|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 72170
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$1,953.65 |
| 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 |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| 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 |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| 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 |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| 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: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$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: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| 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 Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$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 HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO |
$12.83
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health Medicare |
$25.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$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
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72200
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$2,183.46 |
| Rate for Payer: Aetna Commercial |
$40.76
|
| Rate for Payer: Aetna Medicare |
$31.64
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,183.46
|
| Rate for Payer: BCN Commercial |
$48.38
|
| 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: Mclaren Medicaid |
$5.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.94
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| 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 Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO |
$12.32
|
| Rate for Payer: Priority Health Medicare |
$30.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.32
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADIOLOGIC EXAMINATION SKULL 4< VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 70250
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,779.84 |
| 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 |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.84
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Commercial |
$52.78
|
| 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 |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| 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: Mclaren Medicaid |
$5.54
|
| Rate for Payer: Mclaren Medicaid |
$5.54
|
| 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: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| 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 Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO |
$13.34
|
| Rate for Payer: Priority Health HMO/PPO |
$13.34
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Medicare |
$32.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 73590
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$598.56 |
| 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 |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Commercial |
$46.43
|
| 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 |
$29.60
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$67.20
|
| 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: 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: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Mclaren Medicaid |
$4.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| 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: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| 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 Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$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 HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO |
$11.81
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: Priority Health Medicare |
$28.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.62
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 73564
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$1,700.07 |
| 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 |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| 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 |
$32.00
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$48.80
|
| 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: 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: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| 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: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| 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 Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| 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 HMO/PPO |
$16.93
|
| Rate for Payer: Priority Health HMO/PPO |
$16.93
|
| Rate for Payer: Priority Health HMO/PPO |
$16.93
|
| 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: Priority Health Narrow/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.93
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
|
|
CHG RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 72190
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$1,716.45 |
| 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 |
$8.05
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.45
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Mclaren Medicaid |
$7.67
|
| Rate for Payer: Mclaren Medicaid |
$7.67
|
| 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: Meridian Medicaid |
$8.05
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| 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 Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| 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 HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$38.40
|
| Rate for Payer: Priority Health Medicare |
$38.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.47
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
|
|
CHG RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 72202
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$378.26 |
| 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 |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| 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 Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| 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 HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO |
$16.42
|
| Rate for Payer: Priority Health Medicare |
$35.96
|
| Rate for Payer: Priority Health Medicare |
$35.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$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
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
CHG RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 70260
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$54.22
|
| Rate for Payer: Aetna Medicare |
$42.08
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$40.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,020.75
|
| Rate for Payer: BCN Commercial |
$65.48
|
| 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 |
$54.22
|
| Rate for Payer: Cofinity Commercial |
$58.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.46
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| 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 Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO |
$20.54
|
| Rate for Payer: Priority Health Medicare |
$40.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.54
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
|
|
CHG RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 74250
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$181.79 |
| Rate for Payer: Aetna Commercial |
$145.85
|
| Rate for Payer: Aetna Medicare |
$113.19
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$108.84
|
| Rate for Payer: BCN Commercial |
$181.79
|
| 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: Mclaren Medicaid |
$24.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.28
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| 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 Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO |
$57.99
|
| Rate for Payer: Priority Health Medicare |
$109.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.99
|
| 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
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
|
CHG RADN RX DELIVERY COMPLX 11-19 MEV
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 77414
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$308.75 |
| Rate for Payer: Aetna Medicare |
$237.50
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
|
|
CHG RADN RX DELIVERY COMPLX 6-10 MEV
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 77413
|
| Min. Negotiated Rate |
$168.80 |
| Max. Negotiated Rate |
$274.30 |
| Rate for Payer: Aetna Medicare |
$211.00
|
| Rate for Payer: BCBS Complete |
$168.80
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
|
|
CHG RADN RX DELIVERY SIMPLE 11-19 MEV
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 77404
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
|
|
CHG RADN RX DELIVERY SIMPLE 6-10 MEV
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 77403
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,1 CHANNEL
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 77785
|
| Min. Negotiated Rate |
$123.60 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna Medicare |
$228.00
|
| Rate for Payer: BCBS Complete |
$182.40
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.40
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,2-12 CHANNEL
|
Professional
|
Both
|
$682.00
|
|
|
Service Code
|
HCPCS 77786
|
| Min. Negotiated Rate |
$272.80 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Medicare |
$341.00
|
| Rate for Payer: Aetna Medicare |
$502.50
|
| Rate for Payer: BCBS Complete |
$272.80
|
| Rate for Payer: BCBS Complete |
$402.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.25
|
|
|
CHG REPAIR,ILIAC ANRYSM/PSEUDO/AV MALF/TRAUMA W/ ENDOPROSTHESIS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 75954
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$143.00 |
| Rate for Payer: Aetna Medicare |
$110.00
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
Both
|
$826.00
|
|
|
Service Code
|
HCPCS 77293
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$604.01 |
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$604.01
|
| Rate for Payer: BCN Commercial |
$604.01
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Mclaren Medicaid |
$67.52
|
| Rate for Payer: Mclaren Medicaid |
$67.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health HMO/PPO |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO |
$160.65
|
| Rate for Payer: Priority Health Medicare |
$366.20
|
| Rate for Payer: Priority Health Medicare |
$366.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.57
|
| Rate for Payer: UHC Exchange |
$362.57
|
| Rate for Payer: UHC Exchange |
$362.57
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
|
|
CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 78803
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$1,043.92 |
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Mclaren Medicaid |
$31.52
|
| Rate for Payer: Mclaren Medicaid |
$31.52
|
| Rate for Payer: Mclaren Medicaid |
$31.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO |
$75.97
|
| Rate for Payer: Priority Health Medicare |
$305.65
|
| Rate for Payer: Priority Health Medicare |
$305.65
|
| Rate for Payer: Priority Health Medicare |
$305.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Exchange |
$302.62
|
| Rate for Payer: UHC Exchange |
$302.62
|
| Rate for Payer: UHC Exchange |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
|
|
CHG RP THERAPY INTRAVENOUS ADMINISTRATION
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 79101
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$1,781.96 |
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$134.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.96
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: BCN Medicare Advantage |
$134.80
|
| Rate for Payer: BCN Medicare Advantage |
$134.80
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$180.63
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$180.63
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.80
|
| Rate for Payer: Mclaren Medicaid |
$58.58
|
| Rate for Payer: Mclaren Medicaid |
$58.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.54
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Nomi Health Commercial |
$161.76
|
| Rate for Payer: Nomi Health Commercial |
$161.76
|
| Rate for Payer: PACE SWMI |
$134.80
|
| Rate for Payer: PACE SWMI |
$134.80
|
| Rate for Payer: PHP Medicare Advantage |
$134.80
|
| Rate for Payer: PHP Medicare Advantage |
$134.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO |
$141.15
|
| Rate for Payer: Priority Health HMO/PPO |
$141.15
|
| Rate for Payer: Priority Health Medicare |
$136.15
|
| Rate for Payer: Priority Health Medicare |
$136.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$141.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.80
|
| Rate for Payer: UHC Exchange |
$134.80
|
| Rate for Payer: UHC Exchange |
$134.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.80
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
CHG RP THERAPY ORAL ADMINISTRATION
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 79005
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$1,228.83 |
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Mclaren Medicaid |
$53.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health HMO/PPO |
$126.77
|
| Rate for Payer: Priority Health HMO/PPO |
$126.77
|
| Rate for Payer: Priority Health Medicare |
$126.24
|
| Rate for Payer: Priority Health Medicare |
$126.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$126.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.99
|
| Rate for Payer: UHC Exchange |
$124.99
|
| Rate for Payer: UHC Exchange |
$124.99
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
CHG SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 76831
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$764.98 |
| Rate for Payer: Aetna Commercial |
$138.27
|
| Rate for Payer: Aetna Medicare |
$107.32
|
| Rate for Payer: BCBS Complete |
$22.82
|
| Rate for Payer: BCBS MAPPO |
$103.19
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$103.19
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$138.27
|
| Rate for Payer: Cofinity Commercial |
$148.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.19
|
| Rate for Payer: Mclaren Medicaid |
$21.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.35
|
| Rate for Payer: Meridian Medicaid |
$22.82
|
| Rate for Payer: Nomi Health Commercial |
$123.83
|
| Rate for Payer: PACE SWMI |
$103.19
|
| Rate for Payer: PHP Medicare Advantage |
$103.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO |
$52.35
|
| Rate for Payer: Priority Health Medicare |
$104.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.19
|
| Rate for Payer: UHC Exchange |
$103.19
|
| Rate for Payer: UHC Medicare Advantage |
$103.19
|
| Rate for Payer: UHCCP Medicaid |
$21.73
|
|
|
CHG SCREENING DIGITAL BREAST TOMOSYNTHESIS BI
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 77063
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$77.21 |
| Rate for Payer: Aetna Commercial |
$64.66
|
| Rate for Payer: Aetna Medicare |
$50.18
|
| Rate for Payer: BCBS Complete |
$19.02
|
| Rate for Payer: BCBS MAPPO |
$48.25
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: BCN Medicare Advantage |
$48.25
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$69.48
|
| Rate for Payer: Cofinity Commercial |
$64.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.25
|
| Rate for Payer: Mclaren Medicaid |
$18.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.66
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Nomi Health Commercial |
$57.90
|
| Rate for Payer: PACE SWMI |
$48.25
|
| Rate for Payer: PHP Medicare Advantage |
$48.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO |
$43.11
|
| Rate for Payer: Priority Health Medicare |
$48.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.25
|
| Rate for Payer: UHC Exchange |
$48.25
|
| Rate for Payer: UHC Medicare Advantage |
$48.25
|
| Rate for Payer: UHCCP Medicaid |
$18.11
|
|
|
CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 77067
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$188.15 |
| Rate for Payer: Aetna Commercial |
$155.52
|
| Rate for Payer: Aetna Medicare |
$120.70
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$116.06
|
| Rate for Payer: BCN Commercial |
$188.15
|
| Rate for Payer: BCN Medicare Advantage |
$116.06
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$155.52
|
| Rate for Payer: Cofinity Commercial |
$167.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.06
|
| Rate for Payer: Mclaren Medicaid |
$23.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.86
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$139.27
|
| Rate for Payer: PACE SWMI |
$116.06
|
| Rate for Payer: PHP Medicare Advantage |
$116.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO |
$54.92
|
| Rate for Payer: Priority Health Medicare |
$117.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.06
|
| Rate for Payer: UHC Exchange |
$116.06
|
| Rate for Payer: UHC Medicare Advantage |
$116.06
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
CHG SEDIMENTATION RATE RBC NON-AUTOMATED
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 85651
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$2,682.02 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,682.02
|
| Rate for Payer: BCN Commercial |
$3.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$5.72
|
| Rate for Payer: Cofinity Commercial |
$6.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health HMO/PPO |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
|
|
CHG SEMEN ALYS MOTILITY&CNT X W/HUHNER TST
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 89310
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$940.90 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$940.90
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Nomi Health Commercial |
$10.33
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO |
$13.40
|
| Rate for Payer: Priority Health Medicare |
$8.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Exchange |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
|
