|
CHG MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS
|
Professional
|
$120.00
|
|
|
Service Code
|
HCPCS 78453
|
| Min. Negotiated Rate |
$48.00 |
| Max. Negotiated Rate |
$417.93 |
| Rate for Payer: Aetna Commercial |
$342.20
|
| Rate for Payer: Aetna Medicare |
$265.58
|
| Rate for Payer: BCBS Complete |
$48.00
|
| Rate for Payer: BCBS MAPPO |
$255.37
|
| Rate for Payer: BCN Commercial |
$398.76
|
| Rate for Payer: BCN Medicare Advantage |
$255.37
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$367.73
|
| Rate for Payer: Cofinity Commercial |
$342.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$255.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$268.14
|
| Rate for Payer: PACE SWMI |
$255.37
|
| Rate for Payer: PHP Medicare Advantage |
$255.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$417.93
|
| Rate for Payer: Priority Health Medicare |
$255.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$417.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$255.37
|
| Rate for Payer: UHC Medicare Advantage |
$263.03
|
|
|
CHG MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES
|
Professional
|
$155.00
|
|
|
Service Code
|
HCPCS 78454
|
| Min. Negotiated Rate |
$62.00 |
| Max. Negotiated Rate |
$623.31 |
| Rate for Payer: Aetna Commercial |
$509.91
|
| Rate for Payer: Aetna Medicare |
$395.75
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: BCBS MAPPO |
$380.53
|
| Rate for Payer: BCN Commercial |
$594.72
|
| Rate for Payer: BCN Medicare Advantage |
$380.53
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cofinity Commercial |
$547.96
|
| Rate for Payer: Cofinity Commercial |
$509.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$380.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$399.56
|
| Rate for Payer: PACE SWMI |
$380.53
|
| Rate for Payer: PHP Medicare Advantage |
$380.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$623.31
|
| Rate for Payer: Priority Health Medicare |
$380.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$623.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$380.53
|
| Rate for Payer: UHC Medicare Advantage |
$391.95
|
|
|
CHG MYOCARDIAL SPECT MULTIPLE STUDIES
|
Professional
|
$898.00
|
|
|
Service Code
|
HCPCS 78452
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$671.45 |
| Rate for Payer: Aetna Commercial |
$549.84
|
| Rate for Payer: Aetna Commercial |
$549.84
|
| Rate for Payer: Aetna Medicare |
$426.74
|
| Rate for Payer: Aetna Medicare |
$426.74
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: BCBS Complete |
$359.20
|
| Rate for Payer: BCBS MAPPO |
$410.33
|
| Rate for Payer: BCBS MAPPO |
$410.33
|
| Rate for Payer: BCN Commercial |
$640.66
|
| Rate for Payer: BCN Commercial |
$640.66
|
| Rate for Payer: BCN Medicare Advantage |
$410.33
|
| Rate for Payer: BCN Medicare Advantage |
$410.33
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$718.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$549.84
|
| Rate for Payer: Cofinity Commercial |
$549.84
|
| Rate for Payer: Cofinity Commercial |
$590.88
|
| Rate for Payer: Cofinity Commercial |
$590.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$410.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$430.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$430.85
|
| Rate for Payer: PACE SWMI |
$410.33
|
| Rate for Payer: PACE SWMI |
$410.33
|
| Rate for Payer: PHP Medicare Advantage |
$410.33
|
| Rate for Payer: PHP Medicare Advantage |
$410.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$671.45
|
| Rate for Payer: Priority Health Medicare |
$410.33
|
| Rate for Payer: Priority Health Medicare |
$410.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$671.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$410.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$410.33
|
| Rate for Payer: UHC Medicare Advantage |
$422.64
|
| Rate for Payer: UHC Medicare Advantage |
$422.64
|
|
|
CHG MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS
|
Professional
|
$165.00
|
|
|
Service Code
|
HCPCS 78451
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$483.99 |
| Rate for Payer: Aetna Commercial |
$397.10
|
| Rate for Payer: Aetna Medicare |
$308.19
|
| Rate for Payer: BCBS Complete |
$66.00
|
| Rate for Payer: BCBS MAPPO |
$296.34
|
| Rate for Payer: BCN Commercial |
$461.80
|
| Rate for Payer: BCN Medicare Advantage |
$296.34
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Cofinity Commercial |
$426.73
|
| Rate for Payer: Cofinity Commercial |
$397.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$311.16
|
| Rate for Payer: PACE SWMI |
$296.34
|
| Rate for Payer: PHP Medicare Advantage |
$296.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$483.99
|
| Rate for Payer: Priority Health Medicare |
$296.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$483.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$296.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.34
|
| Rate for Payer: UHC Medicare Advantage |
$305.23
|
|
|
CHG MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS
|
Professional
|
$700.00
|
|
|
Service Code
|
HCPCS 78491
|
| Min. Negotiated Rate |
$280.00 |
| Max. Negotiated Rate |
$1,479.30 |
| Rate for Payer: Aetna Commercial |
$1,378.75
|
| Rate for Payer: BCBS Complete |
$280.00
|
| Rate for Payer: BCN Commercial |
$1,479.30
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Cash Price |
$560.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$490.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$665.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$665.81
|
|
|
CHG NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS
|
Professional
|
$1,718.00
|
|
|
Service Code
|
HCPCS 77301
|
| Min. Negotiated Rate |
$687.20 |
| Max. Negotiated Rate |
$2,813.85 |
| Rate for Payer: Aetna Commercial |
$2,309.89
|
| Rate for Payer: Aetna Commercial |
$2,309.89
|
| Rate for Payer: Aetna Commercial |
$2,309.89
|
| Rate for Payer: Aetna Medicare |
$1,792.75
|
| Rate for Payer: Aetna Medicare |
$1,792.75
|
| Rate for Payer: Aetna Medicare |
$1,792.75
|
| Rate for Payer: BCBS Complete |
$687.20
|
| Rate for Payer: BCBS Complete |
$1,204.40
|
| Rate for Payer: BCBS Complete |
$1,498.00
|
| Rate for Payer: BCBS MAPPO |
$1,723.80
|
| Rate for Payer: BCBS MAPPO |
$1,723.80
|
| Rate for Payer: BCBS MAPPO |
$1,723.80
|
| Rate for Payer: BCN Commercial |
$2,787.78
|
| Rate for Payer: BCN Commercial |
$2,787.78
|
| Rate for Payer: BCN Commercial |
$2,787.78
|
| Rate for Payer: BCN Medicare Advantage |
$1,723.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,723.80
|
| Rate for Payer: BCN Medicare Advantage |
$1,723.80
|
| Rate for Payer: Cash Price |
$2,996.00
|
| Rate for Payer: Cash Price |
$1,374.40
|
| Rate for Payer: Cash Price |
$1,374.40
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,408.80
|
| Rate for Payer: Cash Price |
$2,996.00
|
| Rate for Payer: Cofinity Commercial |
$2,482.27
|
| Rate for Payer: Cofinity Commercial |
$2,482.27
|
| Rate for Payer: Cofinity Commercial |
$2,309.89
|
| Rate for Payer: Cofinity Commercial |
$2,309.89
|
| Rate for Payer: Cofinity Commercial |
$2,482.27
|
| Rate for Payer: Cofinity Commercial |
$2,309.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,723.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,723.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,723.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,809.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,809.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,809.99
|
| Rate for Payer: PACE SWMI |
$1,723.80
|
| Rate for Payer: PACE SWMI |
$1,723.80
|
| Rate for Payer: PACE SWMI |
$1,723.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,723.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,723.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,723.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,107.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,202.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,621.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,813.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,813.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,813.85
|
| Rate for Payer: Priority Health Medicare |
$1,723.80
|
| Rate for Payer: Priority Health Medicare |
$1,723.80
|
| Rate for Payer: Priority Health Medicare |
$1,723.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,813.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,813.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,813.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,723.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,723.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,723.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,723.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,723.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,723.80
|
| Rate for Payer: UHC Medicare Advantage |
$1,775.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,775.51
|
| Rate for Payer: UHC Medicare Advantage |
$1,775.51
|
|
|
CHG OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL
|
Professional
|
$48.00
|
|
|
Service Code
|
HCPCS 76519
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$102.94 |
| Rate for Payer: Aetna Commercial |
$85.48
|
| Rate for Payer: Aetna Medicare |
$66.34
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$63.79
|
| Rate for Payer: BCN Commercial |
$98.23
|
| Rate for Payer: BCN Medicare Advantage |
$63.79
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$85.48
|
| Rate for Payer: Cofinity Commercial |
$91.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.98
|
| Rate for Payer: PACE SWMI |
$63.79
|
| Rate for Payer: PHP Medicare Advantage |
$63.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.94
|
| Rate for Payer: Priority Health Medicare |
$63.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.79
|
| Rate for Payer: UHC Medicare Advantage |
$65.70
|
|
|
CHG OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI
|
Professional
|
$23.00
|
|
|
Service Code
|
HCPCS 76514
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$17.41 |
| Rate for Payer: Aetna Commercial |
$14.78
|
| Rate for Payer: Aetna Medicare |
$11.47
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$11.03
|
| Rate for Payer: BCN Commercial |
$16.61
|
| Rate for Payer: BCN Medicare Advantage |
$11.03
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$15.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.58
|
| Rate for Payer: PACE SWMI |
$11.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.41
|
| Rate for Payer: Priority Health Medicare |
$11.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.03
|
| Rate for Payer: UHC Medicare Advantage |
$11.36
|
|
|
CHG PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY
|
Professional
|
$21.00
|
|
|
Service Code
|
HCPCS 86403
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$16.62 |
| Rate for Payer: Aetna Commercial |
$15.46
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$11.54
|
| Rate for Payer: BCN Commercial |
$8.66
|
| Rate for Payer: BCN Medicare Advantage |
$11.54
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.12
|
| Rate for Payer: PACE SWMI |
$11.54
|
| Rate for Payer: PHP Medicare Advantage |
$11.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.95
|
| Rate for Payer: Priority Health Medicare |
$11.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.54
|
| Rate for Payer: UHC Medicare Advantage |
$11.89
|
|
|
CHG PERCUTANEOUS VERTEBROPLASTY, CT GUIDE
|
Professional
|
$262.00
|
|
|
Service Code
|
HCPCS 72292
|
| Min. Negotiated Rate |
$104.80 |
| Max. Negotiated Rate |
$183.40 |
| Rate for Payer: BCBS Complete |
$104.80
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.40
|
|
|
CHG PERCUTANEOUS VERTEBROPLASTY, FLUOR GUIDE
|
Professional
|
$237.00
|
|
|
Service Code
|
HCPCS 72291
|
| Min. Negotiated Rate |
$94.80 |
| Max. Negotiated Rate |
$165.90 |
| Rate for Payer: BCBS Complete |
$94.80
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.90
|
|
|
CHG PERITONEOGRAM RS&I
|
Professional
|
$45.00
|
|
|
Service Code
|
HCPCS 74190
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$534.94 |
| Rate for Payer: Aetna Commercial |
$534.94
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCN Commercial |
$497.65
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.50
|
|
|
CHG PH BODY FLUID NOT ELSEWHERE SPECIFIED
|
Professional
|
$15.00
|
|
|
Service Code
|
HCPCS 83986
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$4.80
|
| Rate for Payer: Aetna Medicare |
$3.72
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCN Commercial |
$2.69
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$5.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.87
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.58
|
| Rate for Payer: UHC Medicare Advantage |
$3.69
|
|
|
CHG PLACEMNT,PROX/DIST EXT PROS, INFRARENAL
|
Professional
|
$446.00
|
|
|
Service Code
|
HCPCS 75953
|
| Min. Negotiated Rate |
$178.40 |
| Max. Negotiated Rate |
$312.20 |
| Rate for Payer: BCBS Complete |
$178.40
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$312.20
|
|
|
CHG PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I
|
Professional
|
$372.00
|
|
|
Service Code
|
HCPCS 75958
|
| Min. Negotiated Rate |
$148.80 |
| Max. Negotiated Rate |
$339.14 |
| Rate for Payer: Aetna Commercial |
$229.01
|
| Rate for Payer: BCBS Complete |
$148.80
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$284.76
|
|
|
CHG PROTHROMBIN TIME
|
Professional
|
$11.00
|
|
|
Service Code
|
HCPCS 85610
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$7.70 |
| Rate for Payer: Aetna Commercial |
$5.75
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCN Commercial |
$4.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$5.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.57
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.29
|
| Rate for Payer: UHC Medicare Advantage |
$4.42
|
|
|
CHG RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ
|
Professional
|
$70.00
|
|
|
Service Code
|
HCPCS 73050
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$49.00 |
| Rate for Payer: Aetna Commercial |
$36.45
|
| Rate for Payer: Aetna Commercial |
$36.45
|
| Rate for Payer: Aetna Commercial |
$36.45
|
| Rate for Payer: Aetna Medicare |
$28.29
|
| Rate for Payer: Aetna Medicare |
$28.29
|
| Rate for Payer: Aetna Medicare |
$28.29
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Complete |
$28.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: BCBS MAPPO |
$27.20
|
| Rate for Payer: BCBS MAPPO |
$27.20
|
| Rate for Payer: BCBS MAPPO |
$27.20
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$27.20
|
| Rate for Payer: BCN Medicare Advantage |
$27.20
|
| Rate for Payer: BCN Medicare Advantage |
$27.20
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$56.00
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$39.17
|
| Rate for Payer: Cofinity Commercial |
$36.45
|
| Rate for Payer: Cofinity Commercial |
$36.45
|
| Rate for Payer: Cofinity Commercial |
$36.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.56
|
| Rate for Payer: PACE SWMI |
$27.20
|
| Rate for Payer: PACE SWMI |
$27.20
|
| Rate for Payer: PACE SWMI |
$27.20
|
| Rate for Payer: PHP Medicare Advantage |
$27.20
|
| Rate for Payer: PHP Medicare Advantage |
$27.20
|
| Rate for Payer: PHP Medicare Advantage |
$27.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health Medicare |
$27.20
|
| Rate for Payer: Priority Health Medicare |
$27.20
|
| Rate for Payer: Priority Health Medicare |
$27.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.20
|
| Rate for Payer: UHC Medicare Advantage |
$28.02
|
| Rate for Payer: UHC Medicare Advantage |
$28.02
|
| Rate for Payer: UHC Medicare Advantage |
$28.02
|
|
|
CHG RADEX ANKLE COMPLETE MINIMUM 3 VIEWS
|
Professional
|
$87.00
|
|
|
Service Code
|
HCPCS 73610
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$60.90 |
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: Aetna Commercial |
$46.75
|
| Rate for Payer: Aetna Medicare |
$36.29
|
| Rate for Payer: Aetna Medicare |
$36.29
|
| Rate for Payer: Aetna Medicare |
$36.29
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$34.89
|
| Rate for Payer: BCBS MAPPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Medicare Advantage |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$34.89
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$50.24
|
| Rate for Payer: Cofinity Commercial |
$46.75
|
| Rate for Payer: Cofinity Commercial |
$50.24
|
| Rate for Payer: Cofinity Commercial |
$50.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.63
|
| Rate for Payer: PACE SWMI |
$34.89
|
| Rate for Payer: PACE SWMI |
$34.89
|
| Rate for Payer: PACE SWMI |
$34.89
|
| Rate for Payer: PHP Medicare Advantage |
$34.89
|
| Rate for Payer: PHP Medicare Advantage |
$34.89
|
| Rate for Payer: PHP Medicare Advantage |
$34.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.84
|
| Rate for Payer: Priority Health Medicare |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$34.89
|
| Rate for Payer: Priority Health Medicare |
$34.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.89
|
| Rate for Payer: UHC Medicare Advantage |
$35.94
|
| Rate for Payer: UHC Medicare Advantage |
$35.94
|
| Rate for Payer: UHC Medicare Advantage |
$35.94
|
|
|
CHG RADEX CALCANEUS MINIMUM 2 VIEWS
|
Professional
|
$27.00
|
|
|
Service Code
|
HCPCS 73650
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$51.80 |
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: Aetna Commercial |
$36.37
|
| Rate for Payer: Aetna Medicare |
$28.23
|
| Rate for Payer: Aetna Medicare |
$28.23
|
| Rate for Payer: Aetna Medicare |
$28.23
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$27.14
|
| Rate for Payer: BCBS MAPPO |
$27.14
|
| Rate for Payer: BCBS MAPPO |
$27.14
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Medicare Advantage |
$27.14
|
| Rate for Payer: BCN Medicare Advantage |
$27.14
|
| Rate for Payer: BCN Medicare Advantage |
$27.14
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.37
|
| Rate for Payer: Cofinity Commercial |
$36.37
|
| Rate for Payer: Cofinity Commercial |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$36.37
|
| Rate for Payer: Cofinity Commercial |
$39.08
|
| Rate for Payer: Cofinity Commercial |
$39.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.50
|
| Rate for Payer: PACE SWMI |
$27.14
|
| Rate for Payer: PACE SWMI |
$27.14
|
| Rate for Payer: PACE SWMI |
$27.14
|
| Rate for Payer: PHP Medicare Advantage |
$27.14
|
| Rate for Payer: PHP Medicare Advantage |
$27.14
|
| Rate for Payer: PHP Medicare Advantage |
$27.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health Medicare |
$27.14
|
| Rate for Payer: Priority Health Medicare |
$27.14
|
| Rate for Payer: Priority Health Medicare |
$27.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.14
|
| Rate for Payer: UHC Medicare Advantage |
$27.95
|
| Rate for Payer: UHC Medicare Advantage |
$27.95
|
| Rate for Payer: UHC Medicare Advantage |
$27.95
|
|
|
CHG RADEX CLAVICLE COMPLETE
|
Professional
|
$40.00
|
|
|
Service Code
|
HCPCS 73000
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$64.40 |
| Rate for Payer: Aetna Commercial |
$40.92
|
| Rate for Payer: Aetna Commercial |
$40.92
|
| Rate for Payer: Aetna Commercial |
$40.92
|
| Rate for Payer: Aetna Medicare |
$31.76
|
| Rate for Payer: Aetna Medicare |
$31.76
|
| Rate for Payer: Aetna Medicare |
$31.76
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$30.54
|
| Rate for Payer: BCBS MAPPO |
$30.54
|
| Rate for Payer: BCBS MAPPO |
$30.54
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Medicare Advantage |
$30.54
|
| Rate for Payer: BCN Medicare Advantage |
$30.54
|
| Rate for Payer: BCN Medicare Advantage |
$30.54
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Commercial |
$40.92
|
| Rate for Payer: Cofinity Commercial |
$40.92
|
| Rate for Payer: Cofinity Commercial |
$43.98
|
| Rate for Payer: Cofinity Commercial |
$40.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.07
|
| Rate for Payer: PACE SWMI |
$30.54
|
| Rate for Payer: PACE SWMI |
$30.54
|
| Rate for Payer: PACE SWMI |
$30.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.54
|
| Rate for Payer: PHP Medicare Advantage |
$30.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.68
|
| Rate for Payer: Priority Health Medicare |
$30.54
|
| Rate for Payer: Priority Health Medicare |
$30.54
|
| Rate for Payer: Priority Health Medicare |
$30.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.54
|
| Rate for Payer: UHC Medicare Advantage |
$31.46
|
| Rate for Payer: UHC Medicare Advantage |
$31.46
|
| Rate for Payer: UHC Medicare Advantage |
$31.46
|
|
|
CHG RADEX ELBOW 2 VIEWS
|
Professional
|
$39.00
|
|
|
Service Code
|
HCPCS 73070
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$60.20 |
| Rate for Payer: Aetna Commercial |
$37.20
|
| Rate for Payer: Aetna Commercial |
$37.20
|
| Rate for Payer: Aetna Commercial |
$37.20
|
| Rate for Payer: Aetna Medicare |
$28.87
|
| Rate for Payer: Aetna Medicare |
$28.87
|
| Rate for Payer: Aetna Medicare |
$28.87
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCBS MAPPO |
$27.76
|
| Rate for Payer: BCBS MAPPO |
$27.76
|
| Rate for Payer: BCBS MAPPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Medicare Advantage |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$27.76
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$39.97
|
| Rate for Payer: Cofinity Commercial |
$37.20
|
| Rate for Payer: Cofinity Commercial |
$39.97
|
| Rate for Payer: Cofinity Commercial |
$39.97
|
| Rate for Payer: Cofinity Commercial |
$37.20
|
| Rate for Payer: Cofinity Commercial |
$37.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.15
|
| Rate for Payer: PACE SWMI |
$27.76
|
| Rate for Payer: PACE SWMI |
$27.76
|
| Rate for Payer: PACE SWMI |
$27.76
|
| Rate for Payer: PHP Medicare Advantage |
$27.76
|
| Rate for Payer: PHP Medicare Advantage |
$27.76
|
| Rate for Payer: PHP Medicare Advantage |
$27.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.07
|
| Rate for Payer: Priority Health Medicare |
$27.76
|
| Rate for Payer: Priority Health Medicare |
$27.76
|
| Rate for Payer: Priority Health Medicare |
$27.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.76
|
| Rate for Payer: UHC Medicare Advantage |
$28.59
|
| Rate for Payer: UHC Medicare Advantage |
$28.59
|
| Rate for Payer: UHC Medicare Advantage |
$28.59
|
|
|
CHG RADEX ELBOW ARTHROGRAPHY RS&I
|
Professional
|
$84.00
|
|
|
Service Code
|
HCPCS 73085
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$172.09 |
| Rate for Payer: Aetna Commercial |
$141.56
|
| Rate for Payer: Aetna Medicare |
$109.87
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$105.64
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$105.64
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$141.56
|
| Rate for Payer: Cofinity Commercial |
$152.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.92
|
| Rate for Payer: PACE SWMI |
$105.64
|
| Rate for Payer: PHP Medicare Advantage |
$105.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.09
|
| Rate for Payer: Priority Health Medicare |
$105.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.64
|
| Rate for Payer: UHC Medicare Advantage |
$108.81
|
|
|
CHG RADEX ELBOW COMPLETE MINIMUM 3 VIEWS
|
Professional
|
$32.00
|
|
|
Service Code
|
HCPCS 73080
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$69.30 |
| Rate for Payer: Aetna Commercial |
$41.38
|
| Rate for Payer: Aetna Commercial |
$41.38
|
| Rate for Payer: Aetna Commercial |
$41.38
|
| Rate for Payer: Aetna Medicare |
$32.12
|
| Rate for Payer: Aetna Medicare |
$32.12
|
| Rate for Payer: Aetna Medicare |
$32.12
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Complete |
$39.60
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$30.88
|
| Rate for Payer: BCBS MAPPO |
$30.88
|
| Rate for Payer: BCBS MAPPO |
$30.88
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$30.88
|
| Rate for Payer: BCN Medicare Advantage |
$30.88
|
| Rate for Payer: BCN Medicare Advantage |
$30.88
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$41.38
|
| Rate for Payer: Cofinity Commercial |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$41.38
|
| Rate for Payer: Cofinity Commercial |
$44.47
|
| Rate for Payer: Cofinity Commercial |
$41.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.42
|
| Rate for Payer: PACE SWMI |
$30.88
|
| Rate for Payer: PACE SWMI |
$30.88
|
| Rate for Payer: PACE SWMI |
$30.88
|
| Rate for Payer: PHP Medicare Advantage |
$30.88
|
| Rate for Payer: PHP Medicare Advantage |
$30.88
|
| Rate for Payer: PHP Medicare Advantage |
$30.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.19
|
| Rate for Payer: Priority Health Medicare |
$30.88
|
| Rate for Payer: Priority Health Medicare |
$30.88
|
| Rate for Payer: Priority Health Medicare |
$30.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.88
|
| Rate for Payer: UHC Medicare Advantage |
$31.81
|
| Rate for Payer: UHC Medicare Advantage |
$31.81
|
| Rate for Payer: UHC Medicare Advantage |
$31.81
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW
|
Professional
|
$32.00
|
|
|
Service Code
|
HCPCS 72082
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$108.06 |
| Rate for Payer: Aetna Commercial |
$88.76
|
| Rate for Payer: Aetna Medicare |
$68.89
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$66.24
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: BCN Medicare Advantage |
$66.24
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$95.39
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.55
|
| Rate for Payer: PACE SWMI |
$66.24
|
| Rate for Payer: PHP Medicare Advantage |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.06
|
| Rate for Payer: Priority Health Medicare |
$66.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.24
|
| Rate for Payer: UHC Medicare Advantage |
$68.23
|
|
|
CHG RADEX FACIAL BONES < 3 VIEWS
|
Professional
|
$18.00
|
|
|
Service Code
|
HCPCS 70140
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$49.68 |
| Rate for Payer: Aetna Commercial |
$41.04
|
| Rate for Payer: Aetna Medicare |
$31.86
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$30.63
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Medicare Advantage |
$30.63
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$41.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.16
|
| Rate for Payer: PACE SWMI |
$30.63
|
| Rate for Payer: PHP Medicare Advantage |
$30.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.68
|
| Rate for Payer: Priority Health Medicare |
$30.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.63
|
| Rate for Payer: UHC Medicare Advantage |
$31.55
|
|
