|
CHG CHEST X-RAY 1 VW
|
Professional
|
$28.00
|
|
|
Service Code
|
HCPCS 71010
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$50.40 |
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
|
|
CHG CHEST X-RAY 2 VW
|
Professional
|
$38.00
|
|
|
Service Code
|
HCPCS 71020
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$30.10 |
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
|
|
CHG CHOLESTEROL SERUM/WHOLE BLOOD TOTAL
|
Professional
|
$14.00
|
|
|
Service Code
|
HCPCS 82465
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$5.83
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$5.83
|
| Rate for Payer: Cofinity Commercial |
$6.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.57
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.48
|
|
|
CHG CONTINUING MEDICAL PHYSICS CONSLTJ PR WK
|
Professional
|
$151.00
|
|
|
Service Code
|
HCPCS 77336
|
| Min. Negotiated Rate |
$60.40 |
| Max. Negotiated Rate |
$132.14 |
| Rate for Payer: Aetna Commercial |
$107.33
|
| Rate for Payer: Aetna Medicare |
$83.30
|
| Rate for Payer: BCBS Complete |
$60.40
|
| Rate for Payer: BCBS MAPPO |
$80.10
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: BCN Medicare Advantage |
$80.10
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$115.34
|
| Rate for Payer: Cofinity Commercial |
$107.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.10
|
| Rate for Payer: PACE SWMI |
$80.10
|
| Rate for Payer: PHP Medicare Advantage |
$80.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.14
|
| Rate for Payer: Priority Health Medicare |
$80.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$132.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.10
|
| Rate for Payer: UHC Medicare Advantage |
$82.50
|
|
|
CHG CREATININE OTHER SOURCE
|
Professional
|
$11.00
|
|
|
Service Code
|
HCPCS 82570
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$7.70 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Commercial |
$3.89
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.27
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
|
|
CHG CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID
|
Professional
|
$55.00
|
|
|
Service Code
|
HCPCS 89060
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$38.50 |
| Rate for Payer: Aetna Commercial |
$9.82
|
| Rate for Payer: Aetna Medicare |
$7.62
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Cofinity Commercial |
$10.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.44
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.55
|
|
|
CHG CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
|
Professional
|
$300.00
|
|
|
Service Code
|
HCPCS 75635
|
| Min. Negotiated Rate |
$120.00 |
| Max. Negotiated Rate |
$651.98 |
| Rate for Payer: Aetna Commercial |
$537.50
|
| Rate for Payer: Aetna Medicare |
$417.16
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS MAPPO |
$401.12
|
| Rate for Payer: BCN Commercial |
$622.09
|
| Rate for Payer: BCN Medicare Advantage |
$401.12
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$537.50
|
| Rate for Payer: Cofinity Commercial |
$577.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$401.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$421.18
|
| Rate for Payer: PACE SWMI |
$401.12
|
| Rate for Payer: PHP Medicare Advantage |
$401.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$210.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$651.98
|
| Rate for Payer: Priority Health Medicare |
$401.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$651.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$401.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$401.12
|
| Rate for Payer: UHC Medicare Advantage |
$413.15
|
|
|
CHG CT ABDOMEN W/CONTRAST MATERIAL
|
Professional
|
$128.00
|
|
|
Service Code
|
HCPCS 74160
|
| Min. Negotiated Rate |
$51.20 |
| Max. Negotiated Rate |
$374.90 |
| Rate for Payer: Aetna Commercial |
$308.62
|
| Rate for Payer: Aetna Medicare |
$239.52
|
| Rate for Payer: BCBS Complete |
$51.20
|
| Rate for Payer: BCBS MAPPO |
$230.31
|
| Rate for Payer: BCN Commercial |
$357.72
|
| Rate for Payer: BCN Medicare Advantage |
$230.31
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$308.62
|
| Rate for Payer: Cofinity Commercial |
$331.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$230.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$241.83
|
| Rate for Payer: PACE SWMI |
$230.31
|
| Rate for Payer: PHP Medicare Advantage |
$230.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$374.90
|
| Rate for Payer: Priority Health Medicare |
$230.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$374.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$230.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.22
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
$900.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$360.00 |
| Max. Negotiated Rate |
$668.38 |
| Rate for Payer: Aetna Commercial |
$550.74
|
| Rate for Payer: Aetna Medicare |
$427.44
|
| Rate for Payer: BCBS Complete |
$360.00
|
| Rate for Payer: BCBS MAPPO |
$411.00
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Medicare Advantage |
$411.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cash Price |
$720.00
|
| Rate for Payer: Cofinity Commercial |
$591.84
|
| Rate for Payer: Cofinity Commercial |
$550.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$431.55
|
| Rate for Payer: PACE SWMI |
$411.00
|
| Rate for Payer: PHP Medicare Advantage |
$411.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$630.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.38
|
| Rate for Payer: Priority Health Medicare |
$411.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$668.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$411.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$411.00
|
| Rate for Payer: UHC Medicare Advantage |
$423.33
|
|
|
CHG CT GUIDANCE NEEDLE PLACEMENT
|
Professional
|
$214.00
|
|
|
Service Code
|
HCPCS 77012
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$217.16 |
| Rate for Payer: Aetna Commercial |
$182.28
|
| Rate for Payer: Aetna Medicare |
$141.47
|
| Rate for Payer: BCBS Complete |
$85.60
|
| Rate for Payer: BCBS MAPPO |
$136.03
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: BCN Medicare Advantage |
$136.03
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$182.28
|
| Rate for Payer: Cofinity Commercial |
$195.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$142.83
|
| Rate for Payer: PACE SWMI |
$136.03
|
| Rate for Payer: PHP Medicare Advantage |
$136.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.16
|
| Rate for Payer: Priority Health Medicare |
$136.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$217.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.03
|
| Rate for Payer: UHC Medicare Advantage |
$140.11
|
|
|
CHG CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT
|
Professional
|
$238.00
|
|
|
Service Code
|
HCPCS 77014
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$221.20 |
| Rate for Payer: Aetna Commercial |
$153.15
|
| Rate for Payer: Aetna Commercial |
$153.15
|
| Rate for Payer: Aetna Medicare |
$118.86
|
| Rate for Payer: Aetna Medicare |
$118.86
|
| Rate for Payer: BCBS Complete |
$126.40
|
| Rate for Payer: BCBS Complete |
$95.20
|
| Rate for Payer: BCBS MAPPO |
$114.29
|
| Rate for Payer: BCBS MAPPO |
$114.29
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$114.29
|
| Rate for Payer: BCN Medicare Advantage |
$114.29
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$153.15
|
| Rate for Payer: Cofinity Commercial |
$164.58
|
| Rate for Payer: Cofinity Commercial |
$153.15
|
| Rate for Payer: Cofinity Commercial |
$164.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$120.00
|
| Rate for Payer: PACE SWMI |
$114.29
|
| Rate for Payer: PACE SWMI |
$114.29
|
| Rate for Payer: PHP Medicare Advantage |
$114.29
|
| Rate for Payer: PHP Medicare Advantage |
$114.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.89
|
| Rate for Payer: Priority Health Medicare |
$114.29
|
| Rate for Payer: Priority Health Medicare |
$114.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.29
|
| Rate for Payer: UHC Medicare Advantage |
$117.72
|
| Rate for Payer: UHC Medicare Advantage |
$117.72
|
|
|
CHG CT GUIDANCE STEREOTACTIC LOCALIZATION
|
Professional
|
$457.00
|
|
|
Service Code
|
HCPCS 77011
|
| Min. Negotiated Rate |
$182.80 |
| Max. Negotiated Rate |
$344.17 |
| Rate for Payer: Aetna Commercial |
$283.56
|
| Rate for Payer: Aetna Medicare |
$220.07
|
| Rate for Payer: BCBS Complete |
$182.80
|
| Rate for Payer: BCBS MAPPO |
$211.61
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Medicare Advantage |
$211.61
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cofinity Commercial |
$283.56
|
| Rate for Payer: Cofinity Commercial |
$304.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.19
|
| Rate for Payer: PACE SWMI |
$211.61
|
| Rate for Payer: PHP Medicare Advantage |
$211.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.17
|
| Rate for Payer: Priority Health Medicare |
$211.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$344.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$211.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.61
|
| Rate for Payer: UHC Medicare Advantage |
$217.96
|
|
|
CHG CT LIMITED/LOCALIZED FOLLOW UP STUDY
|
Professional
|
$150.00
|
|
|
Service Code
|
HCPCS 76380
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$208.96 |
| Rate for Payer: Aetna Commercial |
$173.26
|
| Rate for Payer: Aetna Medicare |
$134.47
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$129.30
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$129.30
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$186.19
|
| Rate for Payer: Cofinity Commercial |
$173.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.76
|
| Rate for Payer: PACE SWMI |
$129.30
|
| Rate for Payer: PHP Medicare Advantage |
$129.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.96
|
| Rate for Payer: Priority Health Medicare |
$129.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.30
|
| Rate for Payer: UHC Medicare Advantage |
$133.18
|
|
|
CHG CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL
|
Professional
|
$36.00
|
|
|
Service Code
|
HCPCS 87070
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$25.20 |
| Rate for Payer: Aetna Commercial |
$11.55
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCN Commercial |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Cofinity Commercial |
$11.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
|
|
CHG CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ
|
Professional
|
$21.00
|
|
|
Service Code
|
HCPCS 87081
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$14.70 |
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$8.88
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.03
|
| Rate for Payer: Priority Health Medicare |
$6.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.83
|
|
|
CHG CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE
|
Professional
|
$19.00
|
|
|
Service Code
|
HCPCS 87086
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: Aetna Commercial |
$10.81
|
| Rate for Payer: Aetna Medicare |
$8.39
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: BCBS MAPPO |
$8.07
|
| Rate for Payer: BCN Commercial |
$6.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.07
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cofinity Commercial |
$10.81
|
| Rate for Payer: Cofinity Commercial |
$11.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: PACE SWMI |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.43
|
| Rate for Payer: Priority Health Medicare |
$8.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.07
|
| Rate for Payer: UHC Medicare Advantage |
$8.31
|
|
|
CHG CYSTOGRAPHY MINIMUM 3 VIEWS RS&I
|
Professional
|
$102.00
|
|
|
Service Code
|
HCPCS 74430
|
| Min. Negotiated Rate |
$39.41 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial |
$52.81
|
| Rate for Payer: Aetna Medicare |
$40.99
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: BCN Medicare Advantage |
$39.41
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cofinity Commercial |
$52.81
|
| Rate for Payer: Cofinity Commercial |
$56.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.38
|
| Rate for Payer: PACE SWMI |
$39.41
|
| Rate for Payer: PHP Medicare Advantage |
$39.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.51
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.41
|
| Rate for Payer: UHC Medicare Advantage |
$40.59
|
|
|
CHG CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN
|
Professional
|
$63.00
|
|
|
Service Code
|
HCPCS 88141
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$44.10 |
| Rate for Payer: Aetna Commercial |
$29.25
|
| Rate for Payer: Aetna Medicare |
$22.70
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS MAPPO |
$21.83
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: BCN Medicare Advantage |
$21.83
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$31.44
|
| Rate for Payer: Cofinity Commercial |
$29.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.83
|
| Rate for Payer: Mclaren Medicaid |
$15.34
|
| Rate for Payer: Meridian Medicaid |
$16.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.92
|
| Rate for Payer: PACE SWMI |
$21.83
|
| Rate for Payer: PHP Medicare Advantage |
$21.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.31
|
| Rate for Payer: Priority Health Medicare |
$21.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.83
|
| Rate for Payer: UHC Medicare Advantage |
$22.48
|
|
|
CHG CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN
|
Professional
|
$46.00
|
|
|
Service Code
|
HCPCS 88142
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$21.07
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCN Commercial |
$15.20
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$27.15
|
| Rate for Payer: Cofinity Commercial |
$29.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.16
|
| Rate for Payer: Priority Health Medicare |
$20.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.26
|
| Rate for Payer: UHC Medicare Advantage |
$20.87
|
|
|
CHG DEXA,BONE DENSITY,VERTEB FRACT
|
Professional
|
$19.00
|
|
|
Service Code
|
HCPCS 77082
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$13.30 |
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.30
|
|
|
CHG DISKOGRAPY LUMBAR RS&I
|
Professional
|
$103.00
|
|
|
Service Code
|
HCPCS 72295
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$170.55 |
| Rate for Payer: Aetna Commercial |
$141.48
|
| Rate for Payer: Aetna Medicare |
$109.80
|
| Rate for Payer: BCBS Complete |
$41.20
|
| Rate for Payer: BCBS MAPPO |
$105.58
|
| Rate for Payer: BCN Commercial |
$162.73
|
| Rate for Payer: BCN Medicare Advantage |
$105.58
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$152.04
|
| Rate for Payer: Cofinity Commercial |
$141.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.86
|
| Rate for Payer: PACE SWMI |
$105.58
|
| Rate for Payer: PHP Medicare Advantage |
$105.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.55
|
| Rate for Payer: Priority Health Medicare |
$105.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.58
|
| Rate for Payer: UHC Medicare Advantage |
$108.75
|
|
|
CHG DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT
|
Professional
|
$142.00
|
|
|
Service Code
|
HCPCS 76828
|
| Min. Negotiated Rate |
$47.18 |
| Max. Negotiated Rate |
$99.40 |
| Rate for Payer: Aetna Commercial |
$63.22
|
| Rate for Payer: Aetna Medicare |
$49.07
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS MAPPO |
$47.18
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$47.18
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$63.22
|
| Rate for Payer: Cofinity Commercial |
$67.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.54
|
| Rate for Payer: PACE SWMI |
$47.18
|
| Rate for Payer: PHP Medicare Advantage |
$47.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.28
|
| Rate for Payer: Priority Health Medicare |
$47.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.18
|
| Rate for Payer: UHC Medicare Advantage |
$48.60
|
|
|
CHG DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE
|
Professional
|
$237.00
|
|
|
Service Code
|
HCPCS 76827
|
| Min. Negotiated Rate |
$66.44 |
| Max. Negotiated Rate |
$165.90 |
| Rate for Payer: Aetna Commercial |
$89.03
|
| Rate for Payer: Aetna Medicare |
$69.10
|
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: BCBS MAPPO |
$66.44
|
| Rate for Payer: BCN Commercial |
$102.13
|
| Rate for Payer: BCN Medicare Advantage |
$66.44
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$89.03
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.76
|
| Rate for Payer: PACE SWMI |
$66.44
|
| Rate for Payer: PHP Medicare Advantage |
$66.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.04
|
| Rate for Payer: Priority Health Medicare |
$66.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.44
|
| Rate for Payer: UHC Medicare Advantage |
$68.43
|
|
|
CHG DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART
|
Professional
|
$141.00
|
|
|
Service Code
|
HCPCS 76821
|
| Min. Negotiated Rate |
$56.40 |
| Max. Negotiated Rate |
$136.24 |
| Rate for Payer: Aetna Commercial |
$113.10
|
| Rate for Payer: Aetna Medicare |
$87.78
|
| Rate for Payer: BCBS Complete |
$56.40
|
| Rate for Payer: BCBS MAPPO |
$84.40
|
| Rate for Payer: BCN Commercial |
$129.99
|
| Rate for Payer: BCN Medicare Advantage |
$84.40
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$121.54
|
| Rate for Payer: Cofinity Commercial |
$113.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.62
|
| Rate for Payer: PACE SWMI |
$84.40
|
| Rate for Payer: PHP Medicare Advantage |
$84.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.24
|
| Rate for Payer: Priority Health Medicare |
$84.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.40
|
| Rate for Payer: UHC Medicare Advantage |
$86.93
|
|
|
CHG DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY
|
Professional
|
$244.00
|
|
|
Service Code
|
HCPCS 76820
|
| Min. Negotiated Rate |
$42.99 |
| Max. Negotiated Rate |
$170.80 |
| Rate for Payer: Aetna Commercial |
$57.61
|
| Rate for Payer: Aetna Medicare |
$44.71
|
| Rate for Payer: BCBS Complete |
$97.60
|
| Rate for Payer: BCBS MAPPO |
$42.99
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: BCN Medicare Advantage |
$42.99
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$61.91
|
| Rate for Payer: Cofinity Commercial |
$57.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$45.14
|
| Rate for Payer: PACE SWMI |
$42.99
|
| Rate for Payer: PHP Medicare Advantage |
$42.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.63
|
| Rate for Payer: Priority Health Medicare |
$42.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.99
|
| Rate for Payer: UHC Medicare Advantage |
$44.28
|
|
