|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 72082
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$380.38 |
| Rate for Payer: Aetna Commercial |
$84.85
|
| Rate for Payer: Aetna Medicare |
$65.85
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$63.32
|
| Rate for Payer: BCBS Trust/PPO |
$380.38
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: BCN Medicare Advantage |
$63.32
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$91.18
|
| Rate for Payer: Cofinity Commercial |
$84.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.32
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.49
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Nomi Health Commercial |
$75.98
|
| Rate for Payer: PACE SWMI |
$63.32
|
| Rate for Payer: PHP Medicare Advantage |
$63.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO |
$23.10
|
| Rate for Payer: Priority Health Medicare |
$63.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.32
|
| Rate for Payer: UHC Exchange |
$63.32
|
| Rate for Payer: UHC Medicare Advantage |
$63.32
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 72083
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$115.82 |
| Rate for Payer: Aetna Commercial |
$96.45
|
| Rate for Payer: Aetna Medicare |
$74.86
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$71.98
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: BCN Medicare Advantage |
$71.98
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$96.45
|
| Rate for Payer: Cofinity Commercial |
$103.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.98
|
| Rate for Payer: Mclaren Medicaid |
$10.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.58
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: Nomi Health Commercial |
$86.38
|
| Rate for Payer: PACE SWMI |
$71.98
|
| Rate for Payer: PHP Medicare Advantage |
$71.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO |
$26.18
|
| Rate for Payer: Priority Health Medicare |
$72.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.98
|
| Rate for Payer: UHC Exchange |
$71.98
|
| Rate for Payer: UHC Medicare Advantage |
$71.98
|
| Rate for Payer: UHCCP Medicaid |
$10.86
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72084
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$145.62 |
| Rate for Payer: Aetna Commercial |
$118.52
|
| Rate for Payer: Aetna Medicare |
$91.99
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCBS MAPPO |
$88.45
|
| Rate for Payer: BCN Commercial |
$145.62
|
| Rate for Payer: BCN Medicare Advantage |
$88.45
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$118.52
|
| Rate for Payer: Cofinity Commercial |
$127.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.45
|
| Rate for Payer: Mclaren Medicaid |
$12.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.87
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Nomi Health Commercial |
$106.14
|
| Rate for Payer: PACE SWMI |
$88.45
|
| Rate for Payer: PHP Medicare Advantage |
$88.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO |
$30.28
|
| Rate for Payer: Priority Health Medicare |
$89.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.45
|
| Rate for Payer: UHC Exchange |
$88.45
|
| Rate for Payer: UHC Medicare Advantage |
$88.45
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
|
|
CHG RADEX FACIAL BONES < 3 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70140
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$1,212.45 |
| Rate for Payer: Aetna Commercial |
$38.87
|
| Rate for Payer: Aetna Medicare |
$30.17
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$29.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.45
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Medicare Advantage |
$29.01
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$41.77
|
| Rate for Payer: Cofinity Commercial |
$38.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.01
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.46
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: PACE SWMI |
$29.01
|
| Rate for Payer: PHP Medicare Advantage |
$29.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO |
$14.37
|
| Rate for Payer: Priority Health Medicare |
$29.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.01
|
| Rate for Payer: UHC Exchange |
$29.01
|
| Rate for Payer: UHC Medicare Advantage |
$29.01
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
|
|
CHG RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 70150
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$916.60 |
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Medicare |
$43.86
|
| Rate for Payer: Aetna Medicare |
$43.86
|
| Rate for Payer: Aetna Medicare |
$43.86
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$42.17
|
| Rate for Payer: BCBS MAPPO |
$42.17
|
| Rate for Payer: BCBS MAPPO |
$42.17
|
| Rate for Payer: BCBS Trust/PPO |
$916.60
|
| Rate for Payer: BCBS Trust/PPO |
$916.60
|
| Rate for Payer: BCBS Trust/PPO |
$916.60
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Medicare Advantage |
$42.17
|
| Rate for Payer: BCN Medicare Advantage |
$42.17
|
| Rate for Payer: BCN Medicare Advantage |
$42.17
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Cofinity Commercial |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Cofinity Commercial |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.17
|
| Rate for Payer: Mclaren Medicaid |
$7.88
|
| Rate for Payer: Mclaren Medicaid |
$7.88
|
| Rate for Payer: Mclaren Medicaid |
$7.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.28
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Nomi Health Commercial |
$50.60
|
| Rate for Payer: Nomi Health Commercial |
$50.60
|
| Rate for Payer: Nomi Health Commercial |
$50.60
|
| Rate for Payer: PACE SWMI |
$42.17
|
| Rate for Payer: PACE SWMI |
$42.17
|
| Rate for Payer: PACE SWMI |
$42.17
|
| Rate for Payer: PHP Medicare Advantage |
$42.17
|
| Rate for Payer: PHP Medicare Advantage |
$42.17
|
| Rate for Payer: PHP Medicare Advantage |
$42.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health HMO/PPO |
$19.00
|
| Rate for Payer: Priority Health Medicare |
$42.59
|
| Rate for Payer: Priority Health Medicare |
$42.59
|
| Rate for Payer: Priority Health Medicare |
$42.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.17
|
| Rate for Payer: UHC Exchange |
$42.17
|
| Rate for Payer: UHC Exchange |
$42.17
|
| Rate for Payer: UHC Exchange |
$42.17
|
| Rate for Payer: UHC Medicare Advantage |
$42.17
|
| Rate for Payer: UHC Medicare Advantage |
$42.17
|
| Rate for Payer: UHC Medicare Advantage |
$42.17
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
|
|
CHG RADEX FINGR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 73140
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$349.73 |
| Rate for Payer: Aetna Commercial |
$46.14
|
| Rate for Payer: Aetna Commercial |
$46.14
|
| Rate for Payer: Aetna Commercial |
$46.14
|
| Rate for Payer: Aetna Medicare |
$35.81
|
| Rate for Payer: Aetna Medicare |
$35.81
|
| Rate for Payer: Aetna Medicare |
$35.81
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS MAPPO |
$34.43
|
| Rate for Payer: BCBS MAPPO |
$34.43
|
| Rate for Payer: BCBS MAPPO |
$34.43
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Medicare Advantage |
$34.43
|
| Rate for Payer: BCN Medicare Advantage |
$34.43
|
| Rate for Payer: BCN Medicare Advantage |
$34.43
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$49.58
|
| Rate for Payer: Cofinity Commercial |
$46.14
|
| Rate for Payer: Cofinity Commercial |
$49.58
|
| Rate for Payer: Cofinity Commercial |
$46.14
|
| Rate for Payer: Cofinity Commercial |
$49.58
|
| Rate for Payer: Cofinity Commercial |
$46.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.43
|
| Rate for Payer: Mclaren Medicaid |
$4.26
|
| Rate for Payer: Mclaren Medicaid |
$4.26
|
| Rate for Payer: Mclaren Medicaid |
$4.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.15
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Nomi Health Commercial |
$41.32
|
| Rate for Payer: Nomi Health Commercial |
$41.32
|
| Rate for Payer: Nomi Health Commercial |
$41.32
|
| Rate for Payer: PACE SWMI |
$34.43
|
| Rate for Payer: PACE SWMI |
$34.43
|
| Rate for Payer: PACE SWMI |
$34.43
|
| Rate for Payer: PHP Medicare Advantage |
$34.43
|
| Rate for Payer: PHP Medicare Advantage |
$34.43
|
| Rate for Payer: PHP Medicare Advantage |
$34.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO |
$10.27
|
| Rate for Payer: Priority Health HMO/PPO |
$10.27
|
| Rate for Payer: Priority Health HMO/PPO |
$10.27
|
| Rate for Payer: Priority Health Medicare |
$34.77
|
| Rate for Payer: Priority Health Medicare |
$34.77
|
| Rate for Payer: Priority Health Medicare |
$34.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.43
|
| Rate for Payer: UHC Exchange |
$34.43
|
| Rate for Payer: UHC Exchange |
$34.43
|
| Rate for Payer: UHC Exchange |
$34.43
|
| Rate for Payer: UHC Medicare Advantage |
$34.43
|
| Rate for Payer: UHC Medicare Advantage |
$34.43
|
| Rate for Payer: UHC Medicare Advantage |
$34.43
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
|
|
CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 73630
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$910.26 |
| Rate for Payer: Aetna Commercial |
$41.16
|
| Rate for Payer: Aetna Commercial |
$41.16
|
| Rate for Payer: Aetna Commercial |
$41.16
|
| Rate for Payer: Aetna Medicare |
$31.95
|
| Rate for Payer: Aetna Medicare |
$31.95
|
| Rate for Payer: Aetna Medicare |
$31.95
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$30.72
|
| Rate for Payer: BCBS MAPPO |
$30.72
|
| Rate for Payer: BCBS MAPPO |
$30.72
|
| Rate for Payer: BCBS Trust/PPO |
$910.26
|
| Rate for Payer: BCBS Trust/PPO |
$910.26
|
| Rate for Payer: BCBS Trust/PPO |
$910.26
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Medicare Advantage |
$30.72
|
| Rate for Payer: BCN Medicare Advantage |
$30.72
|
| Rate for Payer: BCN Medicare Advantage |
$30.72
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$44.24
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Commercial |
$44.24
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Commercial |
$44.24
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.72
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.26
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Nomi Health Commercial |
$36.86
|
| Rate for Payer: Nomi Health Commercial |
$36.86
|
| Rate for Payer: Nomi Health Commercial |
$36.86
|
| Rate for Payer: PACE SWMI |
$30.72
|
| Rate for Payer: PACE SWMI |
$30.72
|
| Rate for Payer: PACE SWMI |
$30.72
|
| Rate for Payer: PHP Medicare Advantage |
$30.72
|
| Rate for Payer: PHP Medicare Advantage |
$30.72
|
| Rate for Payer: PHP Medicare Advantage |
$30.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health Medicare |
$31.03
|
| Rate for Payer: Priority Health Medicare |
$31.03
|
| Rate for Payer: Priority Health Medicare |
$31.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.72
|
| Rate for Payer: UHC Exchange |
$30.72
|
| Rate for Payer: UHC Exchange |
$30.72
|
| Rate for Payer: UHC Exchange |
$30.72
|
| Rate for Payer: UHC Medicare Advantage |
$30.72
|
| Rate for Payer: UHC Medicare Advantage |
$30.72
|
| Rate for Payer: UHC Medicare Advantage |
$30.72
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADEX FOREARM 2 VIEWS
|
Professional
|
Both
|
$90.00
|
|
|
Service Code
|
HCPCS 73090
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$439.55 |
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCBS Trust/PPO |
$439.55
|
| Rate for Payer: BCBS Trust/PPO |
$439.55
|
| Rate for Payer: BCBS Trust/PPO |
$439.55
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$35.59
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$35.59
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$35.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health Medicare |
$26.83
|
| Rate for Payer: Priority Health Medicare |
$26.83
|
| Rate for Payer: Priority Health Medicare |
$26.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Exchange |
$26.56
|
| Rate for Payer: UHC Exchange |
$26.56
|
| Rate for Payer: UHC Exchange |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.56
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADEX HAND 2 VIEWS
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 73120
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$138.94 |
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCBS Trust/PPO |
$138.94
|
| Rate for Payer: BCBS Trust/PPO |
$138.94
|
| Rate for Payer: BCBS Trust/PPO |
$138.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Mclaren Medicaid |
$5.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health Medicare |
$28.61
|
| Rate for Payer: Priority Health Medicare |
$28.61
|
| Rate for Payer: Priority Health Medicare |
$28.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Exchange |
$28.33
|
| Rate for Payer: UHC Exchange |
$28.33
|
| Rate for Payer: UHC Exchange |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADEX HAND MINIMUM 3 VIEWS
|
Professional
|
Both
|
$96.00
|
|
|
Service Code
|
HCPCS 73130
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$325.96 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCBS Trust/PPO |
$325.96
|
| Rate for Payer: BCBS Trust/PPO |
$325.96
|
| Rate for Payer: BCBS Trust/PPO |
$325.96
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health Medicare |
$34.00
|
| Rate for Payer: Priority Health Medicare |
$34.00
|
| Rate for Payer: Priority Health Medicare |
$34.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.66
|
| Rate for Payer: UHC Exchange |
$33.66
|
| Rate for Payer: UHC Exchange |
$33.66
|
| Rate for Payer: UHC Exchange |
$33.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.66
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 73521
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$355.02 |
| Rate for Payer: Aetna Commercial |
$50.04
|
| Rate for Payer: Aetna Commercial |
$50.04
|
| Rate for Payer: Aetna Medicare |
$38.83
|
| Rate for Payer: Aetna Medicare |
$38.83
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$37.34
|
| Rate for Payer: BCBS MAPPO |
$37.34
|
| Rate for Payer: BCBS Trust/PPO |
$355.02
|
| Rate for Payer: BCBS Trust/PPO |
$355.02
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: BCN Medicare Advantage |
$37.34
|
| Rate for Payer: BCN Medicare Advantage |
$37.34
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$50.04
|
| Rate for Payer: Cofinity Commercial |
$53.77
|
| Rate for Payer: Cofinity Commercial |
$50.04
|
| Rate for Payer: Cofinity Commercial |
$53.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.34
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.21
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$44.81
|
| Rate for Payer: Nomi Health Commercial |
$44.81
|
| Rate for Payer: PACE SWMI |
$37.34
|
| Rate for Payer: PACE SWMI |
$37.34
|
| Rate for Payer: PHP Medicare Advantage |
$37.34
|
| Rate for Payer: PHP Medicare Advantage |
$37.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health Medicare |
$37.71
|
| Rate for Payer: Priority Health Medicare |
$37.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.34
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$37.34
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 73522
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$358.19 |
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Medicare |
$50.69
|
| Rate for Payer: Aetna Medicare |
$50.69
|
| Rate for Payer: Aetna Medicare |
$50.69
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS Complete |
$9.40
|
| Rate for Payer: BCBS MAPPO |
$48.74
|
| Rate for Payer: BCBS MAPPO |
$48.74
|
| Rate for Payer: BCBS MAPPO |
$48.74
|
| Rate for Payer: BCBS Trust/PPO |
$358.19
|
| Rate for Payer: BCBS Trust/PPO |
$358.19
|
| Rate for Payer: BCBS Trust/PPO |
$358.19
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$48.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.74
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$70.19
|
| Rate for Payer: Cofinity Commercial |
$65.31
|
| Rate for Payer: Cofinity Commercial |
$70.19
|
| Rate for Payer: Cofinity Commercial |
$65.31
|
| Rate for Payer: Cofinity Commercial |
$70.19
|
| Rate for Payer: Cofinity Commercial |
$65.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.74
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Mclaren Medicaid |
$8.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.18
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Meridian Medicaid |
$9.40
|
| Rate for Payer: Nomi Health Commercial |
$58.49
|
| Rate for Payer: Nomi Health Commercial |
$58.49
|
| Rate for Payer: Nomi Health Commercial |
$58.49
|
| Rate for Payer: PACE SWMI |
$48.74
|
| Rate for Payer: PACE SWMI |
$48.74
|
| Rate for Payer: PACE SWMI |
$48.74
|
| Rate for Payer: PHP Medicare Advantage |
$48.74
|
| Rate for Payer: PHP Medicare Advantage |
$48.74
|
| Rate for Payer: PHP Medicare Advantage |
$48.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO |
$21.56
|
| Rate for Payer: Priority Health HMO/PPO |
$21.56
|
| Rate for Payer: Priority Health HMO/PPO |
$21.56
|
| Rate for Payer: Priority Health Medicare |
$49.23
|
| Rate for Payer: Priority Health Medicare |
$49.23
|
| Rate for Payer: Priority Health Medicare |
$49.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.74
|
| Rate for Payer: UHC Exchange |
$48.74
|
| Rate for Payer: UHC Exchange |
$48.74
|
| Rate for Payer: UHC Exchange |
$48.74
|
| Rate for Payer: UHC Medicare Advantage |
$48.74
|
| Rate for Payer: UHC Medicare Advantage |
$48.74
|
| Rate for Payer: UHC Medicare Advantage |
$48.74
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
| Rate for Payer: UHCCP Medicaid |
$8.95
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 73523
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$2,539.54 |
| Rate for Payer: Aetna Commercial |
$74.99
|
| Rate for Payer: Aetna Commercial |
$74.99
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$55.96
|
| Rate for Payer: BCBS MAPPO |
$55.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,539.54
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$55.96
|
| Rate for Payer: BCN Medicare Advantage |
$55.96
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$74.99
|
| Rate for Payer: Cofinity Commercial |
$80.58
|
| Rate for Payer: Cofinity Commercial |
$74.99
|
| Rate for Payer: Cofinity Commercial |
$80.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.96
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.76
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Nomi Health Commercial |
$67.15
|
| Rate for Payer: Nomi Health Commercial |
$67.15
|
| Rate for Payer: PACE SWMI |
$55.96
|
| Rate for Payer: PACE SWMI |
$55.96
|
| Rate for Payer: PHP Medicare Advantage |
$55.96
|
| Rate for Payer: PHP Medicare Advantage |
$55.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health HMO/PPO |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO |
$23.10
|
| Rate for Payer: Priority Health Medicare |
$56.52
|
| Rate for Payer: Priority Health Medicare |
$56.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.96
|
| Rate for Payer: UHC Exchange |
$55.96
|
| Rate for Payer: UHC Exchange |
$55.96
|
| Rate for Payer: UHC Medicare Advantage |
$55.96
|
| Rate for Payer: UHC Medicare Advantage |
$55.96
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 73501
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$471.24 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Medicare |
$31.37
|
| Rate for Payer: Aetna Medicare |
$31.37
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$30.16
|
| Rate for Payer: BCN Medicare Advantage |
$30.16
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.16
|
| Rate for Payer: Mclaren Medicaid |
$5.75
|
| Rate for Payer: Mclaren Medicaid |
$5.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Nomi Health Commercial |
$36.19
|
| Rate for Payer: Nomi Health Commercial |
$36.19
|
| Rate for Payer: PACE SWMI |
$30.16
|
| Rate for Payer: PACE SWMI |
$30.16
|
| Rate for Payer: PHP Medicare Advantage |
$30.16
|
| Rate for Payer: PHP Medicare Advantage |
$30.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO |
$13.86
|
| Rate for Payer: Priority Health HMO/PPO |
$13.86
|
| Rate for Payer: Priority Health Medicare |
$30.46
|
| Rate for Payer: Priority Health Medicare |
$30.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.16
|
| Rate for Payer: UHC Exchange |
$30.16
|
| Rate for Payer: UHC Exchange |
$30.16
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 73502
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$267.32 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health Medicare |
$43.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Exchange |
$42.94
|
| Rate for Payer: UHC Exchange |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 73503
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$86.99 |
| Rate for Payer: Aetna Commercial |
$73.24
|
| Rate for Payer: Aetna Commercial |
$73.24
|
| Rate for Payer: Aetna Medicare |
$56.85
|
| Rate for Payer: Aetna Medicare |
$56.85
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$54.66
|
| Rate for Payer: BCBS MAPPO |
$54.66
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Medicare Advantage |
$54.66
|
| Rate for Payer: BCN Medicare Advantage |
$54.66
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$73.24
|
| Rate for Payer: Cofinity Commercial |
$78.71
|
| Rate for Payer: Cofinity Commercial |
$73.24
|
| Rate for Payer: Cofinity Commercial |
$78.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.66
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.39
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Nomi Health Commercial |
$65.59
|
| Rate for Payer: Nomi Health Commercial |
$65.59
|
| Rate for Payer: PACE SWMI |
$54.66
|
| Rate for Payer: PACE SWMI |
$54.66
|
| Rate for Payer: PHP Medicare Advantage |
$54.66
|
| Rate for Payer: PHP Medicare Advantage |
$54.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO |
$20.01
|
| Rate for Payer: Priority Health HMO/PPO |
$20.01
|
| Rate for Payer: Priority Health Medicare |
$55.21
|
| Rate for Payer: Priority Health Medicare |
$55.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.66
|
| Rate for Payer: UHC Exchange |
$54.66
|
| Rate for Payer: UHC Exchange |
$54.66
|
| Rate for Payer: UHC Medicare Advantage |
$54.66
|
| Rate for Payer: UHC Medicare Advantage |
$54.66
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
|
|
CHG RADEX HUMERUS MINIMUM 2 VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 73060
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$222.41 |
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Exchange |
$28.92
|
| Rate for Payer: UHC Exchange |
$28.92
|
| Rate for Payer: UHC Exchange |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 70160
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$59.17 |
| Rate for Payer: Aetna Commercial |
$45.51
|
| Rate for Payer: Aetna Commercial |
$45.51
|
| Rate for Payer: Aetna Medicare |
$35.32
|
| Rate for Payer: Aetna Medicare |
$35.32
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$56.19
|
| Rate for Payer: BCN Commercial |
$56.19
|
| Rate for Payer: BCN Medicare Advantage |
$33.96
|
| Rate for Payer: BCN Medicare Advantage |
$33.96
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$45.51
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Cofinity Commercial |
$45.51
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.96
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.66
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Nomi Health Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$40.75
|
| Rate for Payer: PACE SWMI |
$33.96
|
| Rate for Payer: PACE SWMI |
$33.96
|
| Rate for Payer: PHP Medicare Advantage |
$33.96
|
| Rate for Payer: PHP Medicare Advantage |
$33.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health Medicare |
$34.30
|
| Rate for Payer: Priority Health Medicare |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.96
|
| Rate for Payer: UHC Exchange |
$33.96
|
| Rate for Payer: UHC Exchange |
$33.96
|
| Rate for Payer: UHC Medicare Advantage |
$33.96
|
| Rate for Payer: UHC Medicare Advantage |
$33.96
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADEX OPTIC FORAMINA
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 70190
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$79.77 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna Medicare |
$35.13
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$33.78
|
| Rate for Payer: BCBS Trust/PPO |
$79.77
|
| Rate for Payer: BCN Commercial |
$55.22
|
| Rate for Payer: BCN Medicare Advantage |
$33.78
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$48.64
|
| Rate for Payer: Cofinity Commercial |
$45.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.78
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.47
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$40.54
|
| Rate for Payer: PACE SWMI |
$33.78
|
| Rate for Payer: PHP Medicare Advantage |
$33.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health Medicare |
$34.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.78
|
| Rate for Payer: UHC Exchange |
$33.78
|
| Rate for Payer: UHC Medicare Advantage |
$33.78
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
CHG RADEX ORBITS COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 70200
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$120.45 |
| Rate for Payer: Aetna Commercial |
$57.77
|
| Rate for Payer: Aetna Medicare |
$44.83
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$43.11
|
| Rate for Payer: BCBS Trust/PPO |
$120.45
|
| Rate for Payer: BCN Commercial |
$70.37
|
| Rate for Payer: BCN Medicare Advantage |
$43.11
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$62.08
|
| Rate for Payer: Cofinity Commercial |
$57.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.11
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.27
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: PACE SWMI |
$43.11
|
| Rate for Payer: PHP Medicare Advantage |
$43.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO |
$20.54
|
| Rate for Payer: Priority Health Medicare |
$43.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.11
|
| Rate for Payer: UHC Exchange |
$43.11
|
| Rate for Payer: UHC Medicare Advantage |
$43.11
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
|
|
CHG RADEX RIBS BILATERAL 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 71110
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$3,046.18 |
| Rate for Payer: Aetna Commercial |
$53.08
|
| Rate for Payer: Aetna Commercial |
$53.08
|
| Rate for Payer: Aetna Medicare |
$41.19
|
| Rate for Payer: Aetna Medicare |
$41.19
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,046.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,046.18
|
| Rate for Payer: BCN Commercial |
$64.51
|
| Rate for Payer: BCN Commercial |
$64.51
|
| Rate for Payer: BCN Medicare Advantage |
$39.61
|
| Rate for Payer: BCN Medicare Advantage |
$39.61
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.61
|
| Rate for Payer: Mclaren Medicaid |
$8.73
|
| Rate for Payer: Mclaren Medicaid |
$8.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.59
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| Rate for Payer: Nomi Health Commercial |
$47.53
|
| Rate for Payer: Nomi Health Commercial |
$47.53
|
| Rate for Payer: PACE SWMI |
$39.61
|
| Rate for Payer: PACE SWMI |
$39.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health HMO/PPO |
$21.05
|
| Rate for Payer: Priority Health HMO/PPO |
$21.05
|
| Rate for Payer: Priority Health Medicare |
$40.01
|
| Rate for Payer: Priority Health Medicare |
$40.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.61
|
| Rate for Payer: UHC Exchange |
$39.61
|
| Rate for Payer: UHC Exchange |
$39.61
|
| Rate for Payer: UHC Medicare Advantage |
$39.61
|
| Rate for Payer: UHC Medicare Advantage |
$39.61
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
|
|
CHG RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 71111
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$2,693.80 |
| Rate for Payer: Aetna Commercial |
$63.57
|
| Rate for Payer: Aetna Commercial |
$63.57
|
| Rate for Payer: Aetna Medicare |
$49.34
|
| Rate for Payer: Aetna Medicare |
$49.34
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,693.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,693.80
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: BCN Medicare Advantage |
$47.44
|
| Rate for Payer: BCN Medicare Advantage |
$47.44
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.44
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Mclaren Medicaid |
$9.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.81
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Nomi Health Commercial |
$56.93
|
| Rate for Payer: Nomi Health Commercial |
$56.93
|
| Rate for Payer: PACE SWMI |
$47.44
|
| Rate for Payer: PACE SWMI |
$47.44
|
| Rate for Payer: PHP Medicare Advantage |
$47.44
|
| Rate for Payer: PHP Medicare Advantage |
$47.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health HMO/PPO |
$23.61
|
| Rate for Payer: Priority Health HMO/PPO |
$23.61
|
| Rate for Payer: Priority Health Medicare |
$47.91
|
| Rate for Payer: Priority Health Medicare |
$47.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.44
|
| Rate for Payer: UHC Exchange |
$47.44
|
| Rate for Payer: UHC Exchange |
$47.44
|
| Rate for Payer: UHC Medicare Advantage |
$47.44
|
| Rate for Payer: UHC Medicare Advantage |
$47.44
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
|
|
CHG RADEX RIBS UNILATERAL 2 VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 71100
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$3,087.39 |
| Rate for Payer: Aetna Commercial |
$44.51
|
| Rate for Payer: Aetna Medicare |
$34.55
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$33.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,087.39
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Medicare Advantage |
$33.22
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| Rate for Payer: Cofinity Commercial |
$44.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.22
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.88
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$39.86
|
| Rate for Payer: PACE SWMI |
$33.22
|
| Rate for Payer: PHP Medicare Advantage |
$33.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO |
$15.91
|
| Rate for Payer: Priority Health Medicare |
$33.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.22
|
| Rate for Payer: UHC Exchange |
$33.22
|
| Rate for Payer: UHC Medicare Advantage |
$33.22
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
CHG RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 71101
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$2,607.16 |
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Medicare |
$39.60
|
| Rate for Payer: Aetna Medicare |
$39.60
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,607.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,607.16
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Medicare Advantage |
$38.08
|
| Rate for Payer: BCN Medicare Advantage |
$38.08
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$54.84
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Cofinity Commercial |
$54.84
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.08
|
| Rate for Payer: Mclaren Medicaid |
$8.09
|
| Rate for Payer: Mclaren Medicaid |
$8.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.98
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Nomi Health Commercial |
$45.70
|
| Rate for Payer: Nomi Health Commercial |
$45.70
|
| Rate for Payer: PACE SWMI |
$38.08
|
| Rate for Payer: PACE SWMI |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$38.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health HMO/PPO |
$19.51
|
| Rate for Payer: Priority Health HMO/PPO |
$19.51
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.08
|
| Rate for Payer: UHC Exchange |
$38.08
|
| Rate for Payer: UHC Exchange |
$38.08
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
|
|
CHG RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72220
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$2,093.12 |
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health Medicare |
$29.84
|
| Rate for Payer: Priority Health Medicare |
$29.84
|
| Rate for Payer: Priority Health Medicare |
$29.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.54
|
| Rate for Payer: UHC Exchange |
$29.54
|
| Rate for Payer: UHC Exchange |
$29.54
|
| Rate for Payer: UHC Exchange |
$29.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.54
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
