.94
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$94.94
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$136.71
|
| Rate for Payer: Cofinity Commercial |
$127.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.94
|
| Rate for Payer: Healthscope Commercial |
$175.64
|
| Rate for Payer: Healthscope Commercial |
$151.90
|
| Rate for Payer: Mclaren Medicaid |
$20.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.69
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,095.00
|
| Rate for Payer: Nomi Health Commercial |
$113.93
|
| Rate for Payer: PACE SWMI |
$94.94
|
| Rate for Payer: PHP Medicare Advantage |
$94.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.19
|
| Rate for Payer: Priority Health Medicare |
$94.94
|
| Rate for Payer: Priority Health Narrow Network |
$162.19
|
| Rate for Payer: Priority Health SBD |
$49.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.94
|
| Rate for Payer: UHC Exchange |
$119.67
|
| Rate for Payer: UHC Medicare Advantage |
$94.94
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
|
|
CHG US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 76801
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$20,259.00 |
| Rate for Payer: Aetna Commercial |
$142.20
|
| Rate for Payer: Aetna Medicare |
$110.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.81
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$106.12
|
| Rate for Payer: BCBS Trust/PPO |
$269.43
|
| Rate for Payer: BCN Commercial |
$172.99
|
| Rate for Payer: BCN Medicare Advantage |
$106.12
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$152.81
|
| Rate for Payer: Cofinity Commercial |
$142.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.12
|
| Rate for Payer: Healthscope Commercial |
$196.32
|
| Rate for Payer: Healthscope Commercial |
$169.79
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.43
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20,259.00
|
| Rate for Payer: Nomi Health Commercial |
$127.34
|
| Rate for Payer: PACE SWMI |
$106.12
|
| Rate for Payer: PHP Medicare Advantage |
$106.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.66
|
| Rate for Payer: Priority Health Medicare |
$106.12
|
| Rate for Payer: Priority Health Narrow Network |
$180.66
|
| Rate for Payer: Priority Health SBD |
$71.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.12
|
| Rate for Payer: UHC Exchange |
$142.88
|
| Rate for Payer: UHC Medicare Advantage |
$106.12
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG US PREGNANT UTERUS LIMITED 1/> FETUSES
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 76815
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$14,017.00 |
| Rate for Payer: Aetna Commercial |
$98.52
|
| Rate for Payer: Aetna Medicare |
$76.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.52
|
| Rate for Payer: BCBS Complete |
$20.58
|
| Rate for Payer: BCBS MAPPO |
$73.52
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$73.52
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$98.52
|
| Rate for Payer: Cofinity Commercial |
$105.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.52
|
| Rate for Payer: Healthscope Commercial |
$136.01
|
| Rate for Payer: Healthscope Commercial |
$117.63
|
| Rate for Payer: Mclaren Medicaid |
$19.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.20
|
| Rate for Payer: Meridian Medicaid |
$20.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,017.00
|
| Rate for Payer: Nomi Health Commercial |
$88.22
|
| Rate for Payer: PACE SWMI |
$73.52
|
| Rate for Payer: PHP Medicare Advantage |
$73.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.72
|
| Rate for Payer: Priority Health Medicare |
$73.52
|
| Rate for Payer: Priority Health Narrow Network |
$124.72
|
| Rate for Payer: Priority Health SBD |
$46.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.52
|
| Rate for Payer: UHC Exchange |
$96.29
|
| Rate for Payer: UHC Medicare Advantage |
$73.52
|
| Rate for Payer: UHCCP Medicaid |
$19.60
|
|
