|
CHG RADEX SPINE LUMBOSACRAL 2/3 VIEWS
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 72100
|
| Min. Negotiated Rate |
$35.87 |
| Max. Negotiated Rate |
$67.60 |
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$41.60
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health Medicare |
$36.23
|
| Rate for Payer: Priority Health Medicare |
$36.23
|
| Rate for Payer: Priority Health Medicare |
$36.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Exchange |
$35.87
|
| Rate for Payer: UHC Exchange |
$35.87
|
| Rate for Payer: UHC Exchange |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
|
|
CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 72110
|
| Min. Negotiated Rate |
$46.89 |
| Max. Negotiated Rate |
$98.15 |
| Rate for Payer: Aetna Commercial |
$62.83
|
| Rate for Payer: Aetna Commercial |
$62.83
|
| Rate for Payer: Aetna Commercial |
$62.83
|
| Rate for Payer: Aetna Medicare |
$48.77
|
| Rate for Payer: Aetna Medicare |
$48.77
|
| Rate for Payer: Aetna Medicare |
$48.77
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$46.89
|
| Rate for Payer: BCBS MAPPO |
$46.89
|
| Rate for Payer: BCBS MAPPO |
$46.89
|
| Rate for Payer: BCN Medicare Advantage |
$46.89
|
| Rate for Payer: BCN Medicare Advantage |
$46.89
|
| Rate for Payer: BCN Medicare Advantage |
$46.89
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.52
|
| Rate for Payer: Cofinity Commercial |
$67.52
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.52
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.23
|
| Rate for Payer: Nomi Health Commercial |
$56.27
|
| Rate for Payer: Nomi Health Commercial |
$56.27
|
| Rate for Payer: Nomi Health Commercial |
$56.27
|
| Rate for Payer: PACE SWMI |
$46.89
|
| Rate for Payer: PACE SWMI |
$46.89
|
| Rate for Payer: PACE SWMI |
$46.89
|
| Rate for Payer: PHP Medicare Advantage |
$46.89
|
| Rate for Payer: PHP Medicare Advantage |
$46.89
|
| Rate for Payer: PHP Medicare Advantage |
$46.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.15
|
| Rate for Payer: Priority Health Medicare |
$47.36
|
| Rate for Payer: Priority Health Medicare |
$47.36
|
| Rate for Payer: Priority Health Medicare |
$47.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.89
|
| Rate for Payer: UHC Exchange |
$46.89
|
| Rate for Payer: UHC Exchange |
$46.89
|
| Rate for Payer: UHC Exchange |
$46.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.89
|
|
|
CHG RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 72120
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$52.92 |
| Rate for Payer: Aetna Commercial |
$49.24
|
| Rate for Payer: Aetna Medicare |
$38.22
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$36.75
|
| Rate for Payer: BCN Medicare Advantage |
$36.75
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$52.92
|
| Rate for Payer: Cofinity Commercial |
$49.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.59
|
| Rate for Payer: Nomi Health Commercial |
$44.10
|
| Rate for Payer: PACE SWMI |
$36.75
|
| Rate for Payer: PHP Medicare Advantage |
$36.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Medicare |
$37.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.75
|
| Rate for Payer: UHC Exchange |
$36.75
|
| Rate for Payer: UHC Medicare Advantage |
$36.75
|
|
|
CHG RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 72114
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$79.69 |
| Rate for Payer: Aetna Commercial |
$74.16
|
| Rate for Payer: Aetna Commercial |
$74.16
|
| Rate for Payer: Aetna Medicare |
$57.55
|
| Rate for Payer: Aetna Medicare |
$57.55
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS MAPPO |
$55.34
|
| Rate for Payer: BCBS MAPPO |
$55.34
|
| Rate for Payer: BCN Medicare Advantage |
$55.34
|
| Rate for Payer: BCN Medicare Advantage |
$55.34
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$79.69
|
| Rate for Payer: Cofinity Commercial |
$79.69
|
| Rate for Payer: Cofinity Commercial |
$74.16
|
| Rate for Payer: Cofinity Commercial |
$74.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.11
|
| Rate for Payer: Nomi Health Commercial |
$66.41
|
| Rate for Payer: Nomi Health Commercial |
$66.41
|
| Rate for Payer: PACE SWMI |
$55.34
|
| Rate for Payer: PACE SWMI |
$55.34
|
| Rate for Payer: PHP Medicare Advantage |
$55.34
|
| Rate for Payer: PHP Medicare Advantage |
$55.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Medicare |
$55.89
|
| Rate for Payer: Priority Health Medicare |
$55.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.34
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Exchange |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$55.34
|
|
|
CHG RADEX SPINE THORACIC 2 VIEWS
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 72070
|
| Min. Negotiated Rate |
$29.92 |
| Max. Negotiated Rate |
$66.30 |
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Commercial |
$40.09
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$29.92
|
| Rate for Payer: BCBS MAPPO |
$29.92
|
| Rate for Payer: BCBS MAPPO |
$29.92
|
| Rate for Payer: BCN Medicare Advantage |
$29.92
|
| Rate for Payer: BCN Medicare Advantage |
$29.92
|
| Rate for Payer: BCN Medicare Advantage |
$29.92
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$40.09
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$40.09
|
| Rate for Payer: Cofinity Commercial |
$43.08
|
| Rate for Payer: Cofinity Commercial |
$40.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Nomi Health Commercial |
$35.90
|
| Rate for Payer: Nomi Health Commercial |
$35.90
|
| Rate for Payer: Nomi Health Commercial |
$35.90
|
| Rate for Payer: PACE SWMI |
$29.92
|
| Rate for Payer: PACE SWMI |
$29.92
|
| Rate for Payer: PACE SWMI |
$29.92
|
| Rate for Payer: PHP Medicare Advantage |
$29.92
|
| Rate for Payer: PHP Medicare Advantage |
$29.92
|
| Rate for Payer: PHP Medicare Advantage |
$29.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Medicare |
$30.22
|
| Rate for Payer: Priority Health Medicare |
$30.22
|
| Rate for Payer: Priority Health Medicare |
$30.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.92
|
| Rate for Payer: UHC Exchange |
$29.92
|
| Rate for Payer: UHC Exchange |
$29.92
|
| Rate for Payer: UHC Exchange |
$29.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.92
|
| Rate for Payer: UHC Medicare Advantage |
$29.92
|
|
|
CHG RADEX SPINE THORACIC 3 VIEWS
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 72072
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$53.30 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Nomi Health Commercial |
$42.72
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$35.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Exchange |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
|
|
CHG RADEX SPINE THORACIC MINIMUM 4 VIEWS
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 72074
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$58.15 |
| Rate for Payer: Aetna Commercial |
$54.11
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$40.38
|
| Rate for Payer: BCN Medicare Advantage |
$40.38
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$58.15
|
| Rate for Payer: Cofinity Commercial |
$54.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$48.46
|
| Rate for Payer: PACE SWMI |
$40.38
|
| Rate for Payer: PHP Medicare Advantage |
$40.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$40.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.38
|
| Rate for Payer: UHC Exchange |
$40.38
|
| Rate for Payer: UHC Medicare Advantage |
$40.38
|
|
|
CHG RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS
|
Professional
|
Both
|
$111.00
|
|
|
Service Code
|
HCPCS 72080
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$72.15 |
| Rate for Payer: Aetna Commercial |
$42.10
|
| Rate for Payer: Aetna Commercial |
$42.10
|
| Rate for Payer: Aetna Commercial |
$42.10
|
| Rate for Payer: Aetna Medicare |
$32.68
|
| Rate for Payer: Aetna Medicare |
$32.68
|
| Rate for Payer: Aetna Medicare |
$32.68
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$31.42
|
| Rate for Payer: BCBS MAPPO |
$31.42
|
| Rate for Payer: BCBS MAPPO |
$31.42
|
| Rate for Payer: BCN Medicare Advantage |
$31.42
|
| Rate for Payer: BCN Medicare Advantage |
$31.42
|
| Rate for Payer: BCN Medicare Advantage |
$31.42
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$42.10
|
| Rate for Payer: Cofinity Commercial |
$45.24
|
| Rate for Payer: Cofinity Commercial |
$45.24
|
| Rate for Payer: Cofinity Commercial |
$42.10
|
| Rate for Payer: Cofinity Commercial |
$45.24
|
| Rate for Payer: Cofinity Commercial |
$42.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.99
|
| Rate for Payer: Nomi Health Commercial |
$37.70
|
| Rate for Payer: Nomi Health Commercial |
$37.70
|
| Rate for Payer: Nomi Health Commercial |
$37.70
|
| Rate for Payer: PACE SWMI |
$31.42
|
| Rate for Payer: PACE SWMI |
$31.42
|
| Rate for Payer: PACE SWMI |
$31.42
|
| Rate for Payer: PHP Medicare Advantage |
$31.42
|
| Rate for Payer: PHP Medicare Advantage |
$31.42
|
| Rate for Payer: PHP Medicare Advantage |
$31.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: Priority Health Medicare |
$31.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.42
|
| Rate for Payer: UHC Exchange |
$31.42
|
| Rate for Payer: UHC Exchange |
$31.42
|
| Rate for Payer: UHC Exchange |
$31.42
|
| Rate for Payer: UHC Medicare Advantage |
$31.42
|
| Rate for Payer: UHC Medicare Advantage |
$31.42
|
| Rate for Payer: UHC Medicare Advantage |
$31.42
|
|
|
CHG RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 71130
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$53.35 |
| Rate for Payer: Aetna Commercial |
$49.65
|
| Rate for Payer: Aetna Commercial |
$49.65
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$53.35
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Cofinity Commercial |
$53.35
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: Nomi Health Commercial |
$44.46
|
| Rate for Payer: Nomi Health Commercial |
$44.46
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Medicare |
$37.42
|
| Rate for Payer: Priority Health Medicare |
$37.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.05
|
| Rate for Payer: UHC Exchange |
$37.05
|
| Rate for Payer: UHC Exchange |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$37.05
|
|
|
CHG RADEX STERNUM MINIMUM 2 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 71120
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$43.50 |
| Rate for Payer: Aetna Commercial |
$40.48
|
| Rate for Payer: Aetna Commercial |
$40.48
|
| Rate for Payer: Aetna Medicare |
$31.42
|
| Rate for Payer: Aetna Medicare |
$31.42
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$30.21
|
| Rate for Payer: BCBS MAPPO |
$30.21
|
| Rate for Payer: BCN Medicare Advantage |
$30.21
|
| Rate for Payer: BCN Medicare Advantage |
$30.21
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$43.50
|
| Rate for Payer: Cofinity Commercial |
$40.48
|
| Rate for Payer: Cofinity Commercial |
$43.50
|
| Rate for Payer: Cofinity Commercial |
$40.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.72
|
| Rate for Payer: Nomi Health Commercial |
$36.25
|
| Rate for Payer: Nomi Health Commercial |
$36.25
|
| Rate for Payer: PACE SWMI |
$30.21
|
| Rate for Payer: PACE SWMI |
$30.21
|
| Rate for Payer: PHP Medicare Advantage |
$30.21
|
| Rate for Payer: PHP Medicare Advantage |
$30.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Medicare |
$30.51
|
| Rate for Payer: Priority Health Medicare |
$30.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.21
|
| Rate for Payer: UHC Exchange |
$30.21
|
| Rate for Payer: UHC Exchange |
$30.21
|
| Rate for Payer: UHC Medicare Advantage |
$30.21
|
| Rate for Payer: UHC Medicare Advantage |
$30.21
|
|
|
CHG RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 70330
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$68.70 |
| Rate for Payer: Aetna Commercial |
$63.93
|
| Rate for Payer: Aetna Medicare |
$49.62
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS MAPPO |
$47.71
|
| Rate for Payer: BCN Medicare Advantage |
$47.71
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$68.70
|
| Rate for Payer: Cofinity Commercial |
$63.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.10
|
| Rate for Payer: Nomi Health Commercial |
$57.25
|
| Rate for Payer: PACE SWMI |
$47.71
|
| Rate for Payer: PHP Medicare Advantage |
$47.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Medicare |
$48.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.71
|
| Rate for Payer: UHC Exchange |
$47.71
|
| Rate for Payer: UHC Medicare Advantage |
$47.71
|
|
|
CHG RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 70328
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$44.70 |
| Rate for Payer: Aetna Commercial |
$41.59
|
| Rate for Payer: Aetna Medicare |
$32.28
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$31.04
|
| Rate for Payer: BCN Medicare Advantage |
$31.04
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$44.70
|
| Rate for Payer: Cofinity Commercial |
$41.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.59
|
| Rate for Payer: Nomi Health Commercial |
$37.25
|
| Rate for Payer: PACE SWMI |
$31.04
|
| Rate for Payer: PHP Medicare Advantage |
$31.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$31.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.04
|
| Rate for Payer: UHC Exchange |
$31.04
|
| Rate for Payer: UHC Medicare Advantage |
$31.04
|
|
|
CHG RADEX TOE MINIMUM 2 VIEWS
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 73660
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$37.70 |
| Rate for Payer: Aetna Commercial |
$35.08
|
| Rate for Payer: Aetna Commercial |
$35.08
|
| Rate for Payer: Aetna Commercial |
$35.08
|
| Rate for Payer: Aetna Medicare |
$27.23
|
| Rate for Payer: Aetna Medicare |
$27.23
|
| Rate for Payer: Aetna Medicare |
$27.23
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$26.18
|
| Rate for Payer: BCBS MAPPO |
$26.18
|
| Rate for Payer: BCBS MAPPO |
$26.18
|
| Rate for Payer: BCN Medicare Advantage |
$26.18
|
| Rate for Payer: BCN Medicare Advantage |
$26.18
|
| Rate for Payer: BCN Medicare Advantage |
$26.18
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.49
|
| Rate for Payer: Nomi Health Commercial |
$31.42
|
| Rate for Payer: Nomi Health Commercial |
$31.42
|
| Rate for Payer: Nomi Health Commercial |
$31.42
|
| Rate for Payer: PACE SWMI |
$26.18
|
| Rate for Payer: PACE SWMI |
$26.18
|
| Rate for Payer: PACE SWMI |
$26.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.60
|
| Rate for Payer: Priority Health Medicare |
$26.44
|
| Rate for Payer: Priority Health Medicare |
$26.44
|
| Rate for Payer: Priority Health Medicare |
$26.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.18
|
| Rate for Payer: UHC Exchange |
$26.18
|
| Rate for Payer: UHC Exchange |
$26.18
|
| Rate for Payer: UHC Exchange |
$26.18
|
| Rate for Payer: UHC Medicare Advantage |
$26.18
|
| Rate for Payer: UHC Medicare Advantage |
$26.18
|
| Rate for Payer: UHC Medicare Advantage |
$26.18
|
|
|
CHG RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 73092
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$28.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Exchange |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
|
|
CHG RADEX WRIST 2 VIEWS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 73100
|
| Min. Negotiated Rate |
$30.39 |
| Max. Negotiated Rate |
$54.60 |
| Rate for Payer: Aetna Commercial |
$40.72
|
| Rate for Payer: Aetna Commercial |
$40.72
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$30.39
|
| Rate for Payer: BCBS MAPPO |
$30.39
|
| Rate for Payer: BCN Medicare Advantage |
$30.39
|
| Rate for Payer: BCN Medicare Advantage |
$30.39
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Cofinity Commercial |
$43.76
|
| Rate for Payer: Cofinity Commercial |
$40.72
|
| Rate for Payer: Cofinity Commercial |
$40.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.91
|
| Rate for Payer: Nomi Health Commercial |
$36.47
|
| Rate for Payer: Nomi Health Commercial |
$36.47
|
| Rate for Payer: PACE SWMI |
$30.39
|
| Rate for Payer: PACE SWMI |
$30.39
|
| Rate for Payer: PHP Medicare Advantage |
$30.39
|
| Rate for Payer: PHP Medicare Advantage |
$30.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.39
|
| Rate for Payer: UHC Exchange |
$30.39
|
| Rate for Payer: UHC Exchange |
$30.39
|
| Rate for Payer: UHC Medicare Advantage |
$30.39
|
| Rate for Payer: UHC Medicare Advantage |
$30.39
|
|
|
CHG RADEX WRIST COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73110
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$53.57 |
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: Aetna Medicare |
$38.69
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCBS MAPPO |
$37.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.20
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$53.57
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.06
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: Nomi Health Commercial |
$44.64
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PACE SWMI |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: PHP Medicare Advantage |
$37.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$37.57
|
| Rate for Payer: Priority Health Medicare |
$37.57
|
| Rate for Payer: Priority Health Medicare |
$37.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.20
|
| Rate for Payer: UHC Exchange |
$37.20
|
| Rate for Payer: UHC Exchange |
$37.20
|
| Rate for Payer: UHC Exchange |
$37.20
|
| Rate for Payer: UHC Medicare Advantage |
$37.20
|
| Rate for Payer: UHC Medicare Advantage |
$37.20
|
| Rate for Payer: UHC Medicare Advantage |
$37.20
|
|
|
CHG RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 77431
|
| Min. Negotiated Rate |
$84.80 |
| Max. Negotiated Rate |
$148.64 |
| Rate for Payer: Aetna Commercial |
$138.31
|
| Rate for Payer: Aetna Medicare |
$107.35
|
| Rate for Payer: BCBS Complete |
$84.80
|
| Rate for Payer: BCBS MAPPO |
$103.22
|
| Rate for Payer: BCN Medicare Advantage |
$103.22
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$148.64
|
| Rate for Payer: Cofinity Commercial |
$138.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.38
|
| Rate for Payer: Nomi Health Commercial |
$123.86
|
| Rate for Payer: PACE SWMI |
$103.22
|
| Rate for Payer: PHP Medicare Advantage |
$103.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.80
|
| Rate for Payer: Priority Health Medicare |
$104.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.22
|
| Rate for Payer: UHC Exchange |
$103.22
|
| Rate for Payer: UHC Medicare Advantage |
$103.22
|
|
|
CHG RADIATION TREATMENT DELIVERY >=1 MEV COMPLEX
|
Professional
|
Both
|
$553.00
|
|
|
Service Code
|
HCPCS 77412
|
| Min. Negotiated Rate |
$221.20 |
| Max. Negotiated Rate |
$359.45 |
| Rate for Payer: Aetna Medicare |
$276.50
|
| Rate for Payer: BCBS Complete |
$221.20
|
| Rate for Payer: Cash Price |
$442.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.45
|
|
|
CHG RADIATION TREATMENT DELIVERY >=1 MEV SIMPLE
|
Professional
|
Both
|
$362.00
|
|
|
Service Code
|
HCPCS 77402
|
| Min. Negotiated Rate |
$144.80 |
| Max. Negotiated Rate |
$235.30 |
| Rate for Payer: Aetna Medicare |
$181.00
|
| Rate for Payer: BCBS Complete |
$144.80
|
| Rate for Payer: Cash Price |
$289.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$235.30
|
|
|
CHG RADIATION TREATMENT MANAGEMENT 5 TREATMENTS
|
Professional
|
Both
|
$360.00
|
|
|
Service Code
|
HCPCS 77427
|
| Min. Negotiated Rate |
$144.00 |
| Max. Negotiated Rate |
$263.81 |
| Rate for Payer: Aetna Commercial |
$245.49
|
| Rate for Payer: Aetna Medicare |
$190.53
|
| Rate for Payer: BCBS Complete |
$144.00
|
| Rate for Payer: BCBS MAPPO |
$183.20
|
| Rate for Payer: BCN Medicare Advantage |
$183.20
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cash Price |
$288.00
|
| Rate for Payer: Cofinity Commercial |
$245.49
|
| Rate for Payer: Cofinity Commercial |
$263.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.36
|
| Rate for Payer: Nomi Health Commercial |
$219.84
|
| Rate for Payer: PACE SWMI |
$183.20
|
| Rate for Payer: PHP Medicare Advantage |
$183.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.00
|
| Rate for Payer: Priority Health Medicare |
$185.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.20
|
| Rate for Payer: UHC Exchange |
$183.20
|
| Rate for Payer: UHC Medicare Advantage |
$183.20
|
|
|
CHG RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTAGE
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 77401
|
| Min. Negotiated Rate |
$36.33 |
| Max. Negotiated Rate |
$59.15 |
| Rate for Payer: Aetna Commercial |
$48.68
|
| Rate for Payer: Aetna Medicare |
$37.78
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: BCBS MAPPO |
$36.33
|
| Rate for Payer: BCN Medicare Advantage |
$36.33
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$52.32
|
| Rate for Payer: Cofinity Commercial |
$48.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.15
|
| Rate for Payer: Nomi Health Commercial |
$43.60
|
| Rate for Payer: PACE SWMI |
$36.33
|
| Rate for Payer: PHP Medicare Advantage |
$36.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health Medicare |
$36.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.33
|
| Rate for Payer: UHC Exchange |
$36.33
|
| Rate for Payer: UHC Medicare Advantage |
$36.33
|
|
|
CHG RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS
|
Professional
|
Both
|
$25.00
|
|
|
Service Code
|
HCPCS 70110
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$56.87 |
| Rate for Payer: Aetna Commercial |
$52.92
|
| Rate for Payer: Aetna Medicare |
$41.07
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: BCBS MAPPO |
$39.49
|
| Rate for Payer: BCN Medicare Advantage |
$39.49
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$56.87
|
| Rate for Payer: Cofinity Commercial |
$52.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.46
|
| Rate for Payer: Nomi Health Commercial |
$47.39
|
| Rate for Payer: PACE SWMI |
$39.49
|
| Rate for Payer: PHP Medicare Advantage |
$39.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.25
|
| Rate for Payer: Priority Health Medicare |
$39.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.49
|
| Rate for Payer: UHC Exchange |
$39.49
|
| Rate for Payer: UHC Medicare Advantage |
$39.49
|
|
|
CHG RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 75989
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$150.15 |
| Rate for Payer: Aetna Commercial |
$136.60
|
| Rate for Payer: Aetna Medicare |
$106.02
|
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: BCBS MAPPO |
$101.94
|
| Rate for Payer: BCN Medicare Advantage |
$101.94
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$146.79
|
| Rate for Payer: Cofinity Commercial |
$136.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.04
|
| Rate for Payer: Nomi Health Commercial |
$122.33
|
| Rate for Payer: PACE SWMI |
$101.94
|
| Rate for Payer: PHP Medicare Advantage |
$101.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health Medicare |
$102.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$101.94
|
| Rate for Payer: UHC Exchange |
$101.94
|
| Rate for Payer: UHC Medicare Advantage |
$101.94
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 74018
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.18 |
| Rate for Payer: Aetna Commercial |
$36.46
|
| Rate for Payer: Aetna Medicare |
$28.30
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS MAPPO |
$27.21
|
| Rate for Payer: BCN Medicare Advantage |
$27.21
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$39.18
|
| Rate for Payer: Cofinity Commercial |
$36.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.57
|
| Rate for Payer: Nomi Health Commercial |
$32.65
|
| Rate for Payer: PACE SWMI |
$27.21
|
| Rate for Payer: PHP Medicare Advantage |
$27.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Medicare |
$27.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.21
|
| Rate for Payer: UHC Exchange |
$27.21
|
| Rate for Payer: UHC Medicare Advantage |
$27.21
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 74019
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$48.30 |
| Rate for Payer: Aetna Commercial |
$44.94
|
| Rate for Payer: Aetna Commercial |
$44.94
|
| Rate for Payer: Aetna Medicare |
$34.88
|
| Rate for Payer: Aetna Medicare |
$34.88
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$33.54
|
| Rate for Payer: BCBS MAPPO |
$33.54
|
| Rate for Payer: BCN Medicare Advantage |
$33.54
|
| Rate for Payer: BCN Medicare Advantage |
$33.54
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Cofinity Commercial |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Cofinity Commercial |
$44.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.22
|
| Rate for Payer: Nomi Health Commercial |
$40.25
|
| Rate for Payer: Nomi Health Commercial |
$40.25
|
| Rate for Payer: PACE SWMI |
$33.54
|
| Rate for Payer: PACE SWMI |
$33.54
|
| Rate for Payer: PHP Medicare Advantage |
$33.54
|
| Rate for Payer: PHP Medicare Advantage |
$33.54
|
| 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 Medicare |
$33.88
|
| Rate for Payer: Priority Health Medicare |
$33.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.54
|
| Rate for Payer: UHC Exchange |
$33.54
|
| Rate for Payer: UHC Exchange |
$33.54
|
| Rate for Payer: UHC Medicare Advantage |
$33.54
|
| Rate for Payer: UHC Medicare Advantage |
$33.54
|
|
