CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
$89.00
|
|
Service Code
|
HCPCS 76800
|
Min. Negotiated Rate |
$35.60 |
Max. Negotiated Rate |
$240.72 |
Rate for Payer: Aetna Commercial |
$200.42
|
Rate for Payer: Aetna Medicare |
$155.55
|
Rate for Payer: BCBS Complete |
$35.60
|
Rate for Payer: BCBS MAPPO |
$149.57
|
Rate for Payer: BCN Commercial |
$229.68
|
Rate for Payer: BCN Medicare Advantage |
$149.57
|
Rate for Payer: Cash Price |
$71.20
|
Rate for Payer: Cash Price |
$71.20
|
Rate for Payer: Cofinity Commercial |
$200.42
|
Rate for Payer: Cofinity Commercial |
$215.38
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.57
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.05
|
Rate for Payer: PACE SWMI |
$149.57
|
Rate for Payer: PHP Medicare Advantage |
$149.57
|
Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.72
|
Rate for Payer: Priority Health Medicare |
$149.57
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$240.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$149.57
|
Rate for Payer: UHC Dual Complete DSNP |
$149.57
|
Rate for Payer: UHC Medicare Advantage |
$154.06
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
$250.00
|
|
Service Code
|
HCPCS 76496
|
Min. Negotiated Rate |
$74.70 |
Max. Negotiated Rate |
$175.00 |
Rate for Payer: Aetna Commercial |
$74.70
|
Rate for Payer: BCBS Complete |
$100.00
|
Rate for Payer: Cash Price |
$200.00
|
Rate for Payer: Cash Price |
$200.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
|
CHG URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM
|
Professional
|
$475.00
|
|
Service Code
|
HCPCS 78740
|
Min. Negotiated Rate |
$190.00 |
Max. Negotiated Rate |
$332.50 |
Rate for Payer: Aetna Commercial |
$255.10
|
Rate for Payer: Aetna Medicare |
$197.98
|
Rate for Payer: BCBS Complete |
$190.00
|
Rate for Payer: BCBS MAPPO |
$190.37
|
Rate for Payer: BCN Commercial |
$298.09
|
Rate for Payer: BCN Medicare Advantage |
$190.37
|
Rate for Payer: Cash Price |
$380.00
|
Rate for Payer: Cash Price |
$380.00
|
Rate for Payer: Cofinity Commercial |
$255.10
|
Rate for Payer: Cofinity Commercial |
$274.13
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.37
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.89
|
Rate for Payer: PACE SWMI |
$190.37
|
Rate for Payer: PHP Medicare Advantage |
$190.37
|
Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.42
|
Rate for Payer: Priority Health Medicare |
$190.37
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$312.42
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$190.37
|
Rate for Payer: UHC Dual Complete DSNP |
$190.37
|
Rate for Payer: UHC Medicare Advantage |
$196.08
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
$110.00
|
|
Service Code
|
HCPCS 74450
|
Min. Negotiated Rate |
$44.00 |
Max. Negotiated Rate |
$256.77 |
Rate for Payer: Aetna Commercial |
$256.77
|
Rate for Payer: BCBS Complete |
$44.00
|
Rate for Payer: BCN Commercial |
$238.97
|
Rate for Payer: Cash Price |
$88.00
|
Rate for Payer: Cash Price |
$88.00
|
Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$104.48
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
$32.00
|
|
Service Code
|
HCPCS 74455
|
Min. Negotiated Rate |
$12.80 |
Max. Negotiated Rate |
$161.33 |
Rate for Payer: Aetna Commercial |
$131.79
|
Rate for Payer: Aetna Medicare |
$102.28
|
Rate for Payer: BCBS Complete |
$12.80
|
Rate for Payer: BCBS MAPPO |
$98.35
|
Rate for Payer: BCN Commercial |
$153.93
|
Rate for Payer: BCN Medicare Advantage |
$98.35
|
Rate for Payer: Cash Price |
$25.60
|
Rate for Payer: Cash Price |
$25.60
|
Rate for Payer: Cofinity Commercial |
$131.79
|
Rate for Payer: Cofinity Commercial |
$141.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.35
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.27
|
Rate for Payer: PACE SWMI |
$98.35
|
Rate for Payer: PHP Medicare Advantage |
$98.35
|
Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.33
|
Rate for Payer: Priority Health Medicare |
$98.35
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$161.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$98.35
|
Rate for Payer: UHC Dual Complete DSNP |
$98.35
|
Rate for Payer: UHC Medicare Advantage |
$101.30
|
|
CHG URINALYSIS MICROSCOPIC ONLY
|
Professional
|
$7.00
|
|
Service Code
|
HCPCS 81015
|
Min. Negotiated Rate |
$2.80 |
Max. Negotiated Rate |
$4.90 |
Rate for Payer: Aetna Commercial |
$4.09
|
Rate for Payer: Aetna Medicare |
$3.17
|
Rate for Payer: BCBS Complete |
$2.80
|
Rate for Payer: BCBS MAPPO |
$3.05
|
Rate for Payer: BCN Commercial |
$3.05
|
Rate for Payer: BCN Medicare Advantage |
$3.05
|
Rate for Payer: Cash Price |
$5.60
|
Rate for Payer: Cash Price |
$5.60
|
Rate for Payer: Cofinity Commercial |
$4.09
|
Rate for Payer: Cofinity Commercial |
$4.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.20
|
Rate for Payer: PACE SWMI |
$3.05
|
Rate for Payer: PHP Medicare Advantage |
$3.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$4.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.16
|
Rate for Payer: Priority Health Medicare |
$3.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3.16
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.05
|
Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
Rate for Payer: UHC Medicare Advantage |
$3.14
|
|
CHG URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS
|
Professional
|
$14.00
|
|
Service Code
|
HCPCS 81005
|
Min. Negotiated Rate |
$1.63 |
Max. Negotiated Rate |
$9.80 |
Rate for Payer: Aetna Commercial |
$2.91
|
Rate for Payer: Aetna Medicare |
$2.26
|
Rate for Payer: BCBS Complete |
$5.60
|
Rate for Payer: BCBS MAPPO |
$2.17
|
Rate for Payer: BCN Commercial |
$1.63
|
Rate for Payer: BCN Medicare Advantage |
$2.17
|
Rate for Payer: Cash Price |
$11.20
|
Rate for Payer: Cash Price |
$11.20
|
Rate for Payer: Cofinity Commercial |
$3.12
|
Rate for Payer: Cofinity Commercial |
$2.91
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
Rate for Payer: PACE SWMI |
$2.17
|
Rate for Payer: PHP Medicare Advantage |
$2.17
|
Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.11
|
Rate for Payer: Priority Health Medicare |
$2.17
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2.11
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2.17
|
Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
Rate for Payer: UHC Medicare Advantage |
$2.24
|
|
CHG URINARY BLADDER RESIDUAL STUDY
|
Professional
|
$233.00
|
|
Service Code
|
HCPCS 78730
|
Min. Negotiated Rate |
$63.49 |
Max. Negotiated Rate |
$163.10 |
Rate for Payer: Aetna Commercial |
$85.08
|
Rate for Payer: Aetna Medicare |
$66.03
|
Rate for Payer: BCBS Complete |
$93.20
|
Rate for Payer: BCBS MAPPO |
$63.49
|
Rate for Payer: BCN Commercial |
$99.69
|
Rate for Payer: BCN Medicare Advantage |
$63.49
|
Rate for Payer: Cash Price |
$186.40
|
Rate for Payer: Cash Price |
$186.40
|
Rate for Payer: Cofinity Commercial |
$85.08
|
Rate for Payer: Cofinity Commercial |
$91.43
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.49
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.66
|
Rate for Payer: PACE SWMI |
$63.49
|
Rate for Payer: PHP Medicare Advantage |
$63.49
|
Rate for Payer: Priority Health Cigna Priority Health |
$163.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.48
|
Rate for Payer: Priority Health Medicare |
$63.49
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$104.48
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$63.49
|
Rate for Payer: UHC Dual Complete DSNP |
$63.49
|
Rate for Payer: UHC Medicare Advantage |
$65.39
|
|
CHG URINE ALBUMIN SEMIQUANTITATIVE
|
Professional
|
$14.00
|
|
Service Code
|
HCPCS 82044
|
Min. Negotiated Rate |
$4.67 |
Max. Negotiated Rate |
$9.80 |
Rate for Payer: Aetna Commercial |
$8.35
|
Rate for Payer: Aetna Medicare |
$6.48
|
Rate for Payer: BCBS Complete |
$5.60
|
Rate for Payer: BCBS MAPPO |
$6.23
|
Rate for Payer: BCN Commercial |
$4.67
|
Rate for Payer: BCN Medicare Advantage |
$6.23
|
Rate for Payer: Cash Price |
$11.20
|
Rate for Payer: Cash Price |
$11.20
|
Rate for Payer: Cofinity Commercial |
$8.97
|
Rate for Payer: Cofinity Commercial |
$8.35
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.23
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.54
|
Rate for Payer: PACE SWMI |
$6.23
|
Rate for Payer: PHP Medicare Advantage |
$6.23
|
Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.33
|
Rate for Payer: Priority Health Medicare |
$6.23
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$6.33
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$6.23
|
Rate for Payer: UHC Dual Complete DSNP |
$6.23
|
Rate for Payer: UHC Medicare Advantage |
$6.42
|
|
CHG URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS
|
Professional
|
$23.00
|
|
Service Code
|
HCPCS 81025
|
Min. Negotiated Rate |
$8.61 |
Max. Negotiated Rate |
$16.10 |
Rate for Payer: Aetna Commercial |
$11.54
|
Rate for Payer: Aetna Medicare |
$8.95
|
Rate for Payer: BCBS Complete |
$9.20
|
Rate for Payer: BCBS MAPPO |
$8.61
|
Rate for Payer: BCN Commercial |
$8.61
|
Rate for Payer: BCN Medicare Advantage |
$8.61
|
Rate for Payer: Cash Price |
$18.40
|
Rate for Payer: Cash Price |
$18.40
|
Rate for Payer: Cofinity Commercial |
$11.54
|
Rate for Payer: Cofinity Commercial |
$12.40
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.04
|
Rate for Payer: PACE SWMI |
$8.61
|
Rate for Payer: PHP Medicare Advantage |
$8.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.78
|
Rate for Payer: Priority Health Medicare |
$8.61
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$8.78
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$8.61
|
Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
Rate for Payer: UHC Medicare Advantage |
$8.87
|
|
CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY
|
Professional
|
$17.00
|
|
Service Code
|
HCPCS 81000
|
Min. Negotiated Rate |
$4.02 |
Max. Negotiated Rate |
$11.90 |
Rate for Payer: Aetna Commercial |
$5.39
|
Rate for Payer: Aetna Medicare |
$4.18
|
Rate for Payer: BCBS Complete |
$6.80
|
Rate for Payer: BCBS MAPPO |
$4.02
|
Rate for Payer: BCN Commercial |
$4.02
|
Rate for Payer: BCN Medicare Advantage |
$4.02
|
Rate for Payer: Cash Price |
$13.60
|
Rate for Payer: Cash Price |
$13.60
|
Rate for Payer: Cofinity Commercial |
$5.79
|
Rate for Payer: Cofinity Commercial |
$5.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.22
|
Rate for Payer: PACE SWMI |
$4.02
|
Rate for Payer: PHP Medicare Advantage |
$4.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$11.90
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.22
|
Rate for Payer: Priority Health Medicare |
$4.02
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$4.22
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$4.02
|
Rate for Payer: UHC Dual Complete DSNP |
$4.02
|
Rate for Payer: UHC Medicare Advantage |
$4.14
|
|
CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY
|
Professional
|
$30.00
|
|
Service Code
|
HCPCS 81001
|
Min. Negotiated Rate |
$3.16 |
Max. Negotiated Rate |
$21.00 |
Rate for Payer: Aetna Commercial |
$4.25
|
Rate for Payer: Aetna Medicare |
$3.30
|
Rate for Payer: BCBS Complete |
$12.00
|
Rate for Payer: BCBS MAPPO |
$3.17
|
Rate for Payer: BCN Commercial |
$3.17
|
Rate for Payer: BCN Medicare Advantage |
$3.17
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cash Price |
$24.00
|
Rate for Payer: Cofinity Commercial |
$4.25
|
Rate for Payer: Cofinity Commercial |
$4.56
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.33
|
Rate for Payer: PACE SWMI |
$3.17
|
Rate for Payer: PHP Medicare Advantage |
$3.17
|
Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.16
|
Rate for Payer: Priority Health Medicare |
$3.17
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3.16
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.17
|
Rate for Payer: UHC Dual Complete DSNP |
$3.17
|
Rate for Payer: UHC Medicare Advantage |
$3.27
|
|
CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY
|
Professional
|
$14.00
|
|
Service Code
|
HCPCS 81003
|
Min. Negotiated Rate |
$2.25 |
Max. Negotiated Rate |
$9.80 |
Rate for Payer: Aetna Commercial |
$3.02
|
Rate for Payer: Aetna Medicare |
$2.34
|
Rate for Payer: BCBS Complete |
$5.60
|
Rate for Payer: BCBS MAPPO |
$2.25
|
Rate for Payer: BCN Commercial |
$2.25
|
Rate for Payer: BCN Medicare Advantage |
$2.25
|
Rate for Payer: Cash Price |
$11.20
|
Rate for Payer: Cash Price |
$11.20
|
Rate for Payer: Cofinity Commercial |
$3.24
|
Rate for Payer: Cofinity Commercial |
$3.02
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.36
|
Rate for Payer: PACE SWMI |
$2.25
|
Rate for Payer: PHP Medicare Advantage |
$2.25
|
Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.46
|
Rate for Payer: Priority Health Medicare |
$2.25
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$2.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2.25
|
Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
Rate for Payer: UHC Medicare Advantage |
$2.32
|
|
CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP
|
Professional
|
$12.00
|
|
Service Code
|
HCPCS 81002
|
Min. Negotiated Rate |
$3.48 |
Max. Negotiated Rate |
$8.40 |
Rate for Payer: Aetna Commercial |
$4.66
|
Rate for Payer: Aetna Medicare |
$3.62
|
Rate for Payer: BCBS Complete |
$4.80
|
Rate for Payer: BCBS MAPPO |
$3.48
|
Rate for Payer: BCN Commercial |
$3.48
|
Rate for Payer: BCN Medicare Advantage |
$3.48
|
Rate for Payer: Cash Price |
$9.60
|
Rate for Payer: Cash Price |
$9.60
|
Rate for Payer: Cofinity Commercial |
$5.01
|
Rate for Payer: Cofinity Commercial |
$4.66
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.65
|
Rate for Payer: PACE SWMI |
$3.48
|
Rate for Payer: PHP Medicare Advantage |
$3.48
|
Rate for Payer: Priority Health Cigna Priority Health |
$8.40
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.52
|
Rate for Payer: Priority Health Medicare |
$3.48
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$3.52
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.48
|
Rate for Payer: UHC Dual Complete DSNP |
$3.48
|
Rate for Payer: UHC Medicare Advantage |
$3.58
|
|
CHG UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
|
Professional
|
$137.00
|
|
Service Code
|
HCPCS 74400
|
Min. Negotiated Rate |
$54.80 |
Max. Negotiated Rate |
$209.99 |
Rate for Payer: Aetna Commercial |
$172.04
|
Rate for Payer: Aetna Commercial |
$172.04
|
Rate for Payer: Aetna Medicare |
$133.53
|
Rate for Payer: Aetna Medicare |
$133.53
|
Rate for Payer: BCBS Complete |
$54.80
|
Rate for Payer: BCBS Complete |
$83.60
|
Rate for Payer: BCBS MAPPO |
$128.39
|
Rate for Payer: BCBS MAPPO |
$128.39
|
Rate for Payer: BCN Commercial |
$200.36
|
Rate for Payer: BCN Commercial |
$200.36
|
Rate for Payer: BCN Medicare Advantage |
$128.39
|
Rate for Payer: BCN Medicare Advantage |
$128.39
|
Rate for Payer: Cash Price |
$167.20
|
Rate for Payer: Cash Price |
$167.20
|
Rate for Payer: Cash Price |
$109.60
|
Rate for Payer: Cash Price |
$109.60
|
Rate for Payer: Cofinity Commercial |
$184.88
|
Rate for Payer: Cofinity Commercial |
$184.88
|
Rate for Payer: Cofinity Commercial |
$172.04
|
Rate for Payer: Cofinity Commercial |
$172.04
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.39
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.81
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.81
|
Rate for Payer: PACE SWMI |
$128.39
|
Rate for Payer: PACE SWMI |
$128.39
|
Rate for Payer: PHP Medicare Advantage |
$128.39
|
Rate for Payer: PHP Medicare Advantage |
$128.39
|
Rate for Payer: Priority Health Cigna Priority Health |
$95.90
|
Rate for Payer: Priority Health Cigna Priority Health |
$146.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.99
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.99
|
Rate for Payer: Priority Health Medicare |
$128.39
|
Rate for Payer: Priority Health Medicare |
$128.39
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$209.99
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$209.99
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$128.39
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$128.39
|
Rate for Payer: UHC Dual Complete DSNP |
$128.39
|
Rate for Payer: UHC Dual Complete DSNP |
$128.39
|
Rate for Payer: UHC Medicare Advantage |
$132.24
|
Rate for Payer: UHC Medicare Advantage |
$132.24
|
|
CHG UROGRAPHY RETROGRADE WITH/WO KUB
|
Professional
|
$58.00
|
|
Service Code
|
HCPCS 74420
|
Min. Negotiated Rate |
$23.20 |
Max. Negotiated Rate |
$118.31 |
Rate for Payer: Aetna Commercial |
$97.89
|
Rate for Payer: Aetna Medicare |
$75.97
|
Rate for Payer: BCBS Complete |
$23.20
|
Rate for Payer: BCBS MAPPO |
$73.05
|
Rate for Payer: BCN Commercial |
$112.89
|
Rate for Payer: BCN Medicare Advantage |
$73.05
|
Rate for Payer: Cash Price |
$46.40
|
Rate for Payer: Cash Price |
$46.40
|
Rate for Payer: Cofinity Commercial |
$97.89
|
Rate for Payer: Cofinity Commercial |
$105.19
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.05
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.70
|
Rate for Payer: PACE SWMI |
$73.05
|
Rate for Payer: PHP Medicare Advantage |
$73.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.31
|
Rate for Payer: Priority Health Medicare |
$73.05
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$118.31
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$73.05
|
Rate for Payer: UHC Dual Complete DSNP |
$73.05
|
Rate for Payer: UHC Medicare Advantage |
$75.24
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
$209.00
|
|
Service Code
|
HCPCS 76700
|
Min. Negotiated Rate |
$83.60 |
Max. Negotiated Rate |
$179.76 |
Rate for Payer: Aetna Commercial |
$148.85
|
Rate for Payer: Aetna Medicare |
$115.52
|
Rate for Payer: BCBS Complete |
$83.60
|
Rate for Payer: BCBS MAPPO |
$111.08
|
Rate for Payer: BCN Commercial |
$171.52
|
Rate for Payer: BCN Medicare Advantage |
$111.08
|
Rate for Payer: Cash Price |
$167.20
|
Rate for Payer: Cash Price |
$167.20
|
Rate for Payer: Cofinity Commercial |
$159.96
|
Rate for Payer: Cofinity Commercial |
$148.85
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.08
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.63
|
Rate for Payer: PACE SWMI |
$111.08
|
Rate for Payer: PHP Medicare Advantage |
$111.08
|
Rate for Payer: Priority Health Cigna Priority Health |
$146.30
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.76
|
Rate for Payer: Priority Health Medicare |
$111.08
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$179.76
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$111.08
|
Rate for Payer: UHC Dual Complete DSNP |
$111.08
|
Rate for Payer: UHC Medicare Advantage |
$114.41
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE LIMITED
|
Professional
|
$106.00
|
|
Service Code
|
HCPCS 76705
|
Min. Negotiated Rate |
$42.40 |
Max. Negotiated Rate |
$135.72 |
Rate for Payer: Aetna Commercial |
$112.39
|
Rate for Payer: Aetna Commercial |
$112.39
|
Rate for Payer: Aetna Medicare |
$87.22
|
Rate for Payer: Aetna Medicare |
$87.22
|
Rate for Payer: BCBS Complete |
$70.40
|
Rate for Payer: BCBS Complete |
$42.40
|
Rate for Payer: BCBS MAPPO |
$83.87
|
Rate for Payer: BCBS MAPPO |
$83.87
|
Rate for Payer: BCN Commercial |
$129.50
|
Rate for Payer: BCN Commercial |
$129.50
|
Rate for Payer: BCN Medicare Advantage |
$83.87
|
Rate for Payer: BCN Medicare Advantage |
$83.87
|
Rate for Payer: Cash Price |
$140.80
|
Rate for Payer: Cash Price |
$140.80
|
Rate for Payer: Cash Price |
$84.80
|
Rate for Payer: Cash Price |
$84.80
|
Rate for Payer: Cofinity Commercial |
$120.77
|
Rate for Payer: Cofinity Commercial |
$120.77
|
Rate for Payer: Cofinity Commercial |
$112.39
|
Rate for Payer: Cofinity Commercial |
$112.39
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.87
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.87
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.06
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.06
|
Rate for Payer: PACE SWMI |
$83.87
|
Rate for Payer: PACE SWMI |
$83.87
|
Rate for Payer: PHP Medicare Advantage |
$83.87
|
Rate for Payer: PHP Medicare Advantage |
$83.87
|
Rate for Payer: Priority Health Cigna Priority Health |
$123.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
Rate for Payer: Priority Health Medicare |
$83.87
|
Rate for Payer: Priority Health Medicare |
$83.87
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$135.72
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$135.72
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$83.87
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$83.87
|
Rate for Payer: UHC Dual Complete DSNP |
$83.87
|
Rate for Payer: UHC Dual Complete DSNP |
$83.87
|
Rate for Payer: UHC Medicare Advantage |
$86.39
|
Rate for Payer: UHC Medicare Advantage |
$86.39
|
|
CHG US, BREAST(S), REAL TIME
|
Professional
|
$147.00
|
|
Service Code
|
HCPCS 76645
|
Min. Negotiated Rate |
$58.80 |
Max. Negotiated Rate |
$102.90 |
Rate for Payer: BCBS Complete |
$58.80
|
Rate for Payer: Cash Price |
$117.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
|
CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
$56.00
|
|
Service Code
|
HCPCS 76604
|
Min. Negotiated Rate |
$22.40 |
Max. Negotiated Rate |
$87.07 |
Rate for Payer: Aetna Commercial |
$73.08
|
Rate for Payer: Aetna Medicare |
$56.72
|
Rate for Payer: BCBS Complete |
$22.40
|
Rate for Payer: BCBS MAPPO |
$54.54
|
Rate for Payer: BCN Commercial |
$83.07
|
Rate for Payer: BCN Medicare Advantage |
$54.54
|
Rate for Payer: Cash Price |
$44.80
|
Rate for Payer: Cash Price |
$44.80
|
Rate for Payer: Cofinity Commercial |
$78.54
|
Rate for Payer: Cofinity Commercial |
$73.08
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.54
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.27
|
Rate for Payer: PACE SWMI |
$54.54
|
Rate for Payer: PHP Medicare Advantage |
$54.54
|
Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.07
|
Rate for Payer: Priority Health Medicare |
$54.54
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$87.07
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$54.54
|
Rate for Payer: UHC Dual Complete DSNP |
$54.54
|
Rate for Payer: UHC Medicare Advantage |
$56.18
|
|
CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL
|
Professional
|
$421.00
|
|
Service Code
|
HCPCS 76936
|
Min. Negotiated Rate |
$168.40 |
Max. Negotiated Rate |
$397.44 |
Rate for Payer: Aetna Commercial |
$331.01
|
Rate for Payer: Aetna Medicare |
$256.90
|
Rate for Payer: BCBS Complete |
$168.40
|
Rate for Payer: BCBS MAPPO |
$247.02
|
Rate for Payer: BCN Commercial |
$379.21
|
Rate for Payer: BCN Medicare Advantage |
$247.02
|
Rate for Payer: Cash Price |
$336.80
|
Rate for Payer: Cash Price |
$336.80
|
Rate for Payer: Cofinity Commercial |
$355.71
|
Rate for Payer: Cofinity Commercial |
$331.01
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.02
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$259.37
|
Rate for Payer: PACE SWMI |
$247.02
|
Rate for Payer: PHP Medicare Advantage |
$247.02
|
Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$397.44
|
Rate for Payer: Priority Health Medicare |
$247.02
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$397.44
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$247.02
|
Rate for Payer: UHC Dual Complete DSNP |
$247.02
|
Rate for Payer: UHC Medicare Advantage |
$254.43
|
|
CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION
|
Professional
|
$84.00
|
|
Service Code
|
HCPCS 76881
|
Min. Negotiated Rate |
$33.60 |
Max. Negotiated Rate |
$212.80 |
Rate for Payer: Aetna Commercial |
$70.62
|
Rate for Payer: Aetna Commercial |
$70.62
|
Rate for Payer: Aetna Medicare |
$54.81
|
Rate for Payer: Aetna Medicare |
$54.81
|
Rate for Payer: BCBS Complete |
$121.60
|
Rate for Payer: BCBS Complete |
$33.60
|
Rate for Payer: BCBS MAPPO |
$52.70
|
Rate for Payer: BCBS MAPPO |
$52.70
|
Rate for Payer: BCN Commercial |
$78.68
|
Rate for Payer: BCN Commercial |
$78.68
|
Rate for Payer: BCN Medicare Advantage |
$52.70
|
Rate for Payer: BCN Medicare Advantage |
$52.70
|
Rate for Payer: Cash Price |
$243.20
|
Rate for Payer: Cash Price |
$67.20
|
Rate for Payer: Cash Price |
$243.20
|
Rate for Payer: Cash Price |
$67.20
|
Rate for Payer: Cofinity Commercial |
$75.89
|
Rate for Payer: Cofinity Commercial |
$70.62
|
Rate for Payer: Cofinity Commercial |
$75.89
|
Rate for Payer: Cofinity Commercial |
$70.62
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.70
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.70
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.34
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.34
|
Rate for Payer: PACE SWMI |
$52.70
|
Rate for Payer: PACE SWMI |
$52.70
|
Rate for Payer: PHP Medicare Advantage |
$52.70
|
Rate for Payer: PHP Medicare Advantage |
$52.70
|
Rate for Payer: Priority Health Cigna Priority Health |
$212.80
|
Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.46
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.46
|
Rate for Payer: Priority Health Medicare |
$52.70
|
Rate for Payer: Priority Health Medicare |
$52.70
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$82.46
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$82.46
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$52.70
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$52.70
|
Rate for Payer: UHC Dual Complete DSNP |
$52.70
|
Rate for Payer: UHC Dual Complete DSNP |
$52.70
|
Rate for Payer: UHC Medicare Advantage |
$54.28
|
Rate for Payer: UHC Medicare Advantage |
$54.28
|
|
CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION
|
Professional
|
$286.00
|
|
Service Code
|
HCPCS 76813
|
Min. Negotiated Rate |
$112.51 |
Max. Negotiated Rate |
$200.20 |
Rate for Payer: Aetna Commercial |
$150.76
|
Rate for Payer: Aetna Medicare |
$117.01
|
Rate for Payer: BCBS Complete |
$114.40
|
Rate for Payer: BCBS MAPPO |
$112.51
|
Rate for Payer: BCN Commercial |
$172.01
|
Rate for Payer: BCN Medicare Advantage |
$112.51
|
Rate for Payer: Cash Price |
$228.80
|
Rate for Payer: Cash Price |
$228.80
|
Rate for Payer: Cofinity Commercial |
$162.01
|
Rate for Payer: Cofinity Commercial |
$150.76
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.51
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.14
|
Rate for Payer: PACE SWMI |
$112.51
|
Rate for Payer: PHP Medicare Advantage |
$112.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.28
|
Rate for Payer: Priority Health Medicare |
$112.51
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$180.28
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$112.51
|
Rate for Payer: UHC Dual Complete DSNP |
$112.51
|
Rate for Payer: UHC Medicare Advantage |
$115.89
|
|
CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION
|
Professional
|
$191.00
|
|
Service Code
|
HCPCS 76814
|
Min. Negotiated Rate |
$72.31 |
Max. Negotiated Rate |
$133.70 |
Rate for Payer: Aetna Commercial |
$96.90
|
Rate for Payer: Aetna Medicare |
$75.20
|
Rate for Payer: BCBS Complete |
$76.40
|
Rate for Payer: BCBS MAPPO |
$72.31
|
Rate for Payer: BCN Commercial |
$109.46
|
Rate for Payer: BCN Medicare Advantage |
$72.31
|
Rate for Payer: Cash Price |
$152.80
|
Rate for Payer: Cash Price |
$152.80
|
Rate for Payer: Cofinity Commercial |
$96.90
|
Rate for Payer: Cofinity Commercial |
$104.13
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.31
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.93
|
Rate for Payer: PACE SWMI |
$72.31
|
Rate for Payer: PHP Medicare Advantage |
$72.31
|
Rate for Payer: Priority Health Cigna Priority Health |
$133.70
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.73
|
Rate for Payer: Priority Health Medicare |
$72.31
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$114.73
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$72.31
|
Rate for Payer: UHC Dual Complete DSNP |
$72.31
|
Rate for Payer: UHC Medicare Advantage |
$74.48
|
|
CHG US GUIDANCE AMNIOCENTESIS IMG S&I
|
Professional
|
$314.00
|
|
Service Code
|
HCPCS 76946
|
Min. Negotiated Rate |
$31.51 |
Max. Negotiated Rate |
$219.80 |
Rate for Payer: Aetna Commercial |
$42.22
|
Rate for Payer: Aetna Medicare |
$32.77
|
Rate for Payer: BCBS Complete |
$125.60
|
Rate for Payer: BCBS MAPPO |
$31.51
|
Rate for Payer: BCN Commercial |
$47.89
|
Rate for Payer: BCN Medicare Advantage |
$31.51
|
Rate for Payer: Cash Price |
$251.20
|
Rate for Payer: Cash Price |
$251.20
|
Rate for Payer: Cofinity Commercial |
$45.37
|
Rate for Payer: Cofinity Commercial |
$42.22
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.51
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.09
|
Rate for Payer: PACE SWMI |
$31.51
|
Rate for Payer: PHP Medicare Advantage |
$31.51
|
Rate for Payer: Priority Health Cigna Priority Health |
$219.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.19
|
Rate for Payer: Priority Health Medicare |
$31.51
|
Rate for Payer: Priority Health Narrow/Tiered Network |
$50.19
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$31.51
|
Rate for Payer: UHC Dual Complete DSNP |
$31.51
|
Rate for Payer: UHC Medicare Advantage |
$32.46
|
|