|
CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 76981
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$193.77 |
| Rate for Payer: Aetna Commercial |
$140.35
|
| Rate for Payer: Aetna Medicare |
$108.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.83
|
| Rate for Payer: BCBS MAPPO |
$104.74
|
| Rate for Payer: BCN Commercial |
$157.86
|
| Rate for Payer: BCN Medicare Advantage |
$104.74
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$140.35
|
| Rate for Payer: Cofinity Commercial |
$150.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.74
|
| Rate for Payer: Healthscope Commercial |
$167.58
|
| Rate for Payer: Healthscope Commercial |
$193.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.64
|
| Rate for Payer: Nomi Health Commercial |
$125.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$104.74
|
| Rate for Payer: PHP Medicare Advantage |
$104.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$159.05
|
| Rate for Payer: Priority Health Medicare |
$104.74
|
| Rate for Payer: Priority Health SBD |
$159.05
|
| Rate for Payer: Priority Health Tiered Network |
$159.05
|
| Rate for Payer: Railroad Medicare Medicare |
$104.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$152.35
|
| Rate for Payer: UHC Core |
$152.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.74
|
| Rate for Payer: UHC Exchange |
$152.35
|
|
|
CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 76800
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$330.69 |
| Rate for Payer: Aetna Commercial |
$239.53
|
| Rate for Payer: Aetna Medicare |
$185.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.40
|
| Rate for Payer: BCBS MAPPO |
$178.75
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: BCN Medicare Advantage |
$178.75
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$239.53
|
| Rate for Payer: Cofinity Commercial |
$257.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.75
|
| Rate for Payer: Healthscope Commercial |
$286.00
|
| Rate for Payer: Healthscope Commercial |
$330.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$196.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.23
|
| Rate for Payer: Nomi Health Commercial |
$214.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: PACE SWMI |
$178.75
|
| Rate for Payer: PHP Medicare Advantage |
$178.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.94
|
| Rate for Payer: Priority Health Medicare |
$178.75
|
| Rate for Payer: Priority Health SBD |
$271.94
|
| Rate for Payer: Priority Health Tiered Network |
$271.94
|
| Rate for Payer: Railroad Medicare Medicare |
$178.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.44
|
| Rate for Payer: UHC Core |
$204.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$178.75
|
| Rate for Payer: UHC Exchange |
$204.44
|
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 76496
|
| Min. Negotiated Rate |
$74.70 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Medicare |
$131.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.70
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$115.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
CHG URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 78740
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$376.72 |
| Rate for Payer: Aetna Commercial |
$272.86
|
| Rate for Payer: Aetna Medicare |
$211.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.23
|
| Rate for Payer: BCBS MAPPO |
$203.63
|
| Rate for Payer: BCN Commercial |
$312.23
|
| Rate for Payer: BCN Medicare Advantage |
$203.63
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$272.86
|
| Rate for Payer: Cofinity Commercial |
$293.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.63
|
| Rate for Payer: Healthscope Commercial |
$376.72
|
| Rate for Payer: Healthscope Commercial |
$325.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.67
|
| Rate for Payer: Nomi Health Commercial |
$244.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
| Rate for Payer: PACE SWMI |
$203.63
|
| Rate for Payer: PHP Medicare Advantage |
$203.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$314.58
|
| Rate for Payer: Priority Health Medicare |
$203.63
|
| Rate for Payer: Priority Health SBD |
$314.58
|
| Rate for Payer: Priority Health Tiered Network |
$314.58
|
| Rate for Payer: Railroad Medicare Medicare |
$203.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.27
|
| Rate for Payer: UHC Core |
$308.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$203.63
|
| Rate for Payer: UHC Exchange |
$308.27
|
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 74450
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$341.84 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: Aetna Medicare |
$57.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.77
|
| Rate for Payer: BCN Commercial |
$22.92
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$100.34
|
| Rate for Payer: Priority Health SBD |
$100.34
|
| Rate for Payer: Priority Health Tiered Network |
$100.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.84
|
| Rate for Payer: UHC Core |
$341.84
|
| Rate for Payer: UHC Exchange |
$341.84
|
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 74455
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$180.39 |
| Rate for Payer: Aetna Commercial |
$130.66
|
| Rate for Payer: Aetna Medicare |
$101.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.66
|
| Rate for Payer: BCBS MAPPO |
$97.51
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$97.51
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$140.41
|
| Rate for Payer: Cofinity Commercial |
$130.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.51
|
| Rate for Payer: Healthscope Commercial |
$180.39
|
| Rate for Payer: Healthscope Commercial |
$156.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.03
|
| Rate for Payer: Nomi Health Commercial |
$117.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$97.51
|
| Rate for Payer: PHP Medicare Advantage |
$97.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$152.52
|
| Rate for Payer: Priority Health Medicare |
$97.51
|
| Rate for Payer: Priority Health SBD |
$152.52
|
| Rate for Payer: Priority Health Tiered Network |
$152.52
|
| Rate for Payer: Railroad Medicare Medicare |
$97.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.32
|
| Rate for Payer: UHC Core |
$136.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.51
|
| Rate for Payer: UHC Exchange |
$136.32
|
|
|
CHG URINALYSIS MICROSCOPIC ONLY
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 81015
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$5.64 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Cofinity Commercial |
$4.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$5.64
|
| Rate for Payer: Healthscope Commercial |
$4.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.58
|
| Rate for Payer: Nomi Health Commercial |
$3.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.02
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health SBD |
$3.02
|
| Rate for Payer: Priority Health Tiered Network |
$3.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.83
|
| Rate for Payer: UHC Core |
$1.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.05
|
| Rate for Payer: UHC Exchange |
$1.83
|
|
|
CHG URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81005
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.91
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$4.01
|
| Rate for Payer: Healthscope Commercial |
$3.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.26
|
| Rate for Payer: Nomi Health Commercial |
$2.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.35
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$2.35
|
| Rate for Payer: Priority Health Tiered Network |
$2.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.30
|
| Rate for Payer: UHC Core |
$1.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$1.30
|
|
|
CHG URINARY BLADDER RESIDUAL STUDY
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 78730
|
| Min. Negotiated Rate |
$67.29 |
| Max. Negotiated Rate |
$183.75 |
| Rate for Payer: Aetna Commercial |
$90.17
|
| Rate for Payer: Aetna Medicare |
$69.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.90
|
| Rate for Payer: BCBS MAPPO |
$67.29
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$67.29
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$96.90
|
| Rate for Payer: Cofinity Commercial |
$90.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.29
|
| Rate for Payer: Healthscope Commercial |
$124.49
|
| Rate for Payer: Healthscope Commercial |
$107.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.28
|
| Rate for Payer: Nomi Health Commercial |
$80.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.75
|
| Rate for Payer: PACE SWMI |
$67.29
|
| Rate for Payer: PHP Medicare Advantage |
$67.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$99.35
|
| Rate for Payer: Priority Health Medicare |
$67.29
|
| Rate for Payer: Priority Health SBD |
$99.35
|
| Rate for Payer: Priority Health Tiered Network |
$99.35
|
| Rate for Payer: Railroad Medicare Medicare |
$67.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.43
|
| Rate for Payer: UHC Core |
$107.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.29
|
| Rate for Payer: UHC Exchange |
$107.43
|
|
|
CHG URINE ALBUMIN SEMIQUANTITATIVE
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82044
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$11.53 |
| Rate for Payer: Aetna Commercial |
$8.35
|
| Rate for Payer: Aetna Medicare |
$6.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.35
|
| Rate for Payer: BCBS MAPPO |
$6.23
|
| Rate for Payer: BCN Commercial |
$4.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.23
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$8.97
|
| Rate for Payer: Cofinity Commercial |
$8.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.23
|
| Rate for Payer: Healthscope Commercial |
$9.97
|
| Rate for Payer: Healthscope Commercial |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.35
|
| Rate for Payer: Nomi Health Commercial |
$7.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$6.23
|
| Rate for Payer: PHP Medicare Advantage |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.39
|
| Rate for Payer: Priority Health Medicare |
$6.23
|
| Rate for Payer: Priority Health SBD |
$6.39
|
| Rate for Payer: Priority Health Tiered Network |
$6.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.74
|
| Rate for Payer: UHC Core |
$3.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.23
|
| Rate for Payer: UHC Exchange |
$3.74
|
|
|
CHG URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 81025
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| 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 |
$18.00
|
| 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 |
$9.07
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health SBD |
$9.07
|
| Rate for Payer: Priority Health Tiered Network |
$9.07
|
| 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 URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 81000
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna Commercial |
$5.39
|
| Rate for Payer: Aetna Medicare |
$4.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.39
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$5.79
|
| Rate for Payer: Cofinity Commercial |
$5.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$7.44
|
| Rate for Payer: Healthscope Commercial |
$6.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6.03
|
| Rate for Payer: Nomi Health Commercial |
$4.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.50
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.03
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health SBD |
$4.03
|
| Rate for Payer: Priority Health Tiered Network |
$4.03
|
| Rate for Payer: Railroad Medicare Medicare |
$4.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.41
|
| Rate for Payer: UHC Core |
$2.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.02
|
| Rate for Payer: UHC Exchange |
$2.41
|
|
|
CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 81001
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$4.25
|
| Rate for Payer: Aetna Medicare |
$3.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.56
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Cofinity Commercial |
$4.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
| Rate for Payer: Healthscope Commercial |
$5.86
|
| Rate for Payer: Healthscope Commercial |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4.76
|
| Rate for Payer: Nomi Health Commercial |
$3.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.36
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health SBD |
$3.36
|
| Rate for Payer: Priority Health Tiered Network |
$3.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.90
|
| Rate for Payer: UHC Core |
$1.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.17
|
| Rate for Payer: UHC Exchange |
$1.90
|
|
|
CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81003
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$3.02
|
| Rate for Payer: Aetna Medicare |
$2.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.24
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$3.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.38
|
| Rate for Payer: Nomi Health Commercial |
$2.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.35
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health SBD |
$2.35
|
| Rate for Payer: Priority Health Tiered Network |
$2.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.35
|
| Rate for Payer: UHC Core |
$1.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.25
|
| Rate for Payer: UHC Exchange |
$1.35
|
|
|
CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 81002
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$4.66
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$5.01
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$6.44
|
| Rate for Payer: Healthscope Commercial |
$5.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.22
|
| Rate for Payer: Nomi Health Commercial |
$4.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.70
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health SBD |
$3.70
|
| Rate for Payer: Priority Health Tiered Network |
$3.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.09
|
| Rate for Payer: UHC Core |
$2.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.48
|
| Rate for Payer: UHC Exchange |
$2.09
|
|
|
CHG UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 74400
|
| Min. Negotiated Rate |
$122.21 |
| Max. Negotiated Rate |
$231.10 |
| Rate for Payer: Aetna Commercial |
$163.76
|
| Rate for Payer: Aetna Commercial |
$163.76
|
| Rate for Payer: Aetna Medicare |
$127.10
|
| Rate for Payer: Aetna Medicare |
$127.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.76
|
| Rate for Payer: BCBS MAPPO |
$122.21
|
| Rate for Payer: BCBS MAPPO |
$122.21
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Medicare Advantage |
$122.21
|
| Rate for Payer: BCN Medicare Advantage |
$122.21
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.21
|
| Rate for Payer: Healthscope Commercial |
$226.09
|
| Rate for Payer: Healthscope Commercial |
$226.09
|
| Rate for Payer: Healthscope Commercial |
$195.54
|
| Rate for Payer: Healthscope Commercial |
$195.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.10
|
| Rate for Payer: Nomi Health Commercial |
$146.65
|
| Rate for Payer: Nomi Health Commercial |
$146.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$122.21
|
| Rate for Payer: PACE SWMI |
$122.21
|
| Rate for Payer: PHP Medicare Advantage |
$122.21
|
| Rate for Payer: PHP Medicare Advantage |
$122.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$199.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$199.19
|
| Rate for Payer: Priority Health Medicare |
$122.21
|
| Rate for Payer: Priority Health Medicare |
$122.21
|
| Rate for Payer: Priority Health SBD |
$199.19
|
| Rate for Payer: Priority Health SBD |
$199.19
|
| Rate for Payer: Priority Health Tiered Network |
$199.19
|
| Rate for Payer: Priority Health Tiered Network |
$199.19
|
| Rate for Payer: Railroad Medicare Medicare |
$122.21
|
| Rate for Payer: Railroad Medicare Medicare |
$122.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.38
|
| Rate for Payer: UHC Core |
$179.38
|
| Rate for Payer: UHC Core |
$179.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.21
|
| Rate for Payer: UHC Exchange |
$179.38
|
| Rate for Payer: UHC Exchange |
$179.38
|
|
|
CHG UROGRAPHY RETROGRADE WITH/WO KUB
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 74420
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$140.23 |
| Rate for Payer: Aetna Commercial |
$101.57
|
| Rate for Payer: Aetna Medicare |
$78.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.57
|
| Rate for Payer: BCBS MAPPO |
$75.80
|
| Rate for Payer: BCN Commercial |
$116.53
|
| Rate for Payer: BCN Medicare Advantage |
$75.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$109.15
|
| Rate for Payer: Cofinity Commercial |
$101.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.80
|
| Rate for Payer: Healthscope Commercial |
$140.23
|
| Rate for Payer: Healthscope Commercial |
$121.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.49
|
| Rate for Payer: Nomi Health Commercial |
$90.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$75.80
|
| Rate for Payer: PHP Medicare Advantage |
$75.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$117.40
|
| Rate for Payer: Priority Health Medicare |
$75.80
|
| Rate for Payer: Priority Health SBD |
$117.40
|
| Rate for Payer: Priority Health Tiered Network |
$117.40
|
| Rate for Payer: Railroad Medicare Medicare |
$75.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$104.78
|
| Rate for Payer: UHC Core |
$104.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.80
|
| Rate for Payer: UHC Exchange |
$104.78
|
|
|
CHG US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 76706
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$182.41 |
| Rate for Payer: Aetna Commercial |
$132.12
|
| Rate for Payer: Aetna Medicare |
$102.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.98
|
| Rate for Payer: BCBS MAPPO |
$98.60
|
| Rate for Payer: BCN Commercial |
$159.35
|
| Rate for Payer: BCN Medicare Advantage |
$98.60
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$141.98
|
| Rate for Payer: Cofinity Commercial |
$132.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.60
|
| Rate for Payer: Healthscope Commercial |
$182.41
|
| Rate for Payer: Healthscope Commercial |
$157.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.87
|
| Rate for Payer: Nomi Health Commercial |
$118.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$98.60
|
| Rate for Payer: PHP Medicare Advantage |
$98.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$160.56
|
| Rate for Payer: Priority Health Medicare |
$98.60
|
| Rate for Payer: Priority Health SBD |
$160.56
|
| Rate for Payer: Priority Health Tiered Network |
$160.56
|
| Rate for Payer: Railroad Medicare Medicare |
$98.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.53
|
| Rate for Payer: UHC Core |
$160.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.60
|
| Rate for Payer: UHC Exchange |
$160.53
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 76700
|
| Min. Negotiated Rate |
$107.02 |
| Max. Negotiated Rate |
$199.94 |
| Rate for Payer: Aetna Commercial |
$143.41
|
| Rate for Payer: Aetna Medicare |
$111.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$143.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.11
|
| Rate for Payer: BCBS MAPPO |
$107.02
|
| Rate for Payer: BCN Commercial |
$172.30
|
| Rate for Payer: BCN Medicare Advantage |
$107.02
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$154.11
|
| Rate for Payer: Cofinity Commercial |
$143.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.02
|
| Rate for Payer: Healthscope Commercial |
$197.99
|
| Rate for Payer: Healthscope Commercial |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$199.94
|
| Rate for Payer: Nomi Health Commercial |
$128.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$107.02
|
| Rate for Payer: PHP Medicare Advantage |
$107.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$173.60
|
| Rate for Payer: Priority Health Medicare |
$107.02
|
| Rate for Payer: Priority Health SBD |
$173.60
|
| Rate for Payer: Priority Health Tiered Network |
$173.60
|
| Rate for Payer: Railroad Medicare Medicare |
$107.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.59
|
| Rate for Payer: UHC Core |
$174.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.02
|
| Rate for Payer: UHC Exchange |
$174.59
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE LIMITED
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 76705
|
| Min. Negotiated Rate |
$80.65 |
| Max. Negotiated Rate |
$150.97 |
| Rate for Payer: Aetna Commercial |
$108.07
|
| Rate for Payer: Aetna Commercial |
$108.07
|
| Rate for Payer: Aetna Medicare |
$83.88
|
| Rate for Payer: Aetna Medicare |
$83.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.14
|
| Rate for Payer: BCBS MAPPO |
$80.65
|
| Rate for Payer: BCBS MAPPO |
$80.65
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: BCN Commercial |
$129.48
|
| Rate for Payer: BCN Medicare Advantage |
$80.65
|
| Rate for Payer: BCN Medicare Advantage |
$80.65
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$108.07
|
| Rate for Payer: Cofinity Commercial |
$116.14
|
| Rate for Payer: Cofinity Commercial |
$108.07
|
| Rate for Payer: Cofinity Commercial |
$116.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.65
|
| Rate for Payer: Healthscope Commercial |
$149.20
|
| Rate for Payer: Healthscope Commercial |
$149.20
|
| Rate for Payer: Healthscope Commercial |
$129.04
|
| Rate for Payer: Healthscope Commercial |
$129.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$84.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$88.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.97
|
| Rate for Payer: Nomi Health Commercial |
$96.78
|
| Rate for Payer: Nomi Health Commercial |
$96.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.25
|
| Rate for Payer: PACE SWMI |
$80.65
|
| Rate for Payer: PACE SWMI |
$80.65
|
| Rate for Payer: PHP Medicare Advantage |
$80.65
|
| Rate for Payer: PHP Medicare Advantage |
$80.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$130.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$130.45
|
| Rate for Payer: Priority Health Medicare |
$80.65
|
| Rate for Payer: Priority Health Medicare |
$80.65
|
| Rate for Payer: Priority Health SBD |
$130.45
|
| Rate for Payer: Priority Health SBD |
$130.45
|
| Rate for Payer: Priority Health Tiered Network |
$130.45
|
| Rate for Payer: Priority Health Tiered Network |
$130.45
|
| Rate for Payer: Railroad Medicare Medicare |
$80.65
|
| Rate for Payer: Railroad Medicare Medicare |
$80.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.25
|
| Rate for Payer: UHC Core |
$129.25
|
| Rate for Payer: UHC Core |
$129.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$80.65
|
| Rate for Payer: UHC Exchange |
$129.25
|
| Rate for Payer: UHC Exchange |
$129.25
|
|
|
CHG US, BREAST(S), REAL TIME
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 76645
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$116.25 |
| Rate for Payer: Aetna Medicare |
$77.50
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.25
|
|
|
CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 76604
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$112.52 |
| Rate for Payer: Aetna Commercial |
$77.52
|
| Rate for Payer: Aetna Medicare |
$60.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.30
|
| Rate for Payer: BCBS MAPPO |
$57.85
|
| Rate for Payer: BCN Commercial |
$86.65
|
| Rate for Payer: BCN Medicare Advantage |
$57.85
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$83.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.85
|
| Rate for Payer: Healthscope Commercial |
$92.56
|
| Rate for Payer: Healthscope Commercial |
$107.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.17
|
| Rate for Payer: Nomi Health Commercial |
$69.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$57.85
|
| Rate for Payer: PHP Medicare Advantage |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$87.30
|
| Rate for Payer: Priority Health Medicare |
$57.85
|
| Rate for Payer: Priority Health SBD |
$87.30
|
| Rate for Payer: Priority Health Tiered Network |
$87.30
|
| Rate for Payer: Railroad Medicare Medicare |
$57.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.52
|
| Rate for Payer: UHC Core |
$112.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.85
|
| Rate for Payer: UHC Exchange |
$112.52
|
|
|
CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL
|
Professional
|
Both
|
$442.00
|
|
|
Service Code
|
HCPCS 76936
|
| Min. Negotiated Rate |
$249.19 |
| Max. Negotiated Rate |
$461.00 |
| Rate for Payer: Aetna Commercial |
$333.91
|
| Rate for Payer: Aetna Medicare |
$259.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.83
|
| Rate for Payer: BCBS MAPPO |
$249.19
|
| Rate for Payer: BCN Commercial |
$384.44
|
| Rate for Payer: BCN Medicare Advantage |
$249.19
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cash Price |
$353.60
|
| Rate for Payer: Cofinity Commercial |
$358.83
|
| Rate for Payer: Cofinity Commercial |
$333.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$249.19
|
| Rate for Payer: Healthscope Commercial |
$461.00
|
| Rate for Payer: Healthscope Commercial |
$398.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$274.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$444.64
|
| Rate for Payer: Nomi Health Commercial |
$299.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.50
|
| Rate for Payer: PACE SWMI |
$249.19
|
| Rate for Payer: PHP Medicare Advantage |
$249.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$387.33
|
| Rate for Payer: Priority Health Medicare |
$249.19
|
| Rate for Payer: Priority Health SBD |
$387.33
|
| Rate for Payer: Priority Health Tiered Network |
$387.33
|
| Rate for Payer: Railroad Medicare Medicare |
$249.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$384.80
|
| Rate for Payer: UHC Core |
$384.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$249.19
|
| Rate for Payer: UHC Exchange |
$384.80
|
|
|
CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 76881
|
| Min. Negotiated Rate |
$52.01 |
| Max. Negotiated Rate |
$239.25 |
| Rate for Payer: Aetna Commercial |
$69.69
|
| Rate for Payer: Aetna Commercial |
$69.69
|
| Rate for Payer: Aetna Medicare |
$54.09
|
| Rate for Payer: Aetna Medicare |
$54.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.89
|
| Rate for Payer: BCBS MAPPO |
$52.01
|
| Rate for Payer: BCBS MAPPO |
$52.01
|
| Rate for Payer: BCN Commercial |
$79.68
|
| Rate for Payer: BCN Commercial |
$79.68
|
| Rate for Payer: BCN Medicare Advantage |
$52.01
|
| Rate for Payer: BCN Medicare Advantage |
$52.01
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$69.69
|
| Rate for Payer: Cofinity Commercial |
$74.89
|
| Rate for Payer: Cofinity Commercial |
$69.69
|
| Rate for Payer: Cofinity Commercial |
$74.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.01
|
| Rate for Payer: Healthscope Commercial |
$96.22
|
| Rate for Payer: Healthscope Commercial |
$96.22
|
| Rate for Payer: Healthscope Commercial |
$83.22
|
| Rate for Payer: Healthscope Commercial |
$83.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.86
|
| Rate for Payer: Nomi Health Commercial |
$62.41
|
| Rate for Payer: Nomi Health Commercial |
$62.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$239.25
|
| Rate for Payer: PACE SWMI |
$52.01
|
| Rate for Payer: PACE SWMI |
$52.01
|
| Rate for Payer: PHP Medicare Advantage |
$52.01
|
| Rate for Payer: PHP Medicare Advantage |
$52.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$80.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$80.27
|
| Rate for Payer: Priority Health Medicare |
$52.01
|
| Rate for Payer: Priority Health Medicare |
$52.01
|
| Rate for Payer: Priority Health SBD |
$80.27
|
| Rate for Payer: Priority Health SBD |
$80.27
|
| Rate for Payer: Priority Health Tiered Network |
$80.27
|
| Rate for Payer: Priority Health Tiered Network |
$80.27
|
| Rate for Payer: Railroad Medicare Medicare |
$52.01
|
| Rate for Payer: Railroad Medicare Medicare |
$52.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.69
|
| Rate for Payer: UHC Core |
$110.69
|
| Rate for Payer: UHC Core |
$110.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$52.01
|
| Rate for Payer: UHC Exchange |
$110.69
|
| Rate for Payer: UHC Exchange |
$110.69
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 76813
|
| Min. Negotiated Rate |
$109.36 |
| Max. Negotiated Rate |
$225.75 |
| Rate for Payer: Aetna Commercial |
$146.54
|
| Rate for Payer: Aetna Medicare |
$113.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.54
|
| Rate for Payer: BCBS MAPPO |
$109.36
|
| Rate for Payer: BCN Commercial |
$169.31
|
| Rate for Payer: BCN Medicare Advantage |
$109.36
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$157.48
|
| Rate for Payer: Cofinity Commercial |
$146.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.36
|
| Rate for Payer: Healthscope Commercial |
$202.32
|
| Rate for Payer: Healthscope Commercial |
$174.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.52
|
| Rate for Payer: Nomi Health Commercial |
$131.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.75
|
| Rate for Payer: PACE SWMI |
$109.36
|
| Rate for Payer: PHP Medicare Advantage |
$109.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$170.59
|
| Rate for Payer: Priority Health Medicare |
$109.36
|
| Rate for Payer: Priority Health SBD |
$170.59
|
| Rate for Payer: Priority Health Tiered Network |
$170.59
|
| Rate for Payer: Railroad Medicare Medicare |
$109.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.83
|
| Rate for Payer: UHC Core |
$173.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$109.36
|
| Rate for Payer: UHC Exchange |
$173.83
|
|
