|
CHG REPAIR,ILIAC ANRYSM/PSEUDO/AV MALF/TRAUMA W/ ENDOPROSTHESIS
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 75954
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$170.25 |
| Rate for Payer: Aetna Medicare |
$113.50
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
Both
|
$637.00
|
|
|
Service Code
|
HCPCS 77293
|
| Min. Negotiated Rate |
$373.24 |
| Max. Negotiated Rate |
$698.89 |
| Rate for Payer: Aetna Commercial |
$500.14
|
| Rate for Payer: Aetna Commercial |
$500.14
|
| Rate for Payer: Aetna Medicare |
$388.17
|
| Rate for Payer: Aetna Medicare |
$388.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$537.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$500.14
|
| Rate for Payer: BCBS MAPPO |
$373.24
|
| Rate for Payer: BCBS MAPPO |
$373.24
|
| Rate for Payer: BCN Commercial |
$601.56
|
| Rate for Payer: BCN Commercial |
$601.56
|
| Rate for Payer: BCN Medicare Advantage |
$373.24
|
| Rate for Payer: BCN Medicare Advantage |
$373.24
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cash Price |
$680.80
|
| Rate for Payer: Cash Price |
$509.60
|
| Rate for Payer: Cofinity Commercial |
$500.14
|
| Rate for Payer: Cofinity Commercial |
$500.14
|
| Rate for Payer: Cofinity Commercial |
$537.47
|
| Rate for Payer: Cofinity Commercial |
$537.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$373.24
|
| Rate for Payer: Healthscope Commercial |
$597.18
|
| Rate for Payer: Healthscope Commercial |
$690.49
|
| Rate for Payer: Healthscope Commercial |
$597.18
|
| Rate for Payer: Healthscope Commercial |
$690.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$391.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$410.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.89
|
| Rate for Payer: Nomi Health Commercial |
$447.89
|
| Rate for Payer: Nomi Health Commercial |
$447.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$638.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.75
|
| Rate for Payer: PACE SWMI |
$373.24
|
| Rate for Payer: PACE SWMI |
$373.24
|
| Rate for Payer: PHP Medicare Advantage |
$373.24
|
| Rate for Payer: PHP Medicare Advantage |
$373.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$606.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$606.10
|
| Rate for Payer: Priority Health Medicare |
$373.24
|
| Rate for Payer: Priority Health Medicare |
$373.24
|
| Rate for Payer: Priority Health SBD |
$606.10
|
| Rate for Payer: Priority Health SBD |
$606.10
|
| Rate for Payer: Priority Health Tiered Network |
$606.10
|
| Rate for Payer: Priority Health Tiered Network |
$606.10
|
| Rate for Payer: Railroad Medicare Medicare |
$373.24
|
| Rate for Payer: Railroad Medicare Medicare |
$373.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.57
|
| Rate for Payer: UHC Core |
$637.57
|
| Rate for Payer: UHC Core |
$637.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$373.24
|
| Rate for Payer: UHC Exchange |
$637.57
|
| Rate for Payer: UHC Exchange |
$637.57
|
|
|
CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 78803
|
| Min. Negotiated Rate |
$67.50 |
| Max. Negotiated Rate |
$597.42 |
| Rate for Payer: Aetna Commercial |
$415.78
|
| Rate for Payer: Aetna Commercial |
$415.78
|
| Rate for Payer: Aetna Commercial |
$415.78
|
| Rate for Payer: Aetna Medicare |
$322.69
|
| Rate for Payer: Aetna Medicare |
$322.69
|
| Rate for Payer: Aetna Medicare |
$322.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.78
|
| Rate for Payer: BCBS MAPPO |
$310.28
|
| Rate for Payer: BCBS MAPPO |
$310.28
|
| Rate for Payer: BCBS MAPPO |
$310.28
|
| Rate for Payer: BCN Commercial |
$504.96
|
| Rate for Payer: BCN Commercial |
$504.96
|
| Rate for Payer: BCN Commercial |
$504.96
|
| Rate for Payer: BCN Medicare Advantage |
$310.28
|
| Rate for Payer: BCN Medicare Advantage |
$310.28
|
| Rate for Payer: BCN Medicare Advantage |
$310.28
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$504.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$415.78
|
| Rate for Payer: Cofinity Commercial |
$446.80
|
| Rate for Payer: Cofinity Commercial |
$446.80
|
| Rate for Payer: Cofinity Commercial |
$415.78
|
| Rate for Payer: Cofinity Commercial |
$415.78
|
| Rate for Payer: Cofinity Commercial |
$446.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.28
|
| Rate for Payer: Healthscope Commercial |
$574.02
|
| Rate for Payer: Healthscope Commercial |
$574.02
|
| Rate for Payer: Healthscope Commercial |
$496.45
|
| Rate for Payer: Healthscope Commercial |
$496.45
|
| Rate for Payer: Healthscope Commercial |
$574.02
|
| Rate for Payer: Healthscope Commercial |
$496.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$341.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$597.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$597.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$597.42
|
| Rate for Payer: Nomi Health Commercial |
$372.34
|
| Rate for Payer: Nomi Health Commercial |
$372.34
|
| Rate for Payer: Nomi Health Commercial |
$372.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$472.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$540.00
|
| Rate for Payer: PACE SWMI |
$310.28
|
| Rate for Payer: PACE SWMI |
$310.28
|
| Rate for Payer: PACE SWMI |
$310.28
|
| Rate for Payer: PHP Medicare Advantage |
$310.28
|
| Rate for Payer: PHP Medicare Advantage |
$310.28
|
| Rate for Payer: PHP Medicare Advantage |
$310.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$508.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$508.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$508.75
|
| Rate for Payer: Priority Health Medicare |
$310.28
|
| Rate for Payer: Priority Health Medicare |
$310.28
|
| Rate for Payer: Priority Health Medicare |
$310.28
|
| Rate for Payer: Priority Health SBD |
$508.75
|
| Rate for Payer: Priority Health SBD |
$508.75
|
| Rate for Payer: Priority Health SBD |
$508.75
|
| Rate for Payer: Priority Health Tiered Network |
$508.75
|
| Rate for Payer: Priority Health Tiered Network |
$508.75
|
| Rate for Payer: Priority Health Tiered Network |
$508.75
|
| Rate for Payer: Railroad Medicare Medicare |
$310.28
|
| Rate for Payer: Railroad Medicare Medicare |
$310.28
|
| Rate for Payer: Railroad Medicare Medicare |
$310.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.20
|
| Rate for Payer: UHC Core |
$552.20
|
| Rate for Payer: UHC Core |
$552.20
|
| Rate for Payer: UHC Core |
$552.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$310.28
|
| Rate for Payer: UHC Exchange |
$552.20
|
| Rate for Payer: UHC Exchange |
$552.20
|
| Rate for Payer: UHC Exchange |
$552.20
|
|
|
CHG RP THERAPY INTRAVENOUS ADMINISTRATION
|
Professional
|
Both
|
$543.00
|
|
|
Service Code
|
HCPCS 79101
|
| Min. Negotiated Rate |
$136.72 |
| Max. Negotiated Rate |
$407.25 |
| Rate for Payer: Aetna Commercial |
$183.20
|
| Rate for Payer: Aetna Commercial |
$183.20
|
| Rate for Payer: Aetna Medicare |
$142.19
|
| Rate for Payer: Aetna Medicare |
$142.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.20
|
| Rate for Payer: BCBS MAPPO |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$136.72
|
| Rate for Payer: BCN Commercial |
$217.12
|
| Rate for Payer: BCN Commercial |
$217.12
|
| Rate for Payer: BCN Medicare Advantage |
$136.72
|
| Rate for Payer: BCN Medicare Advantage |
$136.72
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cash Price |
$434.40
|
| Rate for Payer: Cofinity Commercial |
$196.88
|
| Rate for Payer: Cofinity Commercial |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$183.20
|
| Rate for Payer: Cofinity Commercial |
$196.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.72
|
| Rate for Payer: Healthscope Commercial |
$252.93
|
| Rate for Payer: Healthscope Commercial |
$252.93
|
| Rate for Payer: Healthscope Commercial |
$218.75
|
| Rate for Payer: Healthscope Commercial |
$218.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.93
|
| Rate for Payer: Nomi Health Commercial |
$164.06
|
| Rate for Payer: Nomi Health Commercial |
$164.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$407.25
|
| Rate for Payer: PACE SWMI |
$136.72
|
| Rate for Payer: PACE SWMI |
$136.72
|
| Rate for Payer: PHP Medicare Advantage |
$136.72
|
| Rate for Payer: PHP Medicare Advantage |
$136.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$218.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$218.75
|
| Rate for Payer: Priority Health Medicare |
$136.72
|
| Rate for Payer: Priority Health Medicare |
$136.72
|
| Rate for Payer: Priority Health SBD |
$218.75
|
| Rate for Payer: Priority Health SBD |
$218.75
|
| Rate for Payer: Priority Health Tiered Network |
$218.75
|
| Rate for Payer: Priority Health Tiered Network |
$218.75
|
| Rate for Payer: Railroad Medicare Medicare |
$136.72
|
| Rate for Payer: Railroad Medicare Medicare |
$136.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$217.39
|
| Rate for Payer: UHC Core |
$217.39
|
| Rate for Payer: UHC Core |
$217.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$136.72
|
| Rate for Payer: UHC Exchange |
$217.39
|
| Rate for Payer: UHC Exchange |
$217.39
|
|
|
CHG RP THERAPY ORAL ADMINISTRATION
|
Professional
|
Both
|
$268.00
|
|
|
Service Code
|
HCPCS 79005
|
| Min. Negotiated Rate |
$126.52 |
| Max. Negotiated Rate |
$234.06 |
| Rate for Payer: Aetna Commercial |
$169.54
|
| Rate for Payer: Aetna Commercial |
$169.54
|
| Rate for Payer: Aetna Medicare |
$131.58
|
| Rate for Payer: Aetna Medicare |
$131.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.54
|
| Rate for Payer: BCBS MAPPO |
$126.52
|
| Rate for Payer: BCBS MAPPO |
$126.52
|
| Rate for Payer: BCN Commercial |
$201.18
|
| Rate for Payer: BCN Commercial |
$201.18
|
| Rate for Payer: BCN Medicare Advantage |
$126.52
|
| Rate for Payer: BCN Medicare Advantage |
$126.52
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cash Price |
$214.40
|
| Rate for Payer: Cofinity Commercial |
$182.19
|
| Rate for Payer: Cofinity Commercial |
$169.54
|
| Rate for Payer: Cofinity Commercial |
$169.54
|
| Rate for Payer: Cofinity Commercial |
$182.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.52
|
| Rate for Payer: Healthscope Commercial |
$234.06
|
| Rate for Payer: Healthscope Commercial |
$234.06
|
| Rate for Payer: Healthscope Commercial |
$202.43
|
| Rate for Payer: Healthscope Commercial |
$202.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$139.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.05
|
| Rate for Payer: Nomi Health Commercial |
$151.82
|
| Rate for Payer: Nomi Health Commercial |
$151.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.00
|
| Rate for Payer: PACE SWMI |
$126.52
|
| Rate for Payer: PACE SWMI |
$126.52
|
| Rate for Payer: PHP Medicare Advantage |
$126.52
|
| Rate for Payer: PHP Medicare Advantage |
$126.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.70
|
| Rate for Payer: Priority Health Medicare |
$126.52
|
| Rate for Payer: Priority Health Medicare |
$126.52
|
| Rate for Payer: Priority Health SBD |
$202.70
|
| Rate for Payer: Priority Health SBD |
$202.70
|
| Rate for Payer: Priority Health Tiered Network |
$202.70
|
| Rate for Payer: Priority Health Tiered Network |
$202.70
|
| Rate for Payer: Railroad Medicare Medicare |
$126.52
|
| Rate for Payer: Railroad Medicare Medicare |
$126.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.42
|
| Rate for Payer: UHC Core |
$201.42
|
| Rate for Payer: UHC Core |
$201.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$126.52
|
| Rate for Payer: UHC Exchange |
$201.42
|
| Rate for Payer: UHC Exchange |
$201.42
|
|
|
CHG SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 76831
|
| Min. Negotiated Rate |
$109.43 |
| Max. Negotiated Rate |
$202.45 |
| Rate for Payer: Aetna Commercial |
$146.64
|
| Rate for Payer: Aetna Medicare |
$113.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.64
|
| Rate for Payer: BCBS MAPPO |
$109.43
|
| Rate for Payer: BCN Commercial |
$170.31
|
| Rate for Payer: BCN Medicare Advantage |
$109.43
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$157.58
|
| Rate for Payer: Cofinity Commercial |
$146.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.43
|
| Rate for Payer: Healthscope Commercial |
$202.45
|
| Rate for Payer: Healthscope Commercial |
$175.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.70
|
| Rate for Payer: Nomi Health Commercial |
$131.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.25
|
| Rate for Payer: PACE SWMI |
$109.43
|
| Rate for Payer: PHP Medicare Advantage |
$109.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$171.60
|
| Rate for Payer: Priority Health Medicare |
$109.43
|
| Rate for Payer: Priority Health SBD |
$171.60
|
| Rate for Payer: Priority Health Tiered Network |
$171.60
|
| Rate for Payer: Railroad Medicare Medicare |
$109.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.67
|
| Rate for Payer: UHC Core |
$168.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.43
|
| Rate for Payer: UHC Exchange |
$168.67
|
|
|
CHG SCREENING DIGITAL BREAST TOMOSYNTHESIS BI
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 77063
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$91.46 |
| Rate for Payer: Aetna Commercial |
$65.11
|
| Rate for Payer: Aetna Medicare |
$50.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.97
|
| Rate for Payer: BCBS MAPPO |
$48.59
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: BCN Medicare Advantage |
$48.59
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$65.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.59
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Healthscope Commercial |
$77.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.46
|
| Rate for Payer: Nomi Health Commercial |
$58.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.00
|
| Rate for Payer: PACE SWMI |
$48.59
|
| Rate for Payer: PHP Medicare Advantage |
$48.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$78.77
|
| Rate for Payer: Priority Health Medicare |
$48.59
|
| Rate for Payer: Priority Health SBD |
$78.77
|
| Rate for Payer: Priority Health Tiered Network |
$78.77
|
| Rate for Payer: Railroad Medicare Medicare |
$48.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.10
|
| Rate for Payer: UHC Core |
$79.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$48.59
|
| Rate for Payer: UHC Exchange |
$79.10
|
|
|
CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 77067
|
| Min. Negotiated Rate |
$60.75 |
| Max. Negotiated Rate |
$218.57 |
| Rate for Payer: Aetna Commercial |
$157.83
|
| Rate for Payer: Aetna Medicare |
$122.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.83
|
| Rate for Payer: BCBS MAPPO |
$117.78
|
| Rate for Payer: BCN Commercial |
$191.72
|
| Rate for Payer: BCN Medicare Advantage |
$117.78
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$157.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.78
|
| Rate for Payer: Healthscope Commercial |
$217.89
|
| Rate for Payer: Healthscope Commercial |
$188.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.57
|
| Rate for Payer: Nomi Health Commercial |
$141.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE SWMI |
$117.78
|
| Rate for Payer: PHP Medicare Advantage |
$117.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$193.16
|
| Rate for Payer: Priority Health Medicare |
$117.78
|
| Rate for Payer: Priority Health SBD |
$193.16
|
| Rate for Payer: Priority Health Tiered Network |
$193.16
|
| Rate for Payer: Railroad Medicare Medicare |
$117.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.54
|
| Rate for Payer: UHC Core |
$193.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.78
|
| Rate for Payer: UHC Exchange |
$193.54
|
|
|
CHG SEDIMENTATION RATE RBC NON-AUTOMATED
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 85651
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$11.25 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.15
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCN Commercial |
$3.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$6.15
|
| Rate for Payer: Cofinity Commercial |
$5.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$7.90
|
| Rate for Payer: Healthscope Commercial |
$6.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.41
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.25
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.38
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$4.38
|
| Rate for Payer: Priority Health Tiered Network |
$4.38
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.56
|
| Rate for Payer: UHC Core |
$2.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$2.56
|
|
|
CHG SEMEN ALYS MOTILITY&CNT X W/HUHNER TST
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 89310
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$16.50 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.54
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$15.93
|
| Rate for Payer: Healthscope Commercial |
$13.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.92
|
| Rate for Payer: Nomi Health Commercial |
$10.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.50
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.54
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: Priority Health Tiered Network |
$13.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.17
|
| Rate for Payer: UHC Core |
$5.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.61
|
| Rate for Payer: UHC Exchange |
$5.17
|
|
|
CHG SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 89300
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Aetna Commercial |
$13.19
|
| Rate for Payer: Aetna Medicare |
$10.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.17
|
| Rate for Payer: BCBS MAPPO |
$9.84
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: BCN Medicare Advantage |
$9.84
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$14.17
|
| Rate for Payer: Cofinity Commercial |
$13.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.84
|
| Rate for Payer: Healthscope Commercial |
$18.20
|
| Rate for Payer: Healthscope Commercial |
$15.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.76
|
| Rate for Payer: Nomi Health Commercial |
$11.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: PACE SWMI |
$9.84
|
| Rate for Payer: PHP Medicare Advantage |
$9.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$9.84
|
| Rate for Payer: Priority Health SBD |
$15.05
|
| Rate for Payer: Priority Health Tiered Network |
$15.05
|
| Rate for Payer: Railroad Medicare Medicare |
$9.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.90
|
| Rate for Payer: UHC Core |
$5.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.84
|
| Rate for Payer: UHC Exchange |
$5.90
|
|
|
CHG SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 89321
|
| Min. Negotiated Rate |
$5.06 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna Commercial |
$16.15
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.35
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Commercial |
$9.04
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$16.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$22.29
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.08
|
| Rate for Payer: Nomi Health Commercial |
$14.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.57
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$18.57
|
| Rate for Payer: Priority Health Tiered Network |
$18.57
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.06
|
| Rate for Payer: UHC Core |
$5.06
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$5.06
|
|
|
CHG SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 75809
|
| Min. Negotiated Rate |
$79.46 |
| Max. Negotiated Rate |
$148.50 |
| Rate for Payer: Aetna Commercial |
$106.48
|
| Rate for Payer: Aetna Medicare |
$82.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.42
|
| Rate for Payer: BCBS MAPPO |
$79.46
|
| Rate for Payer: BCN Commercial |
$121.01
|
| Rate for Payer: BCN Medicare Advantage |
$79.46
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$114.42
|
| Rate for Payer: Cofinity Commercial |
$106.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.46
|
| Rate for Payer: Healthscope Commercial |
$127.14
|
| Rate for Payer: Healthscope Commercial |
$147.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.31
|
| Rate for Payer: Nomi Health Commercial |
$95.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.50
|
| Rate for Payer: PACE SWMI |
$79.46
|
| Rate for Payer: PHP Medicare Advantage |
$79.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$121.92
|
| Rate for Payer: Priority Health Medicare |
$79.46
|
| Rate for Payer: Priority Health SBD |
$121.92
|
| Rate for Payer: Priority Health Tiered Network |
$121.92
|
| Rate for Payer: Railroad Medicare Medicare |
$79.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.69
|
| Rate for Payer: UHC Core |
$128.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$79.46
|
| Rate for Payer: UHC Exchange |
$128.69
|
|
|
CHG SKIN TEST TUBERCULOSIS INTRADERMAL
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS 86580
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$18.76 |
| Rate for Payer: Aetna Commercial |
$13.59
|
| Rate for Payer: Aetna Medicare |
$10.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.59
|
| Rate for Payer: BCBS MAPPO |
$10.14
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Medicare Advantage |
$10.14
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.14
|
| Rate for Payer: Healthscope Commercial |
$18.76
|
| Rate for Payer: Healthscope Commercial |
$16.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.78
|
| Rate for Payer: Nomi Health Commercial |
$12.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.00
|
| Rate for Payer: PACE SWMI |
$10.14
|
| Rate for Payer: PHP Medicare Advantage |
$10.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.08
|
| Rate for Payer: Priority Health Medicare |
$10.14
|
| Rate for Payer: Priority Health SBD |
$10.08
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$10.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.17
|
| Rate for Payer: UHC Core |
$5.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.14
|
| Rate for Payer: UHC Exchange |
$5.17
|
|
|
CHG SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 87209
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Aetna Commercial |
$24.09
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.89
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCN Commercial |
$13.49
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Cofinity Commercial |
$24.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$33.26
|
| Rate for Payer: Healthscope Commercial |
$28.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.97
|
| Rate for Payer: Nomi Health Commercial |
$21.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.82
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health SBD |
$18.82
|
| Rate for Payer: Priority Health Tiered Network |
$18.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.55
|
| Rate for Payer: UHC Core |
$7.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.98
|
| Rate for Payer: UHC Exchange |
$7.55
|
|
|
CHG SMR PRIM SRC WET MOUNT NFCT AGT
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 87210
|
| Min. Negotiated Rate |
$3.49 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare |
$6.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.38
|
| Rate for Payer: BCBS MAPPO |
$5.82
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.82
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cofinity Commercial |
$8.38
|
| Rate for Payer: Cofinity Commercial |
$7.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.82
|
| Rate for Payer: Healthscope Commercial |
$9.31
|
| Rate for Payer: Healthscope Commercial |
$10.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.73
|
| Rate for Payer: Nomi Health Commercial |
$6.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.25
|
| Rate for Payer: PACE SWMI |
$5.82
|
| Rate for Payer: PHP Medicare Advantage |
$5.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.05
|
| Rate for Payer: Priority Health Medicare |
$5.82
|
| Rate for Payer: Priority Health SBD |
$6.05
|
| Rate for Payer: Priority Health Tiered Network |
$6.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.49
|
| Rate for Payer: UHC Core |
$3.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.82
|
| Rate for Payer: UHC Exchange |
$3.49
|
|
|
CHG SONO GUIDE PERICARD TAP
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 76930
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$93.75 |
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$93.75
|
|
|
CHG SONO GUIDE RAD THERAPY FIELDS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 76950
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$57.75 |
| Rate for Payer: Aetna Medicare |
$38.50
|
| Rate for Payer: Aetna Medicare |
$71.00
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$106.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
|
|
CHG SPEC DOSIM ONLY PRESCRIBED TREATING PHYS
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 77331
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$115.25 |
| Rate for Payer: Aetna Commercial |
$83.48
|
| Rate for Payer: Aetna Commercial |
$83.48
|
| Rate for Payer: Aetna Medicare |
$64.79
|
| Rate for Payer: Aetna Medicare |
$64.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.71
|
| Rate for Payer: BCBS MAPPO |
$62.30
|
| Rate for Payer: BCBS MAPPO |
$62.30
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: BCN Commercial |
$98.10
|
| Rate for Payer: BCN Medicare Advantage |
$62.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.30
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$83.48
|
| Rate for Payer: Cofinity Commercial |
$83.48
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$89.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$99.68
|
| Rate for Payer: Healthscope Commercial |
$115.25
|
| Rate for Payer: Healthscope Commercial |
$99.68
|
| Rate for Payer: Healthscope Commercial |
$115.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.46
|
| Rate for Payer: Nomi Health Commercial |
$74.76
|
| Rate for Payer: Nomi Health Commercial |
$74.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$62.30
|
| Rate for Payer: PACE SWMI |
$62.30
|
| Rate for Payer: PHP Medicare Advantage |
$62.30
|
| Rate for Payer: PHP Medicare Advantage |
$62.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.84
|
| Rate for Payer: Priority Health Medicare |
$62.30
|
| Rate for Payer: Priority Health Medicare |
$62.30
|
| Rate for Payer: Priority Health SBD |
$98.84
|
| Rate for Payer: Priority Health SBD |
$98.84
|
| Rate for Payer: Priority Health Tiered Network |
$98.84
|
| Rate for Payer: Priority Health Tiered Network |
$98.84
|
| Rate for Payer: Railroad Medicare Medicare |
$62.30
|
| Rate for Payer: Railroad Medicare Medicare |
$62.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.63
|
| Rate for Payer: UHC Core |
$94.63
|
| Rate for Payer: UHC Core |
$94.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.30
|
| Rate for Payer: UHC Exchange |
$94.63
|
| Rate for Payer: UHC Exchange |
$94.63
|
|
|
CHG SPECIAL TREATMENT PROCEDURE
|
Professional
|
Both
|
$726.00
|
|
|
Service Code
|
HCPCS 77470
|
| Min. Negotiated Rate |
$138.82 |
| Max. Negotiated Rate |
$544.50 |
| Rate for Payer: Aetna Commercial |
$186.02
|
| Rate for Payer: Aetna Commercial |
$186.02
|
| Rate for Payer: Aetna Medicare |
$144.37
|
| Rate for Payer: Aetna Medicare |
$144.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.02
|
| Rate for Payer: BCBS MAPPO |
$138.82
|
| Rate for Payer: BCBS MAPPO |
$138.82
|
| Rate for Payer: BCN Commercial |
$219.11
|
| Rate for Payer: BCN Commercial |
$219.11
|
| Rate for Payer: BCN Medicare Advantage |
$138.82
|
| Rate for Payer: BCN Medicare Advantage |
$138.82
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$438.40
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cash Price |
$580.80
|
| Rate for Payer: Cofinity Commercial |
$199.90
|
| Rate for Payer: Cofinity Commercial |
$186.02
|
| Rate for Payer: Cofinity Commercial |
$186.02
|
| Rate for Payer: Cofinity Commercial |
$199.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.82
|
| Rate for Payer: Healthscope Commercial |
$256.82
|
| Rate for Payer: Healthscope Commercial |
$256.82
|
| Rate for Payer: Healthscope Commercial |
$222.11
|
| Rate for Payer: Healthscope Commercial |
$222.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Nomi Health Commercial |
$166.58
|
| Rate for Payer: Nomi Health Commercial |
$166.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$411.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$544.50
|
| Rate for Payer: PACE SWMI |
$138.82
|
| Rate for Payer: PACE SWMI |
$138.82
|
| Rate for Payer: PHP Medicare Advantage |
$138.82
|
| Rate for Payer: PHP Medicare Advantage |
$138.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$220.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$220.75
|
| Rate for Payer: Priority Health Medicare |
$138.82
|
| Rate for Payer: Priority Health Medicare |
$138.82
|
| Rate for Payer: Priority Health SBD |
$220.75
|
| Rate for Payer: Priority Health SBD |
$220.75
|
| Rate for Payer: Priority Health Tiered Network |
$220.75
|
| Rate for Payer: Priority Health Tiered Network |
$220.75
|
| Rate for Payer: Railroad Medicare Medicare |
$138.82
|
| Rate for Payer: Railroad Medicare Medicare |
$138.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.07
|
| Rate for Payer: UHC Core |
$196.07
|
| Rate for Payer: UHC Core |
$196.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.82
|
| Rate for Payer: UHC Exchange |
$196.07
|
| Rate for Payer: UHC Exchange |
$196.07
|
|
|
CHG SPEC MEDICAL RADJ PHYSICS CONSLTJ
|
Professional
|
Both
|
$222.00
|
|
|
Service Code
|
HCPCS 77370
|
| Min. Negotiated Rate |
$138.92 |
| Max. Negotiated Rate |
$257.00 |
| Rate for Payer: Aetna Commercial |
$186.15
|
| Rate for Payer: Aetna Medicare |
$144.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.04
|
| Rate for Payer: BCBS MAPPO |
$138.92
|
| Rate for Payer: BCN Commercial |
$224.09
|
| Rate for Payer: BCN Medicare Advantage |
$138.92
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cash Price |
$177.60
|
| Rate for Payer: Cofinity Commercial |
$200.04
|
| Rate for Payer: Cofinity Commercial |
$186.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.92
|
| Rate for Payer: Healthscope Commercial |
$257.00
|
| Rate for Payer: Healthscope Commercial |
$222.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$152.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.02
|
| Rate for Payer: Nomi Health Commercial |
$166.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$166.50
|
| Rate for Payer: PACE SWMI |
$138.92
|
| Rate for Payer: PHP Medicare Advantage |
$138.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$225.78
|
| Rate for Payer: Priority Health Medicare |
$138.92
|
| Rate for Payer: Priority Health SBD |
$225.78
|
| Rate for Payer: Priority Health Tiered Network |
$225.78
|
| Rate for Payer: Railroad Medicare Medicare |
$138.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.08
|
| Rate for Payer: UHC Core |
$173.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$138.92
|
| Rate for Payer: UHC Exchange |
$173.08
|
|
|
CHG SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY
|
Professional
|
Both
|
$209.00
|
|
|
Service Code
|
HCPCS 77321
|
| Min. Negotiated Rate |
$89.36 |
| Max. Negotiated Rate |
$165.32 |
| Rate for Payer: Aetna Commercial |
$119.74
|
| Rate for Payer: Aetna Commercial |
$119.74
|
| Rate for Payer: Aetna Medicare |
$92.93
|
| Rate for Payer: Aetna Medicare |
$92.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.68
|
| Rate for Payer: BCBS MAPPO |
$89.36
|
| Rate for Payer: BCBS MAPPO |
$89.36
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Commercial |
$142.42
|
| Rate for Payer: BCN Medicare Advantage |
$89.36
|
| Rate for Payer: BCN Medicare Advantage |
$89.36
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$232.00
|
| Rate for Payer: Cofinity Commercial |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$128.68
|
| Rate for Payer: Cofinity Commercial |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$128.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.36
|
| Rate for Payer: Healthscope Commercial |
$165.32
|
| Rate for Payer: Healthscope Commercial |
$165.32
|
| Rate for Payer: Healthscope Commercial |
$142.98
|
| Rate for Payer: Healthscope Commercial |
$142.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$98.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.24
|
| Rate for Payer: Nomi Health Commercial |
$107.23
|
| Rate for Payer: Nomi Health Commercial |
$107.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.75
|
| Rate for Payer: PACE SWMI |
$89.36
|
| Rate for Payer: PACE SWMI |
$89.36
|
| Rate for Payer: PHP Medicare Advantage |
$89.36
|
| Rate for Payer: PHP Medicare Advantage |
$89.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$143.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$143.49
|
| Rate for Payer: Priority Health Medicare |
$89.36
|
| Rate for Payer: Priority Health Medicare |
$89.36
|
| Rate for Payer: Priority Health SBD |
$143.49
|
| Rate for Payer: Priority Health SBD |
$143.49
|
| Rate for Payer: Priority Health Tiered Network |
$143.49
|
| Rate for Payer: Priority Health Tiered Network |
$143.49
|
| Rate for Payer: Railroad Medicare Medicare |
$89.36
|
| Rate for Payer: Railroad Medicare Medicare |
$89.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.39
|
| Rate for Payer: UHC Core |
$136.39
|
| Rate for Payer: UHC Core |
$136.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$89.36
|
| Rate for Payer: UHC Exchange |
$136.39
|
| Rate for Payer: UHC Exchange |
$136.39
|
|
|
CHG STEREOSCOPIC X-RAY GUIDANCE
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 77421
|
| Min. Negotiated Rate |
$84.80 |
| Max. Negotiated Rate |
$159.00 |
| Rate for Payer: Aetna Medicare |
$106.00
|
| Rate for Payer: Aetna Medicare |
$89.50
|
| Rate for Payer: BCBS Complete |
$71.60
|
| Rate for Payer: BCBS Complete |
$84.80
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$159.00
|
|
|
CHG STEREOTACTIC BODY RADIATION MANAGEMENT
|
Professional
|
Both
|
$1,299.00
|
|
|
Service Code
|
HCPCS 77435
|
| Min. Negotiated Rate |
$408.96 |
| Max. Negotiated Rate |
$1,157.66 |
| Rate for Payer: Aetna Commercial |
$838.52
|
| Rate for Payer: Aetna Medicare |
$650.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$901.09
|
| Rate for Payer: BCBS Complete |
$429.41
|
| Rate for Payer: BCBS MAPPO |
$625.76
|
| Rate for Payer: BCN Commercial |
$969.07
|
| Rate for Payer: BCN Medicare Advantage |
$625.76
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cash Price |
$1,039.20
|
| Rate for Payer: Cofinity Commercial |
$838.52
|
| Rate for Payer: Cofinity Commercial |
$901.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.76
|
| Rate for Payer: Healthscope Commercial |
$1,157.66
|
| Rate for Payer: Healthscope Commercial |
$1,001.22
|
| Rate for Payer: Mclaren Medicaid |
$408.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$657.05
|
| Rate for Payer: Meridian Medicaid |
$429.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$688.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,134.40
|
| Rate for Payer: Nomi Health Commercial |
$750.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$974.25
|
| Rate for Payer: PACE SWMI |
$625.76
|
| Rate for Payer: PHP Medicare Advantage |
$625.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$976.36
|
| Rate for Payer: Priority Health Medicare |
$625.76
|
| Rate for Payer: Priority Health SBD |
$976.36
|
| Rate for Payer: Priority Health Tiered Network |
$976.36
|
| Rate for Payer: Railroad Medicare Medicare |
$625.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$960.81
|
| Rate for Payer: UHC Core |
$960.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.76
|
| Rate for Payer: UHC Exchange |
$960.81
|
| Rate for Payer: UHC Medicaid |
$408.96
|
| Rate for Payer: UHCCP Medicaid |
$408.96
|
|
|
CHG STEREOTACTIC BODY RADIATION TREATMENT DELIVERY
|
Professional
|
Both
|
$2,787.00
|
|
|
Service Code
|
HCPCS 77373
|
| Min. Negotiated Rate |
$895.31 |
| Max. Negotiated Rate |
$2,090.25 |
| Rate for Payer: Aetna Commercial |
$1,199.72
|
| Rate for Payer: Aetna Medicare |
$931.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,289.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,199.72
|
| Rate for Payer: BCBS MAPPO |
$895.31
|
| Rate for Payer: BCN Commercial |
$1,461.57
|
| Rate for Payer: BCN Medicare Advantage |
$895.31
|
| Rate for Payer: Cash Price |
$2,229.60
|
| Rate for Payer: Cash Price |
$2,229.60
|
| Rate for Payer: Cofinity Commercial |
$1,289.25
|
| Rate for Payer: Cofinity Commercial |
$1,199.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$895.31
|
| Rate for Payer: Healthscope Commercial |
$1,432.50
|
| Rate for Payer: Healthscope Commercial |
$1,656.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$940.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$984.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.24
|
| Rate for Payer: Nomi Health Commercial |
$1,074.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,090.25
|
| Rate for Payer: PACE SWMI |
$895.31
|
| Rate for Payer: PHP Medicare Advantage |
$895.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,472.58
|
| Rate for Payer: Priority Health Medicare |
$895.31
|
| Rate for Payer: Priority Health SBD |
$1,472.58
|
| Rate for Payer: Priority Health Tiered Network |
$1,472.58
|
| Rate for Payer: Railroad Medicare Medicare |
$895.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,677.55
|
| Rate for Payer: UHC Core |
$1,677.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$895.31
|
| Rate for Payer: UHC Exchange |
$1,677.55
|
|
