|
CHG RADEX FOREARM 2 VIEWS
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 73090
|
| Min. Negotiated Rate |
$15.00 |
| Max. Negotiated Rate |
$44.14 |
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Aetna Medicare |
$46.50
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$74.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$69.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.14
|
|
|
CHG RADEX HAND 2 VIEWS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 73120
|
| Min. Negotiated Rate |
$35.37 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$35.37
|
| Rate for Payer: Aetna Commercial |
$35.37
|
| Rate for Payer: Aetna Commercial |
$35.37
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$47.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.17
|
|
|
CHG RADEX HAND MINIMUM 3 VIEWS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73130
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$56.20 |
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: Aetna Medicare |
$49.50
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.20
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 73521
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$46.65
|
| Rate for Payer: Aetna Commercial |
$46.65
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$62.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.22
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 73522
|
| Min. Negotiated Rate |
$60.50 |
| Max. Negotiated Rate |
$90.75 |
| Rate for Payer: Aetna Commercial |
$60.64
|
| Rate for Payer: Aetna Commercial |
$60.64
|
| Rate for Payer: Aetna Commercial |
$60.64
|
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: Aetna Medicare |
$32.50
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCN Commercial |
$80.67
|
| Rate for Payer: BCN Commercial |
$80.67
|
| Rate for Payer: BCN Commercial |
$80.67
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.28
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 73523
|
| Min. Negotiated Rate |
$58.50 |
| Max. Negotiated Rate |
$93.31 |
| Rate for Payer: Aetna Commercial |
$69.49
|
| Rate for Payer: Aetna Commercial |
$69.49
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: BCN Commercial |
$92.62
|
| Rate for Payer: BCN Commercial |
$92.62
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.31
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 73501
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$50.18 |
| Rate for Payer: Aetna Commercial |
$36.58
|
| Rate for Payer: Aetna Commercial |
$36.58
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.18
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 73502
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$71.75 |
| Rate for Payer: Aetna Commercial |
$52.75
|
| Rate for Payer: Aetna Commercial |
$52.75
|
| Rate for Payer: Aetna Medicare |
$11.50
|
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCN Commercial |
$71.21
|
| Rate for Payer: BCN Commercial |
$71.21
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.75
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS
|
Professional
|
Both
|
$128.00
|
|
|
Service Code
|
HCPCS 73503
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$96.00 |
| Rate for Payer: Aetna Commercial |
$66.29
|
| Rate for Payer: Aetna Commercial |
$66.29
|
| Rate for Payer: Aetna Medicare |
$64.00
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: BCN Commercial |
$90.63
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.31
|
|
|
CHG RADEX HUMERUS MINIMUM 2 VIEWS
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 73060
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$48.16 |
| Rate for Payer: Aetna Commercial |
$36.51
|
| Rate for Payer: Aetna Commercial |
$36.51
|
| Rate for Payer: Aetna Commercial |
$36.51
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: Aetna Medicare |
$54.00
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.16
|
|
|
CHG RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 70160
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$56.69 |
| Rate for Payer: Aetna Commercial |
$43.03
|
| Rate for Payer: Aetna Commercial |
$43.03
|
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: Aetna Medicare |
$29.00
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.69
|
|
|
CHG RADEX OPTIC FORAMINA
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 70190
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$56.20 |
| Rate for Payer: Aetna Commercial |
$43.94
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCN Commercial |
$55.77
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.20
|
|
|
CHG RADEX ORBITS COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 70200
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$71.75 |
| Rate for Payer: Aetna Commercial |
$54.89
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: BCN Commercial |
$71.21
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$71.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.75
|
|
|
CHG RADEX RIBS BILATERAL 3 VIEWS
|
Professional
|
Both
|
$113.00
|
|
|
Service Code
|
HCPCS 71110
|
| Min. Negotiated Rate |
$49.96 |
| Max. Negotiated Rate |
$84.75 |
| Rate for Payer: Aetna Commercial |
$49.96
|
| Rate for Payer: Aetna Commercial |
$49.96
|
| Rate for Payer: Aetna Medicare |
$56.50
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.72
|
|
|
CHG RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 71111
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$78.77 |
| Rate for Payer: Aetna Commercial |
$59.61
|
| Rate for Payer: Aetna Commercial |
$59.61
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: Aetna Medicare |
$37.00
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: BCN Commercial |
$78.18
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$78.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.77
|
|
|
CHG RADEX RIBS UNILATERAL 2 VIEWS
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 71100
|
| Min. Negotiated Rate |
$26.00 |
| Max. Negotiated Rate |
$55.19 |
| Rate for Payer: Aetna Commercial |
$41.69
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: BCN Commercial |
$54.78
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.19
|
|
|
CHG RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS
|
Professional
|
Both
|
$54.00
|
|
|
Service Code
|
HCPCS 71101
|
| Min. Negotiated Rate |
$27.00 |
| Max. Negotiated Rate |
$63.22 |
| Rate for Payer: Aetna Commercial |
$47.98
|
| Rate for Payer: Aetna Commercial |
$47.98
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCN Commercial |
$62.75
|
| Rate for Payer: BCN Commercial |
$62.75
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$63.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.22
|
|
|
CHG RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 72220
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$49.17 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: Aetna Medicare |
$22.00
|
| Rate for Payer: Aetna Medicare |
$65.00
|
| Rate for Payer: BCN Commercial |
$48.80
|
| Rate for Payer: BCN Commercial |
$48.80
|
| Rate for Payer: BCN Commercial |
$48.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$49.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.17
|
|
|
CHG RADEX SCAPULA COMPLETE
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 73010
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$82.50 |
| Rate for Payer: Aetna Commercial |
$27.01
|
| Rate for Payer: Aetna Commercial |
$27.01
|
| Rate for Payer: Aetna Commercial |
$27.01
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: Aetna Medicare |
$55.00
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: BCN Commercial |
$35.86
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.13
|
|
|
CHG RADEX SHOULDER 1 VIEW
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 73020
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$32.62 |
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Commercial |
$24.65
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna Medicare |
$41.50
|
| Rate for Payer: BCN Commercial |
$32.37
|
| Rate for Payer: BCN Commercial |
$32.37
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$32.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.62
|
|
|
CHG RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 73030
|
| Min. Negotiated Rate |
$38.87 |
| Max. Negotiated Rate |
$87.75 |
| Rate for Payer: Aetna Commercial |
$38.87
|
| Rate for Payer: Aetna Commercial |
$38.87
|
| Rate for Payer: Aetna Commercial |
$38.87
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$52.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.18
|
|
|
CHG RADEX SINUSES PARANASAL <3 VIEWS
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 70210
|
| Min. Negotiated Rate |
$9.50 |
| Max. Negotiated Rate |
$48.67 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: Aetna Medicare |
$22.00
|
| Rate for Payer: BCN Commercial |
$48.30
|
| Rate for Payer: BCN Commercial |
$48.30
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.67
|
|
|
CHG RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 70220
|
| Min. Negotiated Rate |
$26.50 |
| Max. Negotiated Rate |
$56.69 |
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna Commercial |
$42.84
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna Medicare |
$34.00
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: BCN Commercial |
$56.27
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.69
|
|
|
CHG RADEX SPINE 1 VIEW SPECIFY LEVEL
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 72020
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$36.62 |
| Rate for Payer: Aetna Commercial |
$28.12
|
| Rate for Payer: Aetna Commercial |
$28.12
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCN Commercial |
$36.35
|
| Rate for Payer: BCN Commercial |
$36.35
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$36.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.62
|
|
|
CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 72040
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$78.75 |
| Rate for Payer: Aetna Commercial |
$44.74
|
| Rate for Payer: Aetna Commercial |
$44.74
|
| Rate for Payer: Aetna Commercial |
$44.74
|
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.70
|
|
