|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 74021
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$55.68 |
| Rate for Payer: Aetna Commercial |
$51.82
|
| Rate for Payer: Aetna Medicare |
$40.22
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$38.67
|
| Rate for Payer: BCN Medicare Advantage |
$38.67
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$55.68
|
| Rate for Payer: Cofinity Commercial |
$51.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$46.40
|
| Rate for Payer: PACE SWMI |
$38.67
|
| Rate for Payer: PHP Medicare Advantage |
$38.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$39.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.67
|
| Rate for Payer: UHC Exchange |
$38.67
|
| Rate for Payer: UHC Medicare Advantage |
$38.67
|
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 73565
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$51.83 |
| Rate for Payer: Aetna Commercial |
$48.23
|
| Rate for Payer: Aetna Commercial |
$48.23
|
| Rate for Payer: Aetna Commercial |
$48.23
|
| Rate for Payer: Aetna Medicare |
$37.43
|
| Rate for Payer: Aetna Medicare |
$37.43
|
| Rate for Payer: Aetna Medicare |
$37.43
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$35.99
|
| Rate for Payer: BCBS MAPPO |
$35.99
|
| Rate for Payer: BCBS MAPPO |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$35.99
|
| Rate for Payer: BCN Medicare Advantage |
$35.99
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Cofinity Commercial |
$48.23
|
| Rate for Payer: Cofinity Commercial |
$51.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.79
|
| Rate for Payer: Nomi Health Commercial |
$43.19
|
| Rate for Payer: Nomi Health Commercial |
$43.19
|
| Rate for Payer: Nomi Health Commercial |
$43.19
|
| Rate for Payer: PACE SWMI |
$35.99
|
| Rate for Payer: PACE SWMI |
$35.99
|
| Rate for Payer: PACE SWMI |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$35.99
|
| Rate for Payer: PHP Medicare Advantage |
$35.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Medicare |
$36.35
|
| Rate for Payer: Priority Health Medicare |
$36.35
|
| Rate for Payer: Priority Health Medicare |
$36.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.99
|
| Rate for Payer: UHC Exchange |
$35.99
|
| Rate for Payer: UHC Exchange |
$35.99
|
| Rate for Payer: UHC Exchange |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$35.99
|
| Rate for Payer: UHC Medicare Advantage |
$35.99
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 71046
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$44.02 |
| Rate for Payer: Aetna Commercial |
$40.96
|
| Rate for Payer: Aetna Medicare |
$31.79
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$30.57
|
| Rate for Payer: BCN Medicare Advantage |
$30.57
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$44.02
|
| Rate for Payer: Cofinity Commercial |
$40.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.10
|
| Rate for Payer: Nomi Health Commercial |
$36.68
|
| Rate for Payer: PACE SWMI |
$30.57
|
| Rate for Payer: PHP Medicare Advantage |
$30.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Medicare |
$30.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.57
|
| Rate for Payer: UHC Exchange |
$30.57
|
| Rate for Payer: UHC Medicare Advantage |
$30.57
|
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 71047
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$54.84 |
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Medicare |
$39.60
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCN Medicare Advantage |
$38.08
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.98
|
| Rate for Payer: Nomi Health Commercial |
$45.70
|
| Rate for Payer: PACE SWMI |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$38.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.08
|
| Rate for Payer: UHC Exchange |
$38.08
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 71045
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$34.08 |
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$23.91
|
| Rate for Payer: Priority Health Medicare |
$23.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Exchange |
$23.67
|
| Rate for Payer: UHC Exchange |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$65.35 |
| Rate for Payer: Aetna Commercial |
$60.81
|
| Rate for Payer: Aetna Medicare |
$47.20
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$45.38
|
| Rate for Payer: BCN Medicare Advantage |
$45.38
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$65.35
|
| Rate for Payer: Cofinity Commercial |
$60.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.65
|
| Rate for Payer: Nomi Health Commercial |
$54.46
|
| Rate for Payer: PACE SWMI |
$45.38
|
| Rate for Payer: PHP Medicare Advantage |
$45.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health Medicare |
$45.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.38
|
| Rate for Payer: UHC Exchange |
$45.38
|
| Rate for Payer: UHC Medicare Advantage |
$45.38
|
|
|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 73600
|
| Min. Negotiated Rate |
$28.92 |
| Max. Negotiated Rate |
$51.35 |
| 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: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| 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: 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: 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: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| 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 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
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 70030
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$43.00 |
| Rate for Payer: Aetna Commercial |
$40.01
|
| Rate for Payer: Aetna Medicare |
$31.05
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$29.86
|
| Rate for Payer: BCN Medicare Advantage |
$29.86
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Cofinity Commercial |
$40.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.35
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PACE SWMI |
$29.86
|
| Rate for Payer: PHP Medicare Advantage |
$29.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.86
|
| Rate for Payer: UHC Exchange |
$29.86
|
| Rate for Payer: UHC Medicare Advantage |
$29.86
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73551
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$38.68 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$27.93
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$26.86
|
| Rate for Payer: BCN Medicare Advantage |
$26.86
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$38.68
|
| Rate for Payer: Cofinity Commercial |
$35.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.20
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: PACE SWMI |
$26.86
|
| Rate for Payer: PHP Medicare Advantage |
$26.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$27.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.86
|
| Rate for Payer: UHC Exchange |
$26.86
|
| Rate for Payer: UHC Medicare Advantage |
$26.86
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$46.40 |
| Rate for Payer: Aetna Commercial |
$43.17
|
| Rate for Payer: Aetna Commercial |
$43.17
|
| Rate for Payer: Aetna Medicare |
$33.51
|
| Rate for Payer: Aetna Medicare |
$33.51
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS MAPPO |
$32.22
|
| Rate for Payer: BCBS MAPPO |
$32.22
|
| Rate for Payer: BCN Medicare Advantage |
$32.22
|
| Rate for Payer: BCN Medicare Advantage |
$32.22
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.83
|
| Rate for Payer: Nomi Health Commercial |
$38.66
|
| Rate for Payer: Nomi Health Commercial |
$38.66
|
| Rate for Payer: PACE SWMI |
$32.22
|
| Rate for Payer: PACE SWMI |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Medicare |
$32.54
|
| Rate for Payer: Priority Health Medicare |
$32.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.22
|
| Rate for Payer: UHC Exchange |
$32.22
|
| Rate for Payer: UHC Exchange |
$32.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.22
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 73620
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$36.98 |
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$31.20
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Medicare |
$25.94
|
| Rate for Payer: Priority Health Medicare |
$25.94
|
| Rate for Payer: Priority Health Medicare |
$25.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Exchange |
$25.68
|
| Rate for Payer: UHC Exchange |
$25.68
|
| Rate for Payer: UHC Exchange |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$44.19 |
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: BCBS Complete |
$16.80
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$31.00
|
| Rate for Payer: Priority Health Medicare |
$31.00
|
| Rate for Payer: Priority Health Medicare |
$31.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Exchange |
$30.69
|
| Rate for Payer: UHC Exchange |
$30.69
|
| Rate for Payer: UHC Exchange |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$52.76 |
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health Medicare |
$37.01
|
| Rate for Payer: Priority Health Medicare |
$37.01
|
| Rate for Payer: Priority Health Medicare |
$37.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Exchange |
$36.64
|
| Rate for Payer: UHC Exchange |
$36.64
|
| Rate for Payer: UHC Exchange |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70100
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$50.21 |
| Rate for Payer: Aetna Commercial |
$46.73
|
| Rate for Payer: Aetna Medicare |
$36.26
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$34.87
|
| Rate for Payer: BCN Medicare Advantage |
$34.87
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$50.21
|
| Rate for Payer: Cofinity Commercial |
$46.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.61
|
| Rate for Payer: Nomi Health Commercial |
$41.84
|
| Rate for Payer: PACE SWMI |
$34.87
|
| Rate for Payer: PHP Medicare Advantage |
$34.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Medicare |
$35.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.87
|
| Rate for Payer: UHC Exchange |
$34.87
|
| Rate for Payer: UHC Medicare Advantage |
$34.87
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 70360
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$40.88 |
| Rate for Payer: Aetna Commercial |
$38.04
|
| Rate for Payer: Aetna Medicare |
$29.53
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$28.39
|
| Rate for Payer: BCN Medicare Advantage |
$28.39
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Cofinity Commercial |
$38.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.81
|
| Rate for Payer: Nomi Health Commercial |
$34.07
|
| Rate for Payer: PACE SWMI |
$28.39
|
| Rate for Payer: PHP Medicare Advantage |
$28.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$28.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.39
|
| Rate for Payer: UHC Exchange |
$28.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.39
|
|
|
CHG RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPLETE
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 77075
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$128.92 |
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna Medicare |
$93.11
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$89.53
|
| Rate for Payer: BCN Medicare Advantage |
$89.53
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$128.92
|
| Rate for Payer: Cofinity Commercial |
$119.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.01
|
| Rate for Payer: Nomi Health Commercial |
$107.44
|
| Rate for Payer: PACE SWMI |
$89.53
|
| Rate for Payer: PHP Medicare Advantage |
$89.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health Medicare |
$90.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.53
|
| Rate for Payer: UHC Exchange |
$89.53
|
| Rate for Payer: UHC Medicare Advantage |
$89.53
|
|
|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 72170
|
| Min. Negotiated Rate |
$25.41 |
| Max. Negotiated Rate |
$77.35 |
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: BCBS Complete |
$47.60
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Exchange |
$25.41
|
| Rate for Payer: UHC Exchange |
$25.41
|
| Rate for Payer: UHC Exchange |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
|
|
CHG RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72200
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$43.80 |
| Rate for Payer: Aetna Commercial |
$40.76
|
| Rate for Payer: Aetna Medicare |
$31.64
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$30.42
|
| Rate for Payer: BCN Medicare Advantage |
$30.42
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$43.80
|
| Rate for Payer: Cofinity Commercial |
$40.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.94
|
| Rate for Payer: Nomi Health Commercial |
$36.50
|
| Rate for Payer: PACE SWMI |
$30.42
|
| Rate for Payer: PHP Medicare Advantage |
$30.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$30.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.42
|
| Rate for Payer: UHC Exchange |
$30.42
|
| Rate for Payer: UHC Medicare Advantage |
$30.42
|
|
|
CHG RADIOLOGIC EXAMINATION SKULL 4< VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 70250
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$46.81 |
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Exchange |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
|
|
CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 73590
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$41.21 |
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Exchange |
$28.62
|
| Rate for Payer: UHC Exchange |
$28.62
|
| Rate for Payer: UHC Exchange |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
|
|
CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 73564
|
| Min. Negotiated Rate |
$42.65 |
| Max. Negotiated Rate |
$73.45 |
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Complete |
$45.20
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health Medicare |
$43.08
|
| Rate for Payer: Priority Health Medicare |
$43.08
|
| Rate for Payer: Priority Health Medicare |
$43.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Exchange |
$42.65
|
| Rate for Payer: UHC Exchange |
$42.65
|
| Rate for Payer: UHC Exchange |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
|
|
CHG RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 72190
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$54.75 |
| Rate for Payer: Aetna Commercial |
$50.95
|
| Rate for Payer: Aetna Commercial |
$50.95
|
| Rate for Payer: Aetna Medicare |
$39.54
|
| Rate for Payer: Aetna Medicare |
$39.54
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.92
|
| Rate for Payer: Nomi Health Commercial |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$45.62
|
| Rate for Payer: PACE SWMI |
$38.02
|
| Rate for Payer: PACE SWMI |
$38.02
|
| Rate for Payer: PHP Medicare Advantage |
$38.02
|
| Rate for Payer: PHP Medicare Advantage |
$38.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Medicare |
$38.40
|
| Rate for Payer: Priority Health Medicare |
$38.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.02
|
| Rate for Payer: UHC Exchange |
$38.02
|
| Rate for Payer: UHC Exchange |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$38.02
|
|
|
CHG RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 72202
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$51.26 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| 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: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| 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: Nomi Health Commercial |
$42.72
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Medicare |
$35.96
|
| Rate for Payer: Priority Health Medicare |
$35.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Exchange |
$35.60
|
| Rate for Payer: UHC Exchange |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
|
|
CHG RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 70260
|
| Min. Negotiated Rate |
$23.60 |
| Max. Negotiated Rate |
$58.26 |
| Rate for Payer: Aetna Commercial |
$54.22
|
| Rate for Payer: Aetna Medicare |
$42.08
|
| Rate for Payer: BCBS Complete |
$23.60
|
| Rate for Payer: BCBS MAPPO |
$40.46
|
| Rate for Payer: BCN Medicare Advantage |
$40.46
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$54.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Nomi Health Commercial |
$48.55
|
| Rate for Payer: PACE SWMI |
$40.46
|
| Rate for Payer: PHP Medicare Advantage |
$40.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.46
|
| Rate for Payer: UHC Exchange |
$40.46
|
| Rate for Payer: UHC Medicare Advantage |
$40.46
|
|
|
CHG RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 74250
|
| Min. Negotiated Rate |
$94.40 |
| Max. Negotiated Rate |
$156.73 |
| Rate for Payer: Aetna Commercial |
$145.85
|
| Rate for Payer: Aetna Medicare |
$113.19
|
| Rate for Payer: BCBS Complete |
$94.40
|
| Rate for Payer: BCBS MAPPO |
$108.84
|
| Rate for Payer: BCN Medicare Advantage |
$108.84
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$156.73
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.28
|
| Rate for Payer: Nomi Health Commercial |
$130.61
|
| Rate for Payer: PACE SWMI |
$108.84
|
| Rate for Payer: PHP Medicare Advantage |
$108.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health Medicare |
$109.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.84
|
| Rate for Payer: UHC Exchange |
$108.84
|
| Rate for Payer: UHC Medicare Advantage |
$108.84
|
|
