|
CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 70450
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$187.94 |
| Rate for Payer: Aetna Commercial |
$134.16
|
| Rate for Payer: Aetna Medicare |
$104.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.17
|
| Rate for Payer: BCBS MAPPO |
$100.12
|
| Rate for Payer: BCN Commercial |
$161.85
|
| Rate for Payer: BCN Medicare Advantage |
$100.12
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$144.17
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.12
|
| Rate for Payer: Healthscope Commercial |
$185.22
|
| Rate for Payer: Healthscope Commercial |
$160.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$187.94
|
| Rate for Payer: Nomi Health Commercial |
$120.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.25
|
| Rate for Payer: PACE SWMI |
$100.12
|
| Rate for Payer: PHP Medicare Advantage |
$100.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$163.07
|
| Rate for Payer: Priority Health Medicare |
$100.12
|
| Rate for Payer: Priority Health SBD |
$163.07
|
| Rate for Payer: Priority Health Tiered Network |
$163.07
|
| Rate for Payer: Railroad Medicare Medicare |
$100.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.95
|
| Rate for Payer: UHC Core |
$163.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.12
|
| Rate for Payer: UHC Exchange |
$163.95
|
|
|
CHG CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 70470
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$307.87 |
| Rate for Payer: Aetna Commercial |
$217.37
|
| Rate for Payer: Aetna Medicare |
$168.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$217.37
|
| Rate for Payer: BCBS MAPPO |
$162.22
|
| Rate for Payer: BCN Commercial |
$262.93
|
| Rate for Payer: BCN Medicare Advantage |
$162.22
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$217.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.22
|
| Rate for Payer: Healthscope Commercial |
$300.11
|
| Rate for Payer: Healthscope Commercial |
$259.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$307.87
|
| Rate for Payer: Nomi Health Commercial |
$194.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$162.22
|
| Rate for Payer: PHP Medicare Advantage |
$162.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$264.91
|
| Rate for Payer: Priority Health Medicare |
$162.22
|
| Rate for Payer: Priority Health SBD |
$264.91
|
| Rate for Payer: Priority Health Tiered Network |
$264.91
|
| Rate for Payer: Railroad Medicare Medicare |
$162.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.66
|
| Rate for Payer: UHC Core |
$270.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.22
|
| Rate for Payer: UHC Exchange |
$270.66
|
|
|
CHG CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 75572
|
| Min. Negotiated Rate |
$138.00 |
| Max. Negotiated Rate |
$401.35 |
| Rate for Payer: Aetna Commercial |
$288.35
|
| Rate for Payer: Aetna Medicare |
$223.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$288.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$309.87
|
| Rate for Payer: BCBS MAPPO |
$215.19
|
| Rate for Payer: BCN Commercial |
$345.59
|
| Rate for Payer: BCN Medicare Advantage |
$215.19
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$309.87
|
| Rate for Payer: Cofinity Commercial |
$288.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.19
|
| Rate for Payer: Healthscope Commercial |
$398.10
|
| Rate for Payer: Healthscope Commercial |
$344.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.35
|
| Rate for Payer: Nomi Health Commercial |
$258.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.00
|
| Rate for Payer: PACE SWMI |
$215.19
|
| Rate for Payer: PHP Medicare Advantage |
$215.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$348.19
|
| Rate for Payer: Priority Health Medicare |
$215.19
|
| Rate for Payer: Priority Health SBD |
$348.19
|
| Rate for Payer: Priority Health Tiered Network |
$348.19
|
| Rate for Payer: Railroad Medicare Medicare |
$215.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.13
|
| Rate for Payer: UHC Core |
$353.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.19
|
| Rate for Payer: UHC Exchange |
$353.13
|
|
|
CHG CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 75571
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$175.36 |
| Rate for Payer: Aetna Commercial |
$124.47
|
| Rate for Payer: Aetna Medicare |
$96.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.47
|
| Rate for Payer: BCBS MAPPO |
$92.89
|
| Rate for Payer: BCN Commercial |
$152.39
|
| Rate for Payer: BCN Medicare Advantage |
$92.89
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$133.76
|
| Rate for Payer: Cofinity Commercial |
$124.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.89
|
| Rate for Payer: Healthscope Commercial |
$171.85
|
| Rate for Payer: Healthscope Commercial |
$148.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.36
|
| Rate for Payer: Nomi Health Commercial |
$111.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$92.89
|
| Rate for Payer: PHP Medicare Advantage |
$92.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$153.53
|
| Rate for Payer: Priority Health Medicare |
$92.89
|
| Rate for Payer: Priority Health SBD |
$153.53
|
| Rate for Payer: Priority Health Tiered Network |
$153.53
|
| Rate for Payer: Railroad Medicare Medicare |
$92.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.89
|
| Rate for Payer: UHC Core |
$147.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$92.89
|
| Rate for Payer: UHC Exchange |
$147.89
|
|
|
CHG CT LIMITED/LOCALIZED FOLLOW UP STUDY
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 76380
|
| Min. Negotiated Rate |
$118.50 |
| Max. Negotiated Rate |
$229.64 |
| Rate for Payer: Aetna Commercial |
$166.33
|
| Rate for Payer: Aetna Medicare |
$129.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.75
|
| Rate for Payer: BCBS MAPPO |
$124.13
|
| Rate for Payer: BCN Commercial |
$198.19
|
| Rate for Payer: BCN Medicare Advantage |
$124.13
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$178.75
|
| Rate for Payer: Cofinity Commercial |
$166.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.13
|
| Rate for Payer: Healthscope Commercial |
$229.64
|
| Rate for Payer: Healthscope Commercial |
$198.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.29
|
| Rate for Payer: Nomi Health Commercial |
$148.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$124.13
|
| Rate for Payer: PHP Medicare Advantage |
$124.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$199.69
|
| Rate for Payer: Priority Health Medicare |
$124.13
|
| Rate for Payer: Priority Health SBD |
$199.69
|
| Rate for Payer: Priority Health Tiered Network |
$199.69
|
| Rate for Payer: Railroad Medicare Medicare |
$124.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.87
|
| Rate for Payer: UHC Core |
$204.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.13
|
| Rate for Payer: UHC Exchange |
$204.87
|
|
|
CHG CT LOWER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 73701
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$294.95 |
| Rate for Payer: Aetna Commercial |
$208.36
|
| Rate for Payer: Aetna Medicare |
$161.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.36
|
| Rate for Payer: BCBS MAPPO |
$155.49
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: BCN Medicare Advantage |
$155.49
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$223.91
|
| Rate for Payer: Cofinity Commercial |
$208.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.49
|
| Rate for Payer: Healthscope Commercial |
$287.66
|
| Rate for Payer: Healthscope Commercial |
$248.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.95
|
| Rate for Payer: Nomi Health Commercial |
$186.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: PACE SWMI |
$155.49
|
| Rate for Payer: PHP Medicare Advantage |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$254.38
|
| Rate for Payer: Priority Health Medicare |
$155.49
|
| Rate for Payer: Priority Health SBD |
$254.38
|
| Rate for Payer: Priority Health Tiered Network |
$254.38
|
| Rate for Payer: Railroad Medicare Medicare |
$155.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.54
|
| Rate for Payer: UHC Core |
$273.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.49
|
| Rate for Payer: UHC Exchange |
$273.54
|
|
|
CHG CT LOWER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 73700
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$228.76 |
| Rate for Payer: Aetna Commercial |
$163.86
|
| Rate for Payer: Aetna Medicare |
$127.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.08
|
| Rate for Payer: BCBS MAPPO |
$122.28
|
| Rate for Payer: BCN Commercial |
$196.71
|
| Rate for Payer: BCN Medicare Advantage |
$122.28
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$176.08
|
| Rate for Payer: Cofinity Commercial |
$163.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.28
|
| Rate for Payer: Healthscope Commercial |
$226.22
|
| Rate for Payer: Healthscope Commercial |
$195.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.76
|
| Rate for Payer: Nomi Health Commercial |
$146.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$122.28
|
| Rate for Payer: PHP Medicare Advantage |
$122.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.19
|
| Rate for Payer: Priority Health Medicare |
$122.28
|
| Rate for Payer: Priority Health SBD |
$198.19
|
| Rate for Payer: Priority Health Tiered Network |
$198.19
|
| Rate for Payer: Railroad Medicare Medicare |
$122.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.23
|
| Rate for Payer: UHC Core |
$219.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.28
|
| Rate for Payer: UHC Exchange |
$219.23
|
|
|
CHG CT LOWER EXTREMITY W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 73702
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$344.74 |
| Rate for Payer: Aetna Commercial |
$243.73
|
| Rate for Payer: Aetna Medicare |
$189.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.73
|
| Rate for Payer: BCBS MAPPO |
$181.89
|
| Rate for Payer: BCN Commercial |
$295.80
|
| Rate for Payer: BCN Medicare Advantage |
$181.89
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Cofinity Commercial |
$243.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.89
|
| Rate for Payer: Healthscope Commercial |
$336.50
|
| Rate for Payer: Healthscope Commercial |
$291.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$344.74
|
| Rate for Payer: Nomi Health Commercial |
$218.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$181.89
|
| Rate for Payer: PHP Medicare Advantage |
$181.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$298.03
|
| Rate for Payer: Priority Health Medicare |
$181.89
|
| Rate for Payer: Priority Health SBD |
$298.03
|
| Rate for Payer: Priority Health Tiered Network |
$298.03
|
| Rate for Payer: Railroad Medicare Medicare |
$181.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.44
|
| Rate for Payer: UHC Core |
$328.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.89
|
| Rate for Payer: UHC Exchange |
$328.44
|
|
|
CHG CT LUMBAR SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 72132
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$299.16 |
| Rate for Payer: Aetna Commercial |
$211.87
|
| Rate for Payer: Aetna Medicare |
$164.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.68
|
| Rate for Payer: BCBS MAPPO |
$158.11
|
| Rate for Payer: BCN Commercial |
$256.46
|
| Rate for Payer: BCN Medicare Advantage |
$158.11
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$227.68
|
| Rate for Payer: Cofinity Commercial |
$211.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.11
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Healthscope Commercial |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$299.16
|
| Rate for Payer: Nomi Health Commercial |
$189.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$158.11
|
| Rate for Payer: PHP Medicare Advantage |
$158.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$258.38
|
| Rate for Payer: Priority Health Medicare |
$158.11
|
| Rate for Payer: Priority Health SBD |
$258.38
|
| Rate for Payer: Priority Health Tiered Network |
$258.38
|
| Rate for Payer: Railroad Medicare Medicare |
$158.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$276.82
|
| Rate for Payer: UHC Core |
$276.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.11
|
| Rate for Payer: UHC Exchange |
$276.82
|
|
|
CHG CT LUMBAR SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 72131
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$228.20 |
| Rate for Payer: Aetna Commercial |
$163.45
|
| Rate for Payer: Aetna Medicare |
$126.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.45
|
| Rate for Payer: BCBS MAPPO |
$121.98
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$121.98
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$175.65
|
| Rate for Payer: Cofinity Commercial |
$163.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.98
|
| Rate for Payer: Healthscope Commercial |
$225.66
|
| Rate for Payer: Healthscope Commercial |
$195.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.20
|
| Rate for Payer: Nomi Health Commercial |
$146.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$121.98
|
| Rate for Payer: PHP Medicare Advantage |
$121.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$197.69
|
| Rate for Payer: Priority Health Medicare |
$121.98
|
| Rate for Payer: Priority Health SBD |
$197.69
|
| Rate for Payer: Priority Health Tiered Network |
$197.69
|
| Rate for Payer: Railroad Medicare Medicare |
$121.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.23
|
| Rate for Payer: UHC Core |
$219.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.98
|
| Rate for Payer: UHC Exchange |
$219.23
|
|
|
CHG CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 72133
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$350.10 |
| Rate for Payer: Aetna Commercial |
$246.39
|
| Rate for Payer: Aetna Medicare |
$191.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.77
|
| Rate for Payer: BCBS MAPPO |
$183.87
|
| Rate for Payer: BCN Commercial |
$298.29
|
| Rate for Payer: BCN Medicare Advantage |
$183.87
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$264.77
|
| Rate for Payer: Cofinity Commercial |
$246.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.87
|
| Rate for Payer: Healthscope Commercial |
$340.16
|
| Rate for Payer: Healthscope Commercial |
$294.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.10
|
| Rate for Payer: Nomi Health Commercial |
$220.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$183.87
|
| Rate for Payer: PHP Medicare Advantage |
$183.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$300.54
|
| Rate for Payer: Priority Health Medicare |
$183.87
|
| Rate for Payer: Priority Health SBD |
$300.54
|
| Rate for Payer: Priority Health Tiered Network |
$300.54
|
| Rate for Payer: Railroad Medicare Medicare |
$183.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$323.26
|
| Rate for Payer: UHC Core |
$323.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$183.87
|
| Rate for Payer: UHC Exchange |
$323.26
|
|
|
CHG CT MAXILLOFACIAL W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 70487
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$269.12 |
| Rate for Payer: Aetna Commercial |
$190.67
|
| Rate for Payer: Aetna Medicare |
$147.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.67
|
| Rate for Payer: BCBS MAPPO |
$142.29
|
| Rate for Payer: BCN Commercial |
$230.56
|
| Rate for Payer: BCN Medicare Advantage |
$142.29
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$204.90
|
| Rate for Payer: Cofinity Commercial |
$190.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.29
|
| Rate for Payer: Healthscope Commercial |
$263.24
|
| Rate for Payer: Healthscope Commercial |
$227.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.12
|
| Rate for Payer: Nomi Health Commercial |
$170.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$142.29
|
| Rate for Payer: PHP Medicare Advantage |
$142.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$232.29
|
| Rate for Payer: Priority Health Medicare |
$142.29
|
| Rate for Payer: Priority Health SBD |
$232.29
|
| Rate for Payer: Priority Health Tiered Network |
$232.29
|
| Rate for Payer: Railroad Medicare Medicare |
$142.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.53
|
| Rate for Payer: UHC Core |
$236.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.29
|
| Rate for Payer: UHC Exchange |
$236.53
|
|
|
CHG CT MAXILLOFACIAL W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 70486
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$226.28 |
| Rate for Payer: Aetna Commercial |
$160.73
|
| Rate for Payer: Aetna Medicare |
$124.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.73
|
| Rate for Payer: BCBS MAPPO |
$119.95
|
| Rate for Payer: BCN Commercial |
$194.21
|
| Rate for Payer: BCN Medicare Advantage |
$119.95
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$172.73
|
| Rate for Payer: Cofinity Commercial |
$160.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.95
|
| Rate for Payer: Healthscope Commercial |
$221.91
|
| Rate for Payer: Healthscope Commercial |
$191.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$226.28
|
| Rate for Payer: Nomi Health Commercial |
$143.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.25
|
| Rate for Payer: PACE SWMI |
$119.95
|
| Rate for Payer: PHP Medicare Advantage |
$119.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$195.67
|
| Rate for Payer: Priority Health Medicare |
$119.95
|
| Rate for Payer: Priority Health SBD |
$195.67
|
| Rate for Payer: Priority Health Tiered Network |
$195.67
|
| Rate for Payer: Railroad Medicare Medicare |
$119.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.91
|
| Rate for Payer: UHC Core |
$196.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.95
|
| Rate for Payer: UHC Exchange |
$196.91
|
|
|
CHG CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 70488
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$327.31 |
| Rate for Payer: Aetna Commercial |
$230.86
|
| Rate for Payer: Aetna Medicare |
$179.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.86
|
| Rate for Payer: BCBS MAPPO |
$172.28
|
| Rate for Payer: BCN Commercial |
$278.87
|
| Rate for Payer: BCN Medicare Advantage |
$172.28
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$248.08
|
| Rate for Payer: Cofinity Commercial |
$230.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.28
|
| Rate for Payer: Healthscope Commercial |
$318.72
|
| Rate for Payer: Healthscope Commercial |
$275.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.31
|
| Rate for Payer: Nomi Health Commercial |
$206.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$172.28
|
| Rate for Payer: PHP Medicare Advantage |
$172.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.97
|
| Rate for Payer: Priority Health Medicare |
$172.28
|
| Rate for Payer: Priority Health SBD |
$280.97
|
| Rate for Payer: Priority Health Tiered Network |
$280.97
|
| Rate for Payer: Railroad Medicare Medicare |
$172.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$287.85
|
| Rate for Payer: UHC Core |
$287.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.28
|
| Rate for Payer: UHC Exchange |
$287.85
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 70481
|
| Min. Negotiated Rate |
$90.75 |
| Max. Negotiated Rate |
$319.23 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare |
$174.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.79
|
| Rate for Payer: BCBS MAPPO |
$167.91
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$167.91
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$241.79
|
| Rate for Payer: Cofinity Commercial |
$225.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.91
|
| Rate for Payer: Healthscope Commercial |
$310.63
|
| Rate for Payer: Healthscope Commercial |
$268.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.23
|
| Rate for Payer: Nomi Health Commercial |
$201.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$167.91
|
| Rate for Payer: PHP Medicare Advantage |
$167.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$275.45
|
| Rate for Payer: Priority Health Medicare |
$167.91
|
| Rate for Payer: Priority Health SBD |
$275.45
|
| Rate for Payer: Priority Health Tiered Network |
$275.45
|
| Rate for Payer: Railroad Medicare Medicare |
$167.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.72
|
| Rate for Payer: UHC Core |
$314.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.91
|
| Rate for Payer: UHC Exchange |
$314.72
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 70480
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$283.48 |
| Rate for Payer: Aetna Commercial |
$199.43
|
| Rate for Payer: Aetna Medicare |
$154.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.43
|
| Rate for Payer: BCBS MAPPO |
$148.83
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: BCN Medicare Advantage |
$148.83
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$214.32
|
| Rate for Payer: Cofinity Commercial |
$199.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.83
|
| Rate for Payer: Healthscope Commercial |
$275.34
|
| Rate for Payer: Healthscope Commercial |
$238.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.14
|
| Rate for Payer: Nomi Health Commercial |
$178.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$148.83
|
| Rate for Payer: PHP Medicare Advantage |
$148.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$242.84
|
| Rate for Payer: Priority Health Medicare |
$148.83
|
| Rate for Payer: Priority Health SBD |
$242.84
|
| Rate for Payer: Priority Health Tiered Network |
$242.84
|
| Rate for Payer: Railroad Medicare Medicare |
$148.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.48
|
| Rate for Payer: UHC Core |
$283.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$148.83
|
| Rate for Payer: UHC Exchange |
$283.48
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 70482
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$372.33 |
| Rate for Payer: Aetna Commercial |
$261.50
|
| Rate for Payer: Aetna Medicare |
$202.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.02
|
| Rate for Payer: BCBS MAPPO |
$195.15
|
| Rate for Payer: BCN Commercial |
$318.21
|
| Rate for Payer: BCN Medicare Advantage |
$195.15
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$281.02
|
| Rate for Payer: Cofinity Commercial |
$261.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.15
|
| Rate for Payer: Healthscope Commercial |
$361.03
|
| Rate for Payer: Healthscope Commercial |
$312.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$214.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.33
|
| Rate for Payer: Nomi Health Commercial |
$234.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$195.15
|
| Rate for Payer: PHP Medicare Advantage |
$195.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$320.60
|
| Rate for Payer: Priority Health Medicare |
$195.15
|
| Rate for Payer: Priority Health SBD |
$320.60
|
| Rate for Payer: Priority Health Tiered Network |
$320.60
|
| Rate for Payer: Railroad Medicare Medicare |
$195.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.87
|
| Rate for Payer: UHC Core |
$348.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$195.15
|
| Rate for Payer: UHC Exchange |
$348.87
|
|
|
CHG CT PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 72193
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$393.86 |
| Rate for Payer: Aetna Commercial |
$281.51
|
| Rate for Payer: Aetna Medicare |
$218.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.51
|
| Rate for Payer: BCBS MAPPO |
$210.08
|
| Rate for Payer: BCN Commercial |
$343.60
|
| Rate for Payer: BCN Medicare Advantage |
$210.08
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$302.52
|
| Rate for Payer: Cofinity Commercial |
$281.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.08
|
| Rate for Payer: Healthscope Commercial |
$388.65
|
| Rate for Payer: Healthscope Commercial |
$336.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.86
|
| Rate for Payer: Nomi Health Commercial |
$252.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: PACE SWMI |
$210.08
|
| Rate for Payer: PHP Medicare Advantage |
$210.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$346.19
|
| Rate for Payer: Priority Health Medicare |
$210.08
|
| Rate for Payer: Priority Health SBD |
$346.19
|
| Rate for Payer: Priority Health Tiered Network |
$346.19
|
| Rate for Payer: Railroad Medicare Medicare |
$210.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$340.42
|
| Rate for Payer: UHC Core |
$340.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$210.08
|
| Rate for Payer: UHC Exchange |
$340.42
|
|
|
CHG CT PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 72192
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$236.12 |
| Rate for Payer: Aetna Commercial |
$167.03
|
| Rate for Payer: Aetna Medicare |
$129.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.50
|
| Rate for Payer: BCBS MAPPO |
$124.65
|
| Rate for Payer: BCN Commercial |
$201.68
|
| Rate for Payer: BCN Medicare Advantage |
$124.65
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$179.50
|
| Rate for Payer: Cofinity Commercial |
$167.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.65
|
| Rate for Payer: Healthscope Commercial |
$230.60
|
| Rate for Payer: Healthscope Commercial |
$199.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.12
|
| Rate for Payer: Nomi Health Commercial |
$149.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: PACE SWMI |
$124.65
|
| Rate for Payer: PHP Medicare Advantage |
$124.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$203.20
|
| Rate for Payer: Priority Health Medicare |
$124.65
|
| Rate for Payer: Priority Health SBD |
$203.20
|
| Rate for Payer: Priority Health Tiered Network |
$203.20
|
| Rate for Payer: Railroad Medicare Medicare |
$124.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$206.36
|
| Rate for Payer: UHC Core |
$206.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.65
|
| Rate for Payer: UHC Exchange |
$206.36
|
|
|
CHG CT PELVIS W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 72194
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$430.72 |
| Rate for Payer: Aetna Commercial |
$311.98
|
| Rate for Payer: Aetna Medicare |
$242.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$335.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$311.98
|
| Rate for Payer: BCBS MAPPO |
$232.82
|
| Rate for Payer: BCN Commercial |
$379.46
|
| Rate for Payer: BCN Medicare Advantage |
$232.82
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$335.26
|
| Rate for Payer: Cofinity Commercial |
$311.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$232.82
|
| Rate for Payer: Healthscope Commercial |
$430.72
|
| Rate for Payer: Healthscope Commercial |
$372.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$244.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$256.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.19
|
| Rate for Payer: Nomi Health Commercial |
$279.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$232.82
|
| Rate for Payer: PHP Medicare Advantage |
$232.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$382.32
|
| Rate for Payer: Priority Health Medicare |
$232.82
|
| Rate for Payer: Priority Health SBD |
$382.32
|
| Rate for Payer: Priority Health Tiered Network |
$382.32
|
| Rate for Payer: Railroad Medicare Medicare |
$232.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.57
|
| Rate for Payer: UHC Core |
$382.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$232.82
|
| Rate for Payer: UHC Exchange |
$382.57
|
|
|
CHG CT SOFT TISSUE NECK W/CONTRAST MATERIAL
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 70491
|
| Min. Negotiated Rate |
$110.25 |
| Max. Negotiated Rate |
$327.37 |
| Rate for Payer: Aetna Commercial |
$230.47
|
| Rate for Payer: Aetna Medicare |
$178.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$247.67
|
| Rate for Payer: BCBS MAPPO |
$171.99
|
| Rate for Payer: BCN Commercial |
$278.87
|
| Rate for Payer: BCN Medicare Advantage |
$171.99
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$247.67
|
| Rate for Payer: Cofinity Commercial |
$230.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$171.99
|
| Rate for Payer: Healthscope Commercial |
$318.18
|
| Rate for Payer: Healthscope Commercial |
$275.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.37
|
| Rate for Payer: Nomi Health Commercial |
$206.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.25
|
| Rate for Payer: PACE SWMI |
$171.99
|
| Rate for Payer: PHP Medicare Advantage |
$171.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.97
|
| Rate for Payer: Priority Health Medicare |
$171.99
|
| Rate for Payer: Priority Health SBD |
$280.97
|
| Rate for Payer: Priority Health Tiered Network |
$280.97
|
| Rate for Payer: Railroad Medicare Medicare |
$171.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.89
|
| Rate for Payer: UHC Core |
$286.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$171.99
|
| Rate for Payer: UHC Exchange |
$286.89
|
|
|
CHG CT SOFT TISSUE NECK W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 70490
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$266.71 |
| Rate for Payer: Aetna Commercial |
$188.71
|
| Rate for Payer: Aetna Medicare |
$146.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.71
|
| Rate for Payer: BCBS MAPPO |
$140.83
|
| Rate for Payer: BCN Commercial |
$227.58
|
| Rate for Payer: BCN Medicare Advantage |
$140.83
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$202.80
|
| Rate for Payer: Cofinity Commercial |
$188.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.83
|
| Rate for Payer: Healthscope Commercial |
$260.54
|
| Rate for Payer: Healthscope Commercial |
$225.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$266.71
|
| Rate for Payer: Nomi Health Commercial |
$169.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$140.83
|
| Rate for Payer: PHP Medicare Advantage |
$140.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$229.29
|
| Rate for Payer: Priority Health Medicare |
$140.83
|
| Rate for Payer: Priority Health SBD |
$229.29
|
| Rate for Payer: Priority Health Tiered Network |
$229.29
|
| Rate for Payer: Railroad Medicare Medicare |
$140.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.82
|
| Rate for Payer: UHC Core |
$233.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.83
|
| Rate for Payer: UHC Exchange |
$233.82
|
|
|
CHG CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$171.00
|
|
|
Service Code
|
HCPCS 70492
|
| Min. Negotiated Rate |
$128.25 |
| Max. Negotiated Rate |
$393.23 |
| Rate for Payer: Aetna Commercial |
$276.00
|
| Rate for Payer: Aetna Medicare |
$214.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$276.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.60
|
| Rate for Payer: BCBS MAPPO |
$205.97
|
| Rate for Payer: BCN Commercial |
$334.65
|
| Rate for Payer: BCN Medicare Advantage |
$205.97
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cofinity Commercial |
$296.60
|
| Rate for Payer: Cofinity Commercial |
$276.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$205.97
|
| Rate for Payer: Healthscope Commercial |
$381.04
|
| Rate for Payer: Healthscope Commercial |
$329.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.23
|
| Rate for Payer: Nomi Health Commercial |
$247.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.25
|
| Rate for Payer: PACE SWMI |
$205.97
|
| Rate for Payer: PHP Medicare Advantage |
$205.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$337.17
|
| Rate for Payer: Priority Health Medicare |
$205.97
|
| Rate for Payer: Priority Health SBD |
$337.17
|
| Rate for Payer: Priority Health Tiered Network |
$337.17
|
| Rate for Payer: Railroad Medicare Medicare |
$205.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.62
|
| Rate for Payer: UHC Core |
$346.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$205.97
|
| Rate for Payer: UHC Exchange |
$346.62
|
|
|
CHG CT THORACIC SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 72129
|
| Min. Negotiated Rate |
$97.50 |
| Max. Negotiated Rate |
$300.92 |
| Rate for Payer: Aetna Commercial |
$212.68
|
| Rate for Payer: Aetna Medicare |
$165.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.68
|
| Rate for Payer: BCBS MAPPO |
$158.72
|
| Rate for Payer: BCN Commercial |
$257.96
|
| Rate for Payer: BCN Medicare Advantage |
$158.72
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$228.56
|
| Rate for Payer: Cofinity Commercial |
$212.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.72
|
| Rate for Payer: Healthscope Commercial |
$293.63
|
| Rate for Payer: Healthscope Commercial |
$253.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$300.92
|
| Rate for Payer: Nomi Health Commercial |
$190.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: PACE SWMI |
$158.72
|
| Rate for Payer: PHP Medicare Advantage |
$158.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$259.89
|
| Rate for Payer: Priority Health Medicare |
$158.72
|
| Rate for Payer: Priority Health SBD |
$259.89
|
| Rate for Payer: Priority Health Tiered Network |
$259.89
|
| Rate for Payer: Railroad Medicare Medicare |
$158.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$278.29
|
| Rate for Payer: UHC Core |
$278.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.72
|
| Rate for Payer: UHC Exchange |
$278.29
|
|
|
CHG CT THORACIC SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 72128
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$229.32 |
| Rate for Payer: Aetna Commercial |
$163.86
|
| Rate for Payer: Aetna Medicare |
$127.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.08
|
| Rate for Payer: BCBS MAPPO |
$122.28
|
| Rate for Payer: BCN Commercial |
$196.71
|
| Rate for Payer: BCN Medicare Advantage |
$122.28
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$176.08
|
| Rate for Payer: Cofinity Commercial |
$163.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.28
|
| Rate for Payer: Healthscope Commercial |
$226.22
|
| Rate for Payer: Healthscope Commercial |
$195.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.32
|
| Rate for Payer: Nomi Health Commercial |
$146.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$122.28
|
| Rate for Payer: PHP Medicare Advantage |
$122.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$198.19
|
| Rate for Payer: Priority Health Medicare |
$122.28
|
| Rate for Payer: Priority Health SBD |
$198.19
|
| Rate for Payer: Priority Health Tiered Network |
$198.19
|
| Rate for Payer: Railroad Medicare Medicare |
$122.28
|
| 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 |
$122.28
|
| Rate for Payer: UHC Exchange |
$220.21
|
|
