|
CHG CTA ABD&PLVS W/CNTRST & IMG POSTPROCESSING
|
Professional
|
Both
|
$232.00
|
|
|
Service Code
|
HCPCS 74174
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$672.59 |
| Rate for Payer: Aetna Commercial |
$472.99
|
| Rate for Payer: Aetna Medicare |
$367.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$472.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$508.29
|
| Rate for Payer: BCBS MAPPO |
$352.98
|
| Rate for Payer: BCN Commercial |
$576.17
|
| Rate for Payer: BCN Medicare Advantage |
$352.98
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cash Price |
$185.60
|
| Rate for Payer: Cofinity Commercial |
$508.29
|
| Rate for Payer: Cofinity Commercial |
$472.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.98
|
| Rate for Payer: Healthscope Commercial |
$653.01
|
| Rate for Payer: Healthscope Commercial |
$564.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$388.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$672.59
|
| Rate for Payer: Nomi Health Commercial |
$423.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$174.00
|
| Rate for Payer: PACE SWMI |
$352.98
|
| Rate for Payer: PHP Medicare Advantage |
$352.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$580.50
|
| Rate for Payer: Priority Health Medicare |
$352.98
|
| Rate for Payer: Priority Health SBD |
$580.50
|
| Rate for Payer: Priority Health Tiered Network |
$580.50
|
| Rate for Payer: Railroad Medicare Medicare |
$352.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$571.21
|
| Rate for Payer: UHC Core |
$571.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$352.98
|
| Rate for Payer: UHC Exchange |
$571.21
|
|
|
CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 74177
|
| Min. Negotiated Rate |
$145.50 |
| Max. Negotiated Rate |
$540.09 |
| Rate for Payer: Aetna Commercial |
$375.51
|
| Rate for Payer: Aetna Medicare |
$291.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$375.51
|
| Rate for Payer: BCBS MAPPO |
$280.23
|
| Rate for Payer: BCN Commercial |
$457.65
|
| Rate for Payer: BCN Medicare Advantage |
$280.23
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$403.53
|
| Rate for Payer: Cofinity Commercial |
$375.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.23
|
| Rate for Payer: Healthscope Commercial |
$518.43
|
| Rate for Payer: Healthscope Commercial |
$448.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$308.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$540.09
|
| Rate for Payer: Nomi Health Commercial |
$336.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: PACE SWMI |
$280.23
|
| Rate for Payer: PHP Medicare Advantage |
$280.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$461.08
|
| Rate for Payer: Priority Health Medicare |
$280.23
|
| Rate for Payer: Priority Health SBD |
$461.08
|
| Rate for Payer: Priority Health Tiered Network |
$461.08
|
| Rate for Payer: Railroad Medicare Medicare |
$280.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.66
|
| Rate for Payer: UHC Core |
$461.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$280.23
|
| Rate for Payer: UHC Exchange |
$461.66
|
|
|
CHG CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 74176
|
| Min. Negotiated Rate |
$138.75 |
| Max. Negotiated Rate |
$326.29 |
| Rate for Payer: Aetna Commercial |
$231.62
|
| Rate for Payer: Aetna Medicare |
$179.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.90
|
| Rate for Payer: BCBS MAPPO |
$172.85
|
| Rate for Payer: BCN Commercial |
$278.37
|
| Rate for Payer: BCN Medicare Advantage |
$172.85
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$248.90
|
| Rate for Payer: Cofinity Commercial |
$231.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.85
|
| Rate for Payer: Healthscope Commercial |
$319.77
|
| Rate for Payer: Healthscope Commercial |
$276.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$190.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.29
|
| Rate for Payer: Nomi Health Commercial |
$207.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.75
|
| Rate for Payer: PACE SWMI |
$172.85
|
| Rate for Payer: PHP Medicare Advantage |
$172.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.47
|
| Rate for Payer: Priority Health Medicare |
$172.85
|
| Rate for Payer: Priority Health SBD |
$280.47
|
| Rate for Payer: Priority Health Tiered Network |
$280.47
|
| Rate for Payer: Railroad Medicare Medicare |
$172.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$285.22
|
| Rate for Payer: UHC Core |
$285.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.85
|
| Rate for Payer: UHC Exchange |
$285.22
|
|
|
CHG CT ABDOMEN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 74160
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$403.45 |
| Rate for Payer: Aetna Commercial |
$287.24
|
| Rate for Payer: Aetna Commercial |
$287.24
|
| Rate for Payer: Aetna Medicare |
$222.93
|
| Rate for Payer: Aetna Medicare |
$222.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.24
|
| Rate for Payer: BCBS MAPPO |
$214.36
|
| Rate for Payer: BCBS MAPPO |
$214.36
|
| Rate for Payer: BCN Commercial |
$349.59
|
| Rate for Payer: BCN Commercial |
$349.59
|
| Rate for Payer: BCN Medicare Advantage |
$214.36
|
| Rate for Payer: BCN Medicare Advantage |
$214.36
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$308.68
|
| Rate for Payer: Cofinity Commercial |
$287.24
|
| Rate for Payer: Cofinity Commercial |
$287.24
|
| Rate for Payer: Cofinity Commercial |
$308.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.36
|
| Rate for Payer: Healthscope Commercial |
$396.57
|
| Rate for Payer: Healthscope Commercial |
$396.57
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Healthscope Commercial |
$342.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$235.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$235.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.45
|
| Rate for Payer: Nomi Health Commercial |
$257.23
|
| Rate for Payer: Nomi Health Commercial |
$257.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$214.36
|
| Rate for Payer: PACE SWMI |
$214.36
|
| Rate for Payer: PHP Medicare Advantage |
$214.36
|
| Rate for Payer: PHP Medicare Advantage |
$214.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$352.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$352.21
|
| Rate for Payer: Priority Health Medicare |
$214.36
|
| Rate for Payer: Priority Health Medicare |
$214.36
|
| Rate for Payer: Priority Health SBD |
$352.21
|
| Rate for Payer: Priority Health SBD |
$352.21
|
| Rate for Payer: Priority Health Tiered Network |
$352.21
|
| Rate for Payer: Priority Health Tiered Network |
$352.21
|
| Rate for Payer: Railroad Medicare Medicare |
$214.36
|
| Rate for Payer: Railroad Medicare Medicare |
$214.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.34
|
| Rate for Payer: UHC Core |
$348.34
|
| Rate for Payer: UHC Core |
$348.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$214.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$214.36
|
| Rate for Payer: UHC Exchange |
$348.34
|
| Rate for Payer: UHC Exchange |
$348.34
|
|
|
CHG CT ABDOMEN W/O CONTRAST FLWD BY CONTRAST MATRL
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 74170
|
| Min. Negotiated Rate |
$111.00 |
| Max. Negotiated Rate |
$445.79 |
| Rate for Payer: Aetna Commercial |
$322.90
|
| Rate for Payer: Aetna Medicare |
$250.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$322.90
|
| Rate for Payer: BCBS MAPPO |
$240.97
|
| Rate for Payer: BCN Commercial |
$392.91
|
| Rate for Payer: BCN Medicare Advantage |
$240.97
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$347.00
|
| Rate for Payer: Cofinity Commercial |
$322.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.97
|
| Rate for Payer: Healthscope Commercial |
$445.79
|
| Rate for Payer: Healthscope Commercial |
$385.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$253.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$265.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$414.16
|
| Rate for Payer: Nomi Health Commercial |
$289.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.00
|
| Rate for Payer: PACE SWMI |
$240.97
|
| Rate for Payer: PHP Medicare Advantage |
$240.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$395.86
|
| Rate for Payer: Priority Health Medicare |
$240.97
|
| Rate for Payer: Priority Health SBD |
$395.86
|
| Rate for Payer: Priority Health Tiered Network |
$395.86
|
| Rate for Payer: Railroad Medicare Medicare |
$240.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$392.83
|
| Rate for Payer: UHC Core |
$392.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$240.97
|
| Rate for Payer: UHC Exchange |
$392.83
|
|
|
CHG CT ABDOMEN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 74150
|
| Min. Negotiated Rate |
$94.50 |
| Max. Negotiated Rate |
$242.77 |
| Rate for Payer: Aetna Commercial |
$172.02
|
| Rate for Payer: Aetna Medicare |
$133.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.85
|
| Rate for Payer: BCBS MAPPO |
$128.37
|
| Rate for Payer: BCN Commercial |
$206.66
|
| Rate for Payer: BCN Medicare Advantage |
$128.37
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$184.85
|
| Rate for Payer: Cofinity Commercial |
$172.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.37
|
| Rate for Payer: Healthscope Commercial |
$237.48
|
| Rate for Payer: Healthscope Commercial |
$205.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.77
|
| Rate for Payer: Nomi Health Commercial |
$154.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.50
|
| Rate for Payer: PACE SWMI |
$128.37
|
| Rate for Payer: PHP Medicare Advantage |
$128.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$208.22
|
| Rate for Payer: Priority Health Medicare |
$128.37
|
| Rate for Payer: Priority Health SBD |
$208.22
|
| Rate for Payer: Priority Health Tiered Network |
$208.22
|
| Rate for Payer: Railroad Medicare Medicare |
$128.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.27
|
| Rate for Payer: UHC Core |
$212.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.37
|
| Rate for Payer: UHC Exchange |
$212.27
|
|
|
CHG CT ABD&PLV W/O CNTRST 1/BTH FLWD CNTRST 1/BTH
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 74178
|
| Min. Negotiated Rate |
$159.00 |
| Max. Negotiated Rate |
$604.48 |
| Rate for Payer: Aetna Commercial |
$422.62
|
| Rate for Payer: Aetna Medicare |
$328.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$454.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$422.62
|
| Rate for Payer: BCBS MAPPO |
$315.39
|
| Rate for Payer: BCN Commercial |
$512.43
|
| Rate for Payer: BCN Medicare Advantage |
$315.39
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$454.16
|
| Rate for Payer: Cofinity Commercial |
$422.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.39
|
| Rate for Payer: Healthscope Commercial |
$583.47
|
| Rate for Payer: Healthscope Commercial |
$504.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$331.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$346.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$604.48
|
| Rate for Payer: Nomi Health Commercial |
$378.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.00
|
| Rate for Payer: PACE SWMI |
$315.39
|
| Rate for Payer: PHP Medicare Advantage |
$315.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$516.29
|
| Rate for Payer: Priority Health Medicare |
$315.39
|
| Rate for Payer: Priority Health SBD |
$516.29
|
| Rate for Payer: Priority Health Tiered Network |
$516.29
|
| Rate for Payer: Railroad Medicare Medicare |
$315.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$518.59
|
| Rate for Payer: UHC Core |
$518.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$315.39
|
| Rate for Payer: UHC Exchange |
$518.59
|
|
|
CHG CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST
|
Professional
|
Both
|
$253.00
|
|
|
Service Code
|
HCPCS 75574
|
| Min. Negotiated Rate |
$189.75 |
| Max. Negotiated Rate |
$564.77 |
| Rate for Payer: Aetna Commercial |
$409.08
|
| Rate for Payer: Aetna Medicare |
$317.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$409.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$439.60
|
| Rate for Payer: BCBS MAPPO |
$305.28
|
| Rate for Payer: BCN Commercial |
$490.01
|
| Rate for Payer: BCN Medicare Advantage |
$305.28
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cash Price |
$202.40
|
| Rate for Payer: Cofinity Commercial |
$439.60
|
| Rate for Payer: Cofinity Commercial |
$409.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.28
|
| Rate for Payer: Healthscope Commercial |
$564.77
|
| Rate for Payer: Healthscope Commercial |
$488.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$335.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$496.76
|
| Rate for Payer: Nomi Health Commercial |
$366.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$189.75
|
| Rate for Payer: PACE SWMI |
$305.28
|
| Rate for Payer: PHP Medicare Advantage |
$305.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$493.70
|
| Rate for Payer: Priority Health Medicare |
$305.28
|
| Rate for Payer: Priority Health SBD |
$493.70
|
| Rate for Payer: Priority Health Tiered Network |
$493.70
|
| Rate for Payer: Railroad Medicare Medicare |
$305.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$509.60
|
| Rate for Payer: UHC Core |
$509.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.28
|
| Rate for Payer: UHC Exchange |
$509.60
|
|
|
CHG CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 71275
|
| Min. Negotiated Rate |
$145.50 |
| Max. Negotiated Rate |
$485.27 |
| Rate for Payer: Aetna Commercial |
$351.50
|
| Rate for Payer: Aetna Medicare |
$272.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$377.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.50
|
| Rate for Payer: BCBS MAPPO |
$262.31
|
| Rate for Payer: BCN Commercial |
$427.76
|
| Rate for Payer: BCN Medicare Advantage |
$262.31
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$377.73
|
| Rate for Payer: Cofinity Commercial |
$351.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.31
|
| Rate for Payer: Healthscope Commercial |
$485.27
|
| Rate for Payer: Healthscope Commercial |
$419.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$275.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$288.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.62
|
| Rate for Payer: Nomi Health Commercial |
$314.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$145.50
|
| Rate for Payer: PACE SWMI |
$262.31
|
| Rate for Payer: PHP Medicare Advantage |
$262.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$430.99
|
| Rate for Payer: Priority Health Medicare |
$262.31
|
| Rate for Payer: Priority Health SBD |
$430.99
|
| Rate for Payer: Priority Health Tiered Network |
$430.99
|
| Rate for Payer: Railroad Medicare Medicare |
$262.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$428.22
|
| Rate for Payer: UHC Core |
$428.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$262.31
|
| Rate for Payer: UHC Exchange |
$428.22
|
|
|
CHG CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 70496
|
| Min. Negotiated Rate |
$139.50 |
| Max. Negotiated Rate |
$473.40 |
| Rate for Payer: Aetna Commercial |
$342.89
|
| Rate for Payer: Aetna Medicare |
$266.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.48
|
| Rate for Payer: BCBS MAPPO |
$255.89
|
| Rate for Payer: BCN Commercial |
$419.30
|
| Rate for Payer: BCN Medicare Advantage |
$255.89
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cofinity Commercial |
$368.48
|
| Rate for Payer: Cofinity Commercial |
$342.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.89
|
| Rate for Payer: Healthscope Commercial |
$473.40
|
| Rate for Payer: Healthscope Commercial |
$409.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$281.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.24
|
| Rate for Payer: Nomi Health Commercial |
$307.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.50
|
| Rate for Payer: PACE SWMI |
$255.89
|
| Rate for Payer: PHP Medicare Advantage |
$255.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$422.46
|
| Rate for Payer: Priority Health Medicare |
$255.89
|
| Rate for Payer: Priority Health SBD |
$422.46
|
| Rate for Payer: Priority Health Tiered Network |
$422.46
|
| Rate for Payer: Railroad Medicare Medicare |
$255.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$419.06
|
| Rate for Payer: UHC Core |
$419.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$255.89
|
| Rate for Payer: UHC Exchange |
$419.06
|
|
|
CHG CT ANGIOGRAPHY LOWER EXTREMITY
|
Professional
|
Both
|
$200.00
|
|
|
Service Code
|
HCPCS 73706
|
| Min. Negotiated Rate |
$150.00 |
| Max. Negotiated Rate |
$555.37 |
| Rate for Payer: Aetna Commercial |
$402.27
|
| Rate for Payer: Aetna Medicare |
$312.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.27
|
| Rate for Payer: BCBS MAPPO |
$300.20
|
| Rate for Payer: BCN Commercial |
$489.52
|
| Rate for Payer: BCN Medicare Advantage |
$300.20
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cofinity Commercial |
$432.29
|
| Rate for Payer: Cofinity Commercial |
$402.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$300.20
|
| Rate for Payer: Healthscope Commercial |
$555.37
|
| Rate for Payer: Healthscope Commercial |
$480.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$315.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$330.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.06
|
| Rate for Payer: Nomi Health Commercial |
$360.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.00
|
| Rate for Payer: PACE SWMI |
$300.20
|
| Rate for Payer: PHP Medicare Advantage |
$300.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$493.21
|
| Rate for Payer: Priority Health Medicare |
$300.20
|
| Rate for Payer: Priority Health SBD |
$493.21
|
| Rate for Payer: Priority Health Tiered Network |
$493.21
|
| Rate for Payer: Railroad Medicare Medicare |
$300.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.91
|
| Rate for Payer: UHC Core |
$500.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$300.20
|
| Rate for Payer: UHC Exchange |
$500.91
|
|
|
CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$186.00
|
|
|
Service Code
|
HCPCS 70498
|
| Min. Negotiated Rate |
$139.50 |
| Max. Negotiated Rate |
$473.40 |
| Rate for Payer: Aetna Commercial |
$342.89
|
| Rate for Payer: Aetna Medicare |
$266.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$342.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$368.48
|
| Rate for Payer: BCBS MAPPO |
$255.89
|
| Rate for Payer: BCN Commercial |
$418.81
|
| Rate for Payer: BCN Medicare Advantage |
$255.89
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cash Price |
$148.80
|
| Rate for Payer: Cofinity Commercial |
$368.48
|
| Rate for Payer: Cofinity Commercial |
$342.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.89
|
| Rate for Payer: Healthscope Commercial |
$473.40
|
| Rate for Payer: Healthscope Commercial |
$409.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$268.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$281.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.24
|
| Rate for Payer: Nomi Health Commercial |
$307.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$139.50
|
| Rate for Payer: PACE SWMI |
$255.89
|
| Rate for Payer: PHP Medicare Advantage |
$255.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$421.95
|
| Rate for Payer: Priority Health Medicare |
$255.89
|
| Rate for Payer: Priority Health SBD |
$421.95
|
| Rate for Payer: Priority Health Tiered Network |
$421.95
|
| Rate for Payer: Railroad Medicare Medicare |
$255.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$418.57
|
| Rate for Payer: UHC Core |
$418.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$255.89
|
| Rate for Payer: UHC Exchange |
$418.57
|
|
|
CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 72191
|
| Min. Negotiated Rate |
$143.25 |
| Max. Negotiated Rate |
$524.72 |
| Rate for Payer: Aetna Commercial |
$380.06
|
| Rate for Payer: Aetna Medicare |
$294.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.06
|
| Rate for Payer: BCBS MAPPO |
$283.63
|
| Rate for Payer: BCN Commercial |
$461.63
|
| Rate for Payer: BCN Medicare Advantage |
$283.63
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$408.43
|
| Rate for Payer: Cofinity Commercial |
$380.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.63
|
| Rate for Payer: Healthscope Commercial |
$524.72
|
| Rate for Payer: Healthscope Commercial |
$453.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$297.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$311.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.34
|
| Rate for Payer: Nomi Health Commercial |
$340.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.25
|
| Rate for Payer: PACE SWMI |
$283.63
|
| Rate for Payer: PHP Medicare Advantage |
$283.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$465.10
|
| Rate for Payer: Priority Health Medicare |
$283.63
|
| Rate for Payer: Priority Health SBD |
$465.10
|
| Rate for Payer: Priority Health Tiered Network |
$465.10
|
| Rate for Payer: Railroad Medicare Medicare |
$283.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$455.23
|
| Rate for Payer: UHC Core |
$455.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$283.63
|
| Rate for Payer: UHC Exchange |
$455.23
|
|
|
CHG CT ANGIOGRAPHY UPPER EXTREMITY
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 73206
|
| Min. Negotiated Rate |
$143.25 |
| Max. Negotiated Rate |
$510.62 |
| Rate for Payer: Aetna Commercial |
$369.85
|
| Rate for Payer: Aetna Medicare |
$287.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.45
|
| Rate for Payer: BCBS MAPPO |
$276.01
|
| Rate for Payer: BCN Commercial |
$450.67
|
| Rate for Payer: BCN Medicare Advantage |
$276.01
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$397.45
|
| Rate for Payer: Cofinity Commercial |
$369.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$276.01
|
| Rate for Payer: Healthscope Commercial |
$510.62
|
| Rate for Payer: Healthscope Commercial |
$441.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$303.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$447.34
|
| Rate for Payer: Nomi Health Commercial |
$331.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.25
|
| Rate for Payer: PACE SWMI |
$276.01
|
| Rate for Payer: PHP Medicare Advantage |
$276.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$454.07
|
| Rate for Payer: Priority Health Medicare |
$276.01
|
| Rate for Payer: Priority Health SBD |
$454.07
|
| Rate for Payer: Priority Health Tiered Network |
$454.07
|
| Rate for Payer: Railroad Medicare Medicare |
$276.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$463.14
|
| Rate for Payer: UHC Core |
$463.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$276.01
|
| Rate for Payer: UHC Exchange |
$463.14
|
|
|
CHG CT CERVICAL SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 72126
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$298.60 |
| Rate for Payer: Aetna Commercial |
$211.45
|
| Rate for Payer: Aetna Medicare |
$164.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.45
|
| Rate for Payer: BCBS MAPPO |
$157.80
|
| Rate for Payer: BCN Commercial |
$255.46
|
| Rate for Payer: BCN Medicare Advantage |
$157.80
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$227.23
|
| Rate for Payer: Cofinity Commercial |
$211.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.80
|
| Rate for Payer: Healthscope Commercial |
$291.93
|
| Rate for Payer: Healthscope Commercial |
$252.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$165.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.60
|
| Rate for Payer: Nomi Health Commercial |
$189.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$157.80
|
| Rate for Payer: PHP Medicare Advantage |
$157.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.39
|
| Rate for Payer: Priority Health Medicare |
$157.80
|
| Rate for Payer: Priority Health SBD |
$257.39
|
| Rate for Payer: Priority Health Tiered Network |
$257.39
|
| Rate for Payer: Railroad Medicare Medicare |
$157.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.33
|
| Rate for Payer: UHC Core |
$276.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.80
|
| Rate for Payer: UHC Exchange |
$276.33
|
|
|
CHG CT CERVICAL SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 72125
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$229.32 |
| Rate for Payer: Aetna Commercial |
$164.27
|
| Rate for Payer: Aetna Medicare |
$127.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.53
|
| Rate for Payer: BCBS MAPPO |
$122.59
|
| Rate for Payer: BCN Commercial |
$197.20
|
| Rate for Payer: BCN Medicare Advantage |
$122.59
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$176.53
|
| Rate for Payer: Cofinity Commercial |
$164.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.59
|
| Rate for Payer: Healthscope Commercial |
$226.79
|
| Rate for Payer: Healthscope Commercial |
$196.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.32
|
| Rate for Payer: Nomi Health Commercial |
$147.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$122.59
|
| Rate for Payer: PHP Medicare Advantage |
$122.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.68
|
| Rate for Payer: Priority Health Medicare |
$122.59
|
| Rate for Payer: Priority Health SBD |
$198.68
|
| Rate for Payer: Priority Health Tiered Network |
$198.68
|
| Rate for Payer: Railroad Medicare Medicare |
$122.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.21
|
| Rate for Payer: UHC Core |
$220.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.59
|
| Rate for Payer: UHC Exchange |
$220.21
|
|
|
CHG CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 72127
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$348.98 |
| Rate for Payer: Aetna Commercial |
$245.57
|
| Rate for Payer: Aetna Medicare |
$190.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.57
|
| Rate for Payer: BCBS MAPPO |
$183.26
|
| Rate for Payer: BCN Commercial |
$297.79
|
| Rate for Payer: BCN Medicare Advantage |
$183.26
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$263.89
|
| Rate for Payer: Cofinity Commercial |
$245.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.26
|
| Rate for Payer: Healthscope Commercial |
$339.03
|
| Rate for Payer: Healthscope Commercial |
$293.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$201.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.98
|
| Rate for Payer: Nomi Health Commercial |
$219.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$183.26
|
| Rate for Payer: PHP Medicare Advantage |
$183.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$300.03
|
| Rate for Payer: Priority Health Medicare |
$183.26
|
| Rate for Payer: Priority Health SBD |
$300.03
|
| Rate for Payer: Priority Health Tiered Network |
$300.03
|
| Rate for Payer: Railroad Medicare Medicare |
$183.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$324.74
|
| Rate for Payer: UHC Core |
$324.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$183.26
|
| Rate for Payer: UHC Exchange |
$324.74
|
|
|
CHG CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 74263
|
| Min. Negotiated Rate |
$181.50 |
| Max. Negotiated Rate |
$1,423.80 |
| Rate for Payer: Aetna Commercial |
$1,031.29
|
| Rate for Payer: Aetna Medicare |
$800.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,031.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,108.25
|
| Rate for Payer: BCBS MAPPO |
$769.62
|
| Rate for Payer: BCN Commercial |
$1,077.63
|
| Rate for Payer: BCN Medicare Advantage |
$769.62
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$1,108.25
|
| Rate for Payer: Cofinity Commercial |
$1,031.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$769.62
|
| Rate for Payer: Healthscope Commercial |
$1,423.80
|
| Rate for Payer: Healthscope Commercial |
$1,231.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$808.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$846.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,155.67
|
| Rate for Payer: Nomi Health Commercial |
$923.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.50
|
| Rate for Payer: PACE SWMI |
$769.62
|
| Rate for Payer: PHP Medicare Advantage |
$769.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,085.75
|
| Rate for Payer: Priority Health Medicare |
$769.62
|
| Rate for Payer: Priority Health SBD |
$1,085.75
|
| Rate for Payer: Priority Health Tiered Network |
$1,085.75
|
| Rate for Payer: Railroad Medicare Medicare |
$769.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,050.85
|
| Rate for Payer: UHC Core |
$1,050.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$769.62
|
| Rate for Payer: UHC Exchange |
$1,050.85
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST
|
Professional
|
Both
|
$266.00
|
|
|
Service Code
|
HCPCS 74262
|
| Min. Negotiated Rate |
$199.50 |
| Max. Negotiated Rate |
$791.67 |
| Rate for Payer: Aetna Commercial |
$573.43
|
| Rate for Payer: Aetna Medicare |
$445.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.22
|
| Rate for Payer: BCBS MAPPO |
$427.93
|
| Rate for Payer: BCN Commercial |
$699.66
|
| Rate for Payer: BCN Medicare Advantage |
$427.93
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cash Price |
$212.80
|
| Rate for Payer: Cofinity Commercial |
$616.22
|
| Rate for Payer: Cofinity Commercial |
$573.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$427.93
|
| Rate for Payer: Healthscope Commercial |
$791.67
|
| Rate for Payer: Healthscope Commercial |
$684.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$470.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.75
|
| Rate for Payer: Nomi Health Commercial |
$513.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$199.50
|
| Rate for Payer: PACE SWMI |
$427.93
|
| Rate for Payer: PHP Medicare Advantage |
$427.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$704.93
|
| Rate for Payer: Priority Health Medicare |
$427.93
|
| Rate for Payer: Priority Health SBD |
$704.93
|
| Rate for Payer: Priority Health Tiered Network |
$704.93
|
| Rate for Payer: Railroad Medicare Medicare |
$427.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.97
|
| Rate for Payer: UHC Core |
$754.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$427.93
|
| Rate for Payer: UHC Exchange |
$754.97
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
Both
|
$254.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$190.50 |
| Max. Negotiated Rate |
$705.94 |
| Rate for Payer: Aetna Commercial |
$511.33
|
| Rate for Payer: Aetna Commercial |
$511.33
|
| Rate for Payer: Aetna Medicare |
$396.85
|
| Rate for Payer: Aetna Medicare |
$396.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$511.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.49
|
| Rate for Payer: BCBS MAPPO |
$381.59
|
| Rate for Payer: BCBS MAPPO |
$381.59
|
| Rate for Payer: BCN Commercial |
$622.48
|
| Rate for Payer: BCN Commercial |
$622.48
|
| Rate for Payer: BCN Medicare Advantage |
$381.59
|
| Rate for Payer: BCN Medicare Advantage |
$381.59
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cofinity Commercial |
$511.33
|
| Rate for Payer: Cofinity Commercial |
$549.49
|
| Rate for Payer: Cofinity Commercial |
$511.33
|
| Rate for Payer: Cofinity Commercial |
$549.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.59
|
| Rate for Payer: Healthscope Commercial |
$705.94
|
| Rate for Payer: Healthscope Commercial |
$705.94
|
| Rate for Payer: Healthscope Commercial |
$610.54
|
| Rate for Payer: Healthscope Commercial |
$610.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$419.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$419.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.75
|
| Rate for Payer: Nomi Health Commercial |
$457.91
|
| Rate for Payer: Nomi Health Commercial |
$457.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: PACE SWMI |
$381.59
|
| Rate for Payer: PACE SWMI |
$381.59
|
| Rate for Payer: PHP Medicare Advantage |
$381.59
|
| Rate for Payer: PHP Medicare Advantage |
$381.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$627.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$627.16
|
| Rate for Payer: Priority Health Medicare |
$381.59
|
| Rate for Payer: Priority Health Medicare |
$381.59
|
| Rate for Payer: Priority Health SBD |
$627.16
|
| Rate for Payer: Priority Health SBD |
$627.16
|
| Rate for Payer: Priority Health Tiered Network |
$627.16
|
| Rate for Payer: Priority Health Tiered Network |
$627.16
|
| Rate for Payer: Railroad Medicare Medicare |
$381.59
|
| Rate for Payer: Railroad Medicare Medicare |
$381.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.39
|
| Rate for Payer: UHC Core |
$672.39
|
| Rate for Payer: UHC Core |
$672.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$381.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$381.59
|
| Rate for Payer: UHC Exchange |
$672.39
|
| Rate for Payer: UHC Exchange |
$672.39
|
|
|
CHG CT GUIDANCE &MONITORING VISC TISS ABLATION
|
Professional
|
Both
|
$409.00
|
|
|
Service Code
|
HCPCS 77013
|
| Min. Negotiated Rate |
$204.50 |
| Max. Negotiated Rate |
$950.99 |
| Rate for Payer: Aetna Commercial |
$620.14
|
| Rate for Payer: Aetna Medicare |
$204.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.14
|
| Rate for Payer: BCN Commercial |
$269.92
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$862.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$755.61
|
| Rate for Payer: Priority Health SBD |
$755.61
|
| Rate for Payer: Priority Health Tiered Network |
$755.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$950.99
|
| Rate for Payer: UHC Core |
$950.99
|
| Rate for Payer: UHC Exchange |
$950.99
|
|
|
CHG CT GUIDANCE NEEDLE PLACEMENT
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 77012
|
| Min. Negotiated Rate |
$117.19 |
| Max. Negotiated Rate |
$244.85 |
| Rate for Payer: Aetna Commercial |
$157.03
|
| Rate for Payer: Aetna Medicare |
$121.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.75
|
| Rate for Payer: BCBS MAPPO |
$117.19
|
| Rate for Payer: BCN Commercial |
$188.23
|
| Rate for Payer: BCN Medicare Advantage |
$117.19
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$157.03
|
| Rate for Payer: Cofinity Commercial |
$168.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.19
|
| Rate for Payer: Healthscope Commercial |
$187.50
|
| Rate for Payer: Healthscope Commercial |
$216.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.85
|
| Rate for Payer: Nomi Health Commercial |
$140.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE SWMI |
$117.19
|
| Rate for Payer: PHP Medicare Advantage |
$117.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.65
|
| Rate for Payer: Priority Health Medicare |
$117.19
|
| Rate for Payer: Priority Health SBD |
$189.65
|
| Rate for Payer: Priority Health Tiered Network |
$189.65
|
| Rate for Payer: Railroad Medicare Medicare |
$117.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$216.77
|
| Rate for Payer: UHC Core |
$216.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.19
|
| Rate for Payer: UHC Exchange |
$216.77
|
|
|
CHG CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT
|
Professional
|
Both
|
$250.00
|
|
|
Service Code
|
HCPCS 77014
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$205.72 |
| Rate for Payer: Aetna Commercial |
$149.64
|
| Rate for Payer: Aetna Commercial |
$149.64
|
| Rate for Payer: Aetna Medicare |
$166.00
|
| Rate for Payer: Aetna Medicare |
$125.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.64
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
|
|
CHG CT GUIDANCE STEREOTACTIC LOCALIZATION
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 77011
|
| Min. Negotiated Rate |
$103.50 |
| Max. Negotiated Rate |
$381.45 |
| Rate for Payer: Aetna Commercial |
$276.29
|
| Rate for Payer: Aetna Commercial |
$276.29
|
| Rate for Payer: Aetna Medicare |
$214.44
|
| Rate for Payer: Aetna Medicare |
$214.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.29
|
| Rate for Payer: BCBS MAPPO |
$206.19
|
| Rate for Payer: BCBS MAPPO |
$206.19
|
| Rate for Payer: BCN Commercial |
$325.68
|
| Rate for Payer: BCN Commercial |
$325.68
|
| Rate for Payer: BCN Medicare Advantage |
$206.19
|
| Rate for Payer: BCN Medicare Advantage |
$206.19
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$276.29
|
| Rate for Payer: Cofinity Commercial |
$296.91
|
| Rate for Payer: Cofinity Commercial |
$296.91
|
| Rate for Payer: Cofinity Commercial |
$276.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.19
|
| Rate for Payer: Healthscope Commercial |
$381.45
|
| Rate for Payer: Healthscope Commercial |
$329.90
|
| Rate for Payer: Healthscope Commercial |
$329.90
|
| Rate for Payer: Healthscope Commercial |
$381.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$380.90
|
| Rate for Payer: Nomi Health Commercial |
$247.43
|
| Rate for Payer: Nomi Health Commercial |
$247.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.50
|
| Rate for Payer: PACE SWMI |
$206.19
|
| Rate for Payer: PACE SWMI |
$206.19
|
| Rate for Payer: PHP Medicare Advantage |
$206.19
|
| Rate for Payer: PHP Medicare Advantage |
$206.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$328.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$328.14
|
| Rate for Payer: Priority Health Medicare |
$206.19
|
| Rate for Payer: Priority Health Medicare |
$206.19
|
| Rate for Payer: Priority Health SBD |
$328.14
|
| Rate for Payer: Priority Health SBD |
$328.14
|
| Rate for Payer: Priority Health Tiered Network |
$328.14
|
| Rate for Payer: Priority Health Tiered Network |
$328.14
|
| Rate for Payer: Railroad Medicare Medicare |
$206.19
|
| Rate for Payer: Railroad Medicare Medicare |
$206.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.02
|
| Rate for Payer: UHC Core |
$329.02
|
| Rate for Payer: UHC Core |
$329.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.19
|
| Rate for Payer: UHC Exchange |
$329.02
|
| Rate for Payer: UHC Exchange |
$329.02
|
|
|
CHG CT HEAD/BRAIN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 70460
|
| Min. Negotiated Rate |
$90.75 |
| Max. Negotiated Rate |
$261.90 |
| Rate for Payer: Aetna Commercial |
$186.58
|
| Rate for Payer: Aetna Medicare |
$144.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.58
|
| Rate for Payer: BCBS MAPPO |
$139.24
|
| Rate for Payer: BCN Commercial |
$225.09
|
| Rate for Payer: BCN Medicare Advantage |
$139.24
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$200.51
|
| Rate for Payer: Cofinity Commercial |
$186.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.24
|
| Rate for Payer: Healthscope Commercial |
$257.59
|
| Rate for Payer: Healthscope Commercial |
$222.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$261.90
|
| Rate for Payer: Nomi Health Commercial |
$167.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$139.24
|
| Rate for Payer: PHP Medicare Advantage |
$139.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$226.79
|
| Rate for Payer: Priority Health Medicare |
$139.24
|
| Rate for Payer: Priority Health SBD |
$226.79
|
| Rate for Payer: Priority Health Tiered Network |
$226.79
|
| Rate for Payer: Railroad Medicare Medicare |
$139.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.12
|
| Rate for Payer: UHC Core |
$231.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.24
|
| Rate for Payer: UHC Exchange |
$231.12
|
|
