|
CHG US PREG UTERUS 14 WK TRANSABDL EACH GESTATION
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 76802
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$304.83 |
| Rate for Payer: Aetna Commercial |
$74.22
|
| Rate for Payer: Aetna Medicare |
$57.61
|
| Rate for Payer: BCBS Complete |
$26.17
|
| Rate for Payer: BCBS MAPPO |
$55.39
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$89.43
|
| Rate for Payer: BCN Medicare Advantage |
$55.39
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$79.76
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.39
|
| Rate for Payer: Mclaren Medicaid |
$24.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.16
|
| Rate for Payer: Meridian Medicaid |
$26.17
|
| Rate for Payer: Nomi Health Commercial |
$66.47
|
| Rate for Payer: PACE SWMI |
$55.39
|
| Rate for Payer: PHP Medicare Advantage |
$55.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO |
$60.06
|
| Rate for Payer: Priority Health Medicare |
$55.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.39
|
| Rate for Payer: UHC Exchange |
$55.39
|
| Rate for Payer: UHC Medicare Advantage |
$55.39
|
| Rate for Payer: UHCCP Medicaid |
$24.92
|
|
|
CHG US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO
|
Professional
|
Both
|
$423.00
|
|
|
Service Code
|
HCPCS 76810
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare |
$82.58
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$79.40
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Medicare Advantage |
$79.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cofinity Commercial |
$114.34
|
| Rate for Payer: Cofinity Commercial |
$106.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.40
|
| Rate for Payer: Mclaren Medicaid |
$29.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.37
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Nomi Health Commercial |
$95.28
|
| Rate for Payer: PACE SWMI |
$79.40
|
| Rate for Payer: PHP Medicare Advantage |
$79.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.95
|
| Rate for Payer: Priority Health HMO/PPO |
$70.83
|
| Rate for Payer: Priority Health Medicare |
$80.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.40
|
| Rate for Payer: UHC Exchange |
$79.40
|
| Rate for Payer: UHC Medicare Advantage |
$79.40
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
|
|
CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 76805
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$362.41 |
| Rate for Payer: Aetna Commercial |
$163.24
|
| Rate for Payer: Aetna Medicare |
$126.69
|
| Rate for Payer: BCBS Complete |
$31.53
|
| Rate for Payer: BCBS MAPPO |
$121.82
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$121.82
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$175.42
|
| Rate for Payer: Cofinity Commercial |
$163.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.82
|
| Rate for Payer: Mclaren Medicaid |
$30.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.91
|
| Rate for Payer: Meridian Medicaid |
$31.53
|
| Rate for Payer: Nomi Health Commercial |
$146.18
|
| Rate for Payer: PACE SWMI |
$121.82
|
| Rate for Payer: PHP Medicare Advantage |
$121.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO |
$71.85
|
| Rate for Payer: Priority Health Medicare |
$123.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.82
|
| Rate for Payer: UHC Exchange |
$121.82
|
| Rate for Payer: UHC Medicare Advantage |
$121.82
|
| Rate for Payer: UHCCP Medicaid |
$30.03
|
|
|
CHG US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 76812
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$280.99 |
| Rate for Payer: Aetna Commercial |
$231.43
|
| Rate for Payer: Aetna Medicare |
$179.62
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$172.71
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$280.99
|
| Rate for Payer: BCN Medicare Advantage |
$172.71
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cofinity Commercial |
$248.70
|
| Rate for Payer: Cofinity Commercial |
$231.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.71
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.35
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Nomi Health Commercial |
$207.25
|
| Rate for Payer: PACE SWMI |
$172.71
|
| Rate for Payer: PHP Medicare Advantage |
$172.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.90
|
| Rate for Payer: Priority Health HMO/PPO |
$128.83
|
| Rate for Payer: Priority Health Medicare |
$174.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.71
|
| Rate for Payer: UHC Exchange |
$172.71
|
| Rate for Payer: UHC Medicare Advantage |
$172.71
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
CHG US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 76816
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$773.43 |
| Rate for Payer: Aetna Commercial |
$131.95
|
| Rate for Payer: Aetna Medicare |
$102.41
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$98.47
|
| Rate for Payer: BCBS Trust/PPO |
$773.43
|
| Rate for Payer: BCN Commercial |
$160.77
|
| Rate for Payer: BCN Medicare Advantage |
$98.47
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$141.80
|
| Rate for Payer: Cofinity Commercial |
$131.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.47
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.39
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Nomi Health Commercial |
$118.16
|
| Rate for Payer: PACE SWMI |
$98.47
|
| Rate for Payer: PHP Medicare Advantage |
$98.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO |
$61.60
|
| Rate for Payer: Priority Health Medicare |
$99.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.47
|
| Rate for Payer: UHC Exchange |
$98.47
|
| Rate for Payer: UHC Medicare Advantage |
$98.47
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
|
|
CHG US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 76817
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$432.68 |
| Rate for Payer: Aetna Commercial |
$111.93
|
| Rate for Payer: Aetna Medicare |
$86.87
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$83.53
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Medicare Advantage |
$83.53
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$120.28
|
| Rate for Payer: Cofinity Commercial |
$111.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.53
|
| Rate for Payer: Mclaren Medicaid |
$22.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.71
|
| Rate for Payer: Meridian Medicaid |
$23.71
|
| Rate for Payer: Nomi Health Commercial |
$100.24
|
| Rate for Payer: PACE SWMI |
$83.53
|
| Rate for Payer: PHP Medicare Advantage |
$83.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health HMO/PPO |
$54.40
|
| Rate for Payer: Priority Health Medicare |
$84.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.53
|
| Rate for Payer: UHC Exchange |
$83.53
|
| Rate for Payer: UHC Medicare Advantage |
$83.53
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
|
|
CHG US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 76811
|
| Min. Negotiated Rate |
$56.87 |
| Max. Negotiated Rate |
$257.53 |
| Rate for Payer: Aetna Commercial |
$218.19
|
| Rate for Payer: Aetna Medicare |
$169.34
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$162.83
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$162.83
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$218.19
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.83
|
| Rate for Payer: Mclaren Medicaid |
$56.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.97
|
| Rate for Payer: Meridian Medicaid |
$59.71
|
| Rate for Payer: Nomi Health Commercial |
$195.40
|
| Rate for Payer: PACE SWMI |
$162.83
|
| Rate for Payer: PHP Medicare Advantage |
$162.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
| Rate for Payer: Priority Health HMO/PPO |
$137.04
|
| Rate for Payer: Priority Health Medicare |
$164.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.83
|
| Rate for Payer: UHC Exchange |
$162.83
|
| Rate for Payer: UHC Medicare Advantage |
$162.83
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
|
|
CHG US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 76770
|
| Min. Negotiated Rate |
$22.15 |
| Max. Negotiated Rate |
$159.79 |
| Rate for Payer: Aetna Commercial |
$131.08
|
| Rate for Payer: Aetna Medicare |
$101.73
|
| Rate for Payer: BCBS Complete |
$23.26
|
| Rate for Payer: BCBS MAPPO |
$97.82
|
| Rate for Payer: BCN Commercial |
$159.79
|
| Rate for Payer: BCN Medicare Advantage |
$97.82
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$140.86
|
| Rate for Payer: Cofinity Commercial |
$131.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.82
|
| Rate for Payer: Mclaren Medicaid |
$22.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.71
|
| Rate for Payer: Meridian Medicaid |
$23.26
|
| Rate for Payer: Nomi Health Commercial |
$117.38
|
| Rate for Payer: PACE SWMI |
$97.82
|
| Rate for Payer: PHP Medicare Advantage |
$97.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health HMO/PPO |
$53.38
|
| Rate for Payer: Priority Health Medicare |
$98.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$53.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.82
|
| Rate for Payer: UHC Exchange |
$97.82
|
| Rate for Payer: UHC Medicare Advantage |
$97.82
|
| Rate for Payer: UHCCP Medicaid |
$22.15
|
|
|
CHG US RETROPERITONEAL REAL TIME W/IMAGE LIMITED
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 76775
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$2,427.54 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna Medicare |
$57.87
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$55.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,427.54
|
| Rate for Payer: BCN Commercial |
$86.50
|
| Rate for Payer: BCN Medicare Advantage |
$55.64
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Cofinity Commercial |
$80.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.64
|
| Rate for Payer: Mclaren Medicaid |
$17.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.42
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$66.77
|
| Rate for Payer: PACE SWMI |
$55.64
|
| Rate for Payer: PHP Medicare Advantage |
$55.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO |
$41.57
|
| Rate for Payer: Priority Health Medicare |
$56.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.64
|
| Rate for Payer: UHC Exchange |
$55.64
|
| Rate for Payer: UHC Medicare Advantage |
$55.64
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
|
|
CHG US SCROTUM & CONTENTS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 76870
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$148.56 |
| Rate for Payer: Aetna Commercial |
$121.10
|
| Rate for Payer: Aetna Medicare |
$93.98
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$90.37
|
| Rate for Payer: BCN Commercial |
$148.56
|
| Rate for Payer: BCN Medicare Advantage |
$90.37
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$130.13
|
| Rate for Payer: Cofinity Commercial |
$121.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.37
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.89
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Nomi Health Commercial |
$108.44
|
| Rate for Payer: PACE SWMI |
$90.37
|
| Rate for Payer: PHP Medicare Advantage |
$90.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO |
$45.69
|
| Rate for Payer: Priority Health Medicare |
$91.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.37
|
| Rate for Payer: UHC Exchange |
$90.37
|
| Rate for Payer: UHC Medicare Advantage |
$90.37
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
CHG US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 76536
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$1,090.94 |
| Rate for Payer: Aetna Commercial |
$132.24
|
| Rate for Payer: Aetna Commercial |
$132.24
|
| Rate for Payer: Aetna Medicare |
$102.64
|
| Rate for Payer: Aetna Medicare |
$102.64
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.94
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Medicare Advantage |
$98.69
|
| Rate for Payer: BCN Medicare Advantage |
$98.69
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$132.24
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Commercial |
$132.24
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.69
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.62
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Nomi Health Commercial |
$118.43
|
| Rate for Payer: Nomi Health Commercial |
$118.43
|
| Rate for Payer: PACE SWMI |
$98.69
|
| Rate for Payer: PACE SWMI |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$98.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.55
|
| Rate for Payer: Priority Health HMO/PPO |
$40.55
|
| Rate for Payer: Priority Health HMO/PPO |
$40.55
|
| Rate for Payer: Priority Health Medicare |
$99.68
|
| Rate for Payer: Priority Health Medicare |
$99.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.69
|
| Rate for Payer: UHC Exchange |
$98.69
|
| Rate for Payer: UHC Exchange |
$98.69
|
| Rate for Payer: UHC Medicare Advantage |
$98.69
|
| Rate for Payer: UHC Medicare Advantage |
$98.69
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
|
|
CHG US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 76873
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$669.36 |
| Rate for Payer: Aetna Commercial |
$213.69
|
| Rate for Payer: Aetna Medicare |
$165.85
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$159.47
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: BCN Commercial |
$255.58
|
| Rate for Payer: BCN Medicare Advantage |
$159.47
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$229.64
|
| Rate for Payer: Cofinity Commercial |
$213.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.47
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.44
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Nomi Health Commercial |
$191.36
|
| Rate for Payer: PACE SWMI |
$159.47
|
| Rate for Payer: PHP Medicare Advantage |
$159.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health HMO/PPO |
$116.00
|
| Rate for Payer: Priority Health Medicare |
$161.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.47
|
| Rate for Payer: UHC Exchange |
$159.47
|
| Rate for Payer: UHC Medicare Advantage |
$159.47
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
CHG US TRANSRECTAL
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 76872
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$932.45 |
| Rate for Payer: Aetna Commercial |
$235.69
|
| Rate for Payer: Aetna Commercial |
$235.69
|
| Rate for Payer: Aetna Medicare |
$182.93
|
| Rate for Payer: Aetna Medicare |
$182.93
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$175.89
|
| Rate for Payer: BCBS MAPPO |
$175.89
|
| Rate for Payer: BCBS Trust/PPO |
$932.45
|
| Rate for Payer: BCBS Trust/PPO |
$932.45
|
| Rate for Payer: BCN Commercial |
$294.67
|
| Rate for Payer: BCN Commercial |
$294.67
|
| Rate for Payer: BCN Medicare Advantage |
$175.89
|
| Rate for Payer: BCN Medicare Advantage |
$175.89
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$253.28
|
| Rate for Payer: Cofinity Commercial |
$235.69
|
| Rate for Payer: Cofinity Commercial |
$253.28
|
| Rate for Payer: Cofinity Commercial |
$235.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.89
|
| Rate for Payer: Mclaren Medicaid |
$20.45
|
| Rate for Payer: Mclaren Medicaid |
$20.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.68
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| Rate for Payer: Nomi Health Commercial |
$211.07
|
| Rate for Payer: Nomi Health Commercial |
$211.07
|
| Rate for Payer: PACE SWMI |
$175.89
|
| Rate for Payer: PACE SWMI |
$175.89
|
| Rate for Payer: PHP Medicare Advantage |
$175.89
|
| Rate for Payer: PHP Medicare Advantage |
$175.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health HMO/PPO |
$49.28
|
| Rate for Payer: Priority Health HMO/PPO |
$49.28
|
| Rate for Payer: Priority Health Medicare |
$177.65
|
| Rate for Payer: Priority Health Medicare |
$177.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.89
|
| Rate for Payer: UHC Exchange |
$175.89
|
| Rate for Payer: UHC Exchange |
$175.89
|
| Rate for Payer: UHC Medicare Advantage |
$175.89
|
| Rate for Payer: UHC Medicare Advantage |
$175.89
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
|
|
CHG US TRANSVAGINAL
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 76830
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$659.85 |
| Rate for Payer: Aetna Commercial |
$142.62
|
| Rate for Payer: Aetna Medicare |
$110.69
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS MAPPO |
$106.43
|
| Rate for Payer: BCBS Trust/PPO |
$659.85
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$106.43
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$153.26
|
| Rate for Payer: Cofinity Commercial |
$142.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.43
|
| Rate for Payer: Mclaren Medicaid |
$20.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.75
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Nomi Health Commercial |
$127.72
|
| Rate for Payer: PACE SWMI |
$106.43
|
| Rate for Payer: PHP Medicare Advantage |
$106.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health HMO/PPO |
$49.79
|
| Rate for Payer: Priority Health Medicare |
$107.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.43
|
| Rate for Payer: UHC Exchange |
$106.43
|
| Rate for Payer: UHC Medicare Advantage |
$106.43
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
|
|
CHG US VASC ACCESS SITS VSL PATENCY NDL ENTRY
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 76937
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$397.81 |
| Rate for Payer: Aetna Commercial |
$46.91
|
| Rate for Payer: Aetna Commercial |
$46.91
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$35.01
|
| Rate for Payer: BCBS MAPPO |
$35.01
|
| Rate for Payer: BCBS Trust/PPO |
$397.81
|
| Rate for Payer: BCBS Trust/PPO |
$397.81
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Medicare Advantage |
$35.01
|
| Rate for Payer: BCN Medicare Advantage |
$35.01
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$50.41
|
| Rate for Payer: Cofinity Commercial |
$46.91
|
| Rate for Payer: Cofinity Commercial |
$50.41
|
| Rate for Payer: Cofinity Commercial |
$46.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.01
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Mclaren Medicaid |
$8.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.76
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Nomi Health Commercial |
$42.01
|
| Rate for Payer: Nomi Health Commercial |
$42.01
|
| Rate for Payer: PACE SWMI |
$35.01
|
| Rate for Payer: PACE SWMI |
$35.01
|
| Rate for Payer: PHP Medicare Advantage |
$35.01
|
| Rate for Payer: PHP Medicare Advantage |
$35.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO |
$21.05
|
| Rate for Payer: Priority Health HMO/PPO |
$21.05
|
| Rate for Payer: Priority Health Medicare |
$35.36
|
| Rate for Payer: Priority Health Medicare |
$35.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.01
|
| Rate for Payer: UHC Exchange |
$35.01
|
| Rate for Payer: UHC Exchange |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$35.01
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
|
|
CHG VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 75840
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$311.17 |
| Rate for Payer: Aetna Commercial |
$156.82
|
| Rate for Payer: Aetna Medicare |
$121.71
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$117.03
|
| Rate for Payer: BCBS Trust/PPO |
$311.17
|
| Rate for Payer: BCN Commercial |
$189.61
|
| Rate for Payer: BCN Medicare Advantage |
$117.03
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$168.52
|
| Rate for Payer: Cofinity Commercial |
$156.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.03
|
| Rate for Payer: Mclaren Medicaid |
$34.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.88
|
| Rate for Payer: Meridian Medicaid |
$36.00
|
| Rate for Payer: Nomi Health Commercial |
$140.44
|
| Rate for Payer: PACE SWMI |
$117.03
|
| Rate for Payer: PHP Medicare Advantage |
$117.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO |
$82.12
|
| Rate for Payer: Priority Health Medicare |
$118.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.03
|
| Rate for Payer: UHC Exchange |
$117.03
|
| Rate for Payer: UHC Medicare Advantage |
$117.03
|
| Rate for Payer: UHCCP Medicaid |
$34.29
|
|
|
CHG VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 75825
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$238.26 |
| Rate for Payer: Aetna Commercial |
$141.26
|
| Rate for Payer: Aetna Medicare |
$109.64
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$105.42
|
| Rate for Payer: BCBS Trust/PPO |
$238.26
|
| Rate for Payer: BCN Commercial |
$167.13
|
| Rate for Payer: BCN Medicare Advantage |
$105.42
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$151.80
|
| Rate for Payer: Cofinity Commercial |
$141.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.42
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.69
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$126.50
|
| Rate for Payer: PACE SWMI |
$105.42
|
| Rate for Payer: PHP Medicare Advantage |
$105.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.20
|
| Rate for Payer: Priority Health HMO/PPO |
$80.58
|
| Rate for Payer: Priority Health Medicare |
$106.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.42
|
| Rate for Payer: UHC Exchange |
$105.42
|
| Rate for Payer: UHC Medicare Advantage |
$105.42
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
CHG VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 75827
|
| Min. Negotiated Rate |
$33.65 |
| Max. Negotiated Rate |
$307.47 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare |
$112.52
|
| Rate for Payer: BCBS Complete |
$35.33
|
| Rate for Payer: BCBS MAPPO |
$108.19
|
| Rate for Payer: BCBS Trust/PPO |
$307.47
|
| Rate for Payer: BCN Commercial |
$174.95
|
| Rate for Payer: BCN Medicare Advantage |
$108.19
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$155.79
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.19
|
| Rate for Payer: Mclaren Medicaid |
$33.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.60
|
| Rate for Payer: Meridian Medicaid |
$35.33
|
| Rate for Payer: Nomi Health Commercial |
$129.83
|
| Rate for Payer: PACE SWMI |
$108.19
|
| Rate for Payer: PHP Medicare Advantage |
$108.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$81.09
|
| Rate for Payer: Priority Health Medicare |
$109.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.19
|
| Rate for Payer: UHC Exchange |
$108.19
|
| Rate for Payer: UHC Medicare Advantage |
$108.19
|
| Rate for Payer: UHCCP Medicaid |
$33.65
|
|
|
CHG VENOGRAPHY EXTREMITY BILATERAL RS&I
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 75822
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$265.21 |
| Rate for Payer: Aetna Commercial |
$164.46
|
| Rate for Payer: Aetna Commercial |
$164.46
|
| Rate for Payer: Aetna Medicare |
$127.64
|
| Rate for Payer: Aetna Medicare |
$127.64
|
| Rate for Payer: BCBS Complete |
$45.62
|
| Rate for Payer: BCBS Complete |
$45.62
|
| Rate for Payer: BCBS MAPPO |
$122.73
|
| Rate for Payer: BCBS MAPPO |
$122.73
|
| Rate for Payer: BCBS Trust/PPO |
$265.21
|
| Rate for Payer: BCBS Trust/PPO |
$265.21
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$122.73
|
| Rate for Payer: BCN Medicare Advantage |
$122.73
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cofinity Commercial |
$176.73
|
| Rate for Payer: Cofinity Commercial |
$164.46
|
| Rate for Payer: Cofinity Commercial |
$176.73
|
| Rate for Payer: Cofinity Commercial |
$164.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.73
|
| Rate for Payer: Mclaren Medicaid |
$43.45
|
| Rate for Payer: Mclaren Medicaid |
$43.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.87
|
| Rate for Payer: Meridian Medicaid |
$45.62
|
| Rate for Payer: Meridian Medicaid |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$147.28
|
| Rate for Payer: Nomi Health Commercial |
$147.28
|
| Rate for Payer: PACE SWMI |
$122.73
|
| Rate for Payer: PACE SWMI |
$122.73
|
| Rate for Payer: PHP Medicare Advantage |
$122.73
|
| Rate for Payer: PHP Medicare Advantage |
$122.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health HMO/PPO |
$104.19
|
| Rate for Payer: Priority Health HMO/PPO |
$104.19
|
| Rate for Payer: Priority Health Medicare |
$123.96
|
| Rate for Payer: Priority Health Medicare |
$123.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.73
|
| Rate for Payer: UHC Exchange |
$122.73
|
| Rate for Payer: UHC Exchange |
$122.73
|
| Rate for Payer: UHC Medicare Advantage |
$122.73
|
| Rate for Payer: UHC Medicare Advantage |
$122.73
|
| Rate for Payer: UHCCP Medicaid |
$43.45
|
| Rate for Payer: UHCCP Medicaid |
$43.45
|
|
|
CHG VENOGRAPHY EXTREMITY UNILATERAL RS&I
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 75820
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$191.77 |
| Rate for Payer: Aetna Commercial |
$130.53
|
| Rate for Payer: Aetna Commercial |
$130.53
|
| Rate for Payer: Aetna Medicare |
$101.31
|
| Rate for Payer: Aetna Medicare |
$101.31
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS Complete |
$32.20
|
| Rate for Payer: BCBS MAPPO |
$97.41
|
| Rate for Payer: BCBS MAPPO |
$97.41
|
| Rate for Payer: BCBS Trust/PPO |
$191.77
|
| Rate for Payer: BCBS Trust/PPO |
$191.77
|
| Rate for Payer: BCN Commercial |
$159.79
|
| Rate for Payer: BCN Commercial |
$159.79
|
| Rate for Payer: BCN Medicare Advantage |
$97.41
|
| Rate for Payer: BCN Medicare Advantage |
$97.41
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$130.53
|
| Rate for Payer: Cofinity Commercial |
$140.27
|
| Rate for Payer: Cofinity Commercial |
$130.53
|
| Rate for Payer: Cofinity Commercial |
$140.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.41
|
| Rate for Payer: Mclaren Medicaid |
$30.67
|
| Rate for Payer: Mclaren Medicaid |
$30.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.28
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Meridian Medicaid |
$32.20
|
| Rate for Payer: Nomi Health Commercial |
$116.89
|
| Rate for Payer: Nomi Health Commercial |
$116.89
|
| Rate for Payer: PACE SWMI |
$97.41
|
| Rate for Payer: PACE SWMI |
$97.41
|
| Rate for Payer: PHP Medicare Advantage |
$97.41
|
| Rate for Payer: PHP Medicare Advantage |
$97.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health HMO/PPO |
$74.43
|
| Rate for Payer: Priority Health HMO/PPO |
$74.43
|
| Rate for Payer: Priority Health Medicare |
$98.38
|
| Rate for Payer: Priority Health Medicare |
$98.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.41
|
| Rate for Payer: UHC Exchange |
$97.41
|
| Rate for Payer: UHC Exchange |
$97.41
|
| Rate for Payer: UHC Medicare Advantage |
$97.41
|
| Rate for Payer: UHC Medicare Advantage |
$97.41
|
| Rate for Payer: UHCCP Medicaid |
$30.67
|
| Rate for Payer: UHCCP Medicaid |
$30.67
|
|
|
CHG VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 75833
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$369.81 |
| Rate for Payer: Aetna Commercial |
$182.55
|
| Rate for Payer: Aetna Medicare |
$141.68
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$136.23
|
| Rate for Payer: BCBS Trust/PPO |
$369.81
|
| Rate for Payer: BCN Commercial |
$215.02
|
| Rate for Payer: BCN Medicare Advantage |
$136.23
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$196.17
|
| Rate for Payer: Cofinity Commercial |
$182.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.23
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.04
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Nomi Health Commercial |
$163.48
|
| Rate for Payer: PACE SWMI |
$136.23
|
| Rate for Payer: PHP Medicare Advantage |
$136.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.35
|
| Rate for Payer: Priority Health HMO/PPO |
$105.73
|
| Rate for Payer: Priority Health Medicare |
$137.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.23
|
| Rate for Payer: UHC Exchange |
$136.23
|
| Rate for Payer: UHC Medicare Advantage |
$136.23
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
|
CHG VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 75831
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$177.45 |
| Rate for Payer: Aetna Commercial |
$147.29
|
| Rate for Payer: Aetna Commercial |
$147.29
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$109.92
|
| Rate for Payer: BCBS MAPPO |
$109.92
|
| Rate for Payer: BCBS Trust/PPO |
$156.38
|
| Rate for Payer: BCBS Trust/PPO |
$156.38
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$109.92
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$158.28
|
| Rate for Payer: Cofinity Commercial |
$147.29
|
| Rate for Payer: Cofinity Commercial |
$158.28
|
| Rate for Payer: Cofinity Commercial |
$147.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.92
|
| Rate for Payer: Mclaren Medicaid |
$32.38
|
| Rate for Payer: Mclaren Medicaid |
$32.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.42
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$131.90
|
| Rate for Payer: Nomi Health Commercial |
$131.90
|
| Rate for Payer: PACE SWMI |
$109.92
|
| Rate for Payer: PACE SWMI |
$109.92
|
| Rate for Payer: PHP Medicare Advantage |
$109.92
|
| Rate for Payer: PHP Medicare Advantage |
$109.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health HMO/PPO |
$78.02
|
| Rate for Payer: Priority Health HMO/PPO |
$78.02
|
| Rate for Payer: Priority Health Medicare |
$111.02
|
| Rate for Payer: Priority Health Medicare |
$111.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.92
|
| Rate for Payer: UHC Exchange |
$109.92
|
| Rate for Payer: UHC Exchange |
$109.92
|
| Rate for Payer: UHC Medicare Advantage |
$109.92
|
| Rate for Payer: UHC Medicare Advantage |
$109.92
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
CHG VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 75860
|
| Min. Negotiated Rate |
$34.08 |
| Max. Negotiated Rate |
$310.64 |
| Rate for Payer: Aetna Commercial |
$155.41
|
| Rate for Payer: Aetna Commercial |
$155.41
|
| Rate for Payer: Aetna Medicare |
$120.62
|
| Rate for Payer: Aetna Medicare |
$120.62
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS Complete |
$35.78
|
| Rate for Payer: BCBS MAPPO |
$115.98
|
| Rate for Payer: BCBS MAPPO |
$115.98
|
| Rate for Payer: BCBS Trust/PPO |
$310.64
|
| Rate for Payer: BCBS Trust/PPO |
$310.64
|
| Rate for Payer: BCN Commercial |
$184.72
|
| Rate for Payer: BCN Commercial |
$184.72
|
| Rate for Payer: BCN Medicare Advantage |
$115.98
|
| Rate for Payer: BCN Medicare Advantage |
$115.98
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cofinity Commercial |
$155.41
|
| Rate for Payer: Cofinity Commercial |
$167.01
|
| Rate for Payer: Cofinity Commercial |
$155.41
|
| Rate for Payer: Cofinity Commercial |
$167.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.98
|
| Rate for Payer: Mclaren Medicaid |
$34.08
|
| Rate for Payer: Mclaren Medicaid |
$34.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.78
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Meridian Medicaid |
$35.78
|
| Rate for Payer: Nomi Health Commercial |
$139.18
|
| Rate for Payer: Nomi Health Commercial |
$139.18
|
| Rate for Payer: PACE SWMI |
$115.98
|
| Rate for Payer: PACE SWMI |
$115.98
|
| Rate for Payer: PHP Medicare Advantage |
$115.98
|
| Rate for Payer: PHP Medicare Advantage |
$115.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.90
|
| Rate for Payer: Priority Health HMO/PPO |
$80.58
|
| Rate for Payer: Priority Health HMO/PPO |
$80.58
|
| Rate for Payer: Priority Health Medicare |
$117.14
|
| Rate for Payer: Priority Health Medicare |
$117.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.98
|
| Rate for Payer: UHC Exchange |
$115.98
|
| Rate for Payer: UHC Exchange |
$115.98
|
| Rate for Payer: UHC Medicare Advantage |
$115.98
|
| Rate for Payer: UHC Medicare Advantage |
$115.98
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
| Rate for Payer: UHCCP Medicaid |
$34.08
|
|
|
CHG VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 75893
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$353.43 |
| Rate for Payer: Aetna Commercial |
$127.54
|
| Rate for Payer: Aetna Medicare |
$98.99
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$95.18
|
| Rate for Payer: BCBS Trust/PPO |
$353.43
|
| Rate for Payer: BCN Commercial |
$151.98
|
| Rate for Payer: BCN Medicare Advantage |
$95.18
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$137.06
|
| Rate for Payer: Cofinity Commercial |
$127.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.18
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.94
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Nomi Health Commercial |
$114.22
|
| Rate for Payer: PACE SWMI |
$95.18
|
| Rate for Payer: PHP Medicare Advantage |
$95.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health HMO/PPO |
$38.50
|
| Rate for Payer: Priority Health Medicare |
$96.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.18
|
| Rate for Payer: UHC Exchange |
$95.18
|
| Rate for Payer: UHC Medicare Advantage |
$95.18
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 78457
|
| Min. Negotiated Rate |
$22.79 |
| Max. Negotiated Rate |
$229.68 |
| Rate for Payer: Aetna Commercial |
$189.70
|
| Rate for Payer: Aetna Commercial |
$189.70
|
| Rate for Payer: Aetna Medicare |
$147.23
|
| Rate for Payer: Aetna Medicare |
$147.23
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS Complete |
$23.93
|
| Rate for Payer: BCBS MAPPO |
$141.57
|
| Rate for Payer: BCBS MAPPO |
$141.57
|
| Rate for Payer: BCN Commercial |
$229.68
|
| Rate for Payer: BCN Commercial |
$229.68
|
| Rate for Payer: BCN Medicare Advantage |
$141.57
|
| Rate for Payer: BCN Medicare Advantage |
$141.57
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$203.86
|
| Rate for Payer: Cofinity Commercial |
$189.70
|
| Rate for Payer: Cofinity Commercial |
$189.70
|
| Rate for Payer: Cofinity Commercial |
$203.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.57
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Mclaren Medicaid |
$22.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.65
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Meridian Medicaid |
$23.93
|
| Rate for Payer: Nomi Health Commercial |
$169.88
|
| Rate for Payer: Nomi Health Commercial |
$169.88
|
| Rate for Payer: PACE SWMI |
$141.57
|
| Rate for Payer: PACE SWMI |
$141.57
|
| Rate for Payer: PHP Medicare Advantage |
$141.57
|
| Rate for Payer: PHP Medicare Advantage |
$141.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO |
$54.40
|
| Rate for Payer: Priority Health HMO/PPO |
$54.40
|
| Rate for Payer: Priority Health Medicare |
$142.99
|
| Rate for Payer: Priority Health Medicare |
$142.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.57
|
| Rate for Payer: UHC Exchange |
$141.57
|
| Rate for Payer: UHC Exchange |
$141.57
|
| Rate for Payer: UHC Medicare Advantage |
$141.57
|
| Rate for Payer: UHC Medicare Advantage |
$141.57
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
| Rate for Payer: UHCCP Medicaid |
$22.79
|
|
