|
CHG ASSAY OF PYRUVATE KINASE
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 84220
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$61.75 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Nomi Health Commercial |
$11.33
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.75
|
| Rate for Payer: Priority Health Medicare |
$9.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Exchange |
$9.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
|
|
CHG ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 84588
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna Medicare |
$35.30
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$45.48
|
| Rate for Payer: Cofinity Commercial |
$48.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Nomi Health Commercial |
$40.73
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health Medicare |
$34.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.94
|
| Rate for Payer: UHC Exchange |
$33.94
|
| Rate for Payer: UHC Medicare Advantage |
$33.94
|
|
|
CHG BALLOON ANGIOPLASTY VISCERAL
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 75966
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
|
|
CHG BALLOON ANGIO VENOUS
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 75978
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$33.15 |
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: BCBS Complete |
$158.80
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.05
|
|
|
CHG BASIC RADIATION DOSIMETRY CALCULATION
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 77300
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$88.78 |
| Rate for Payer: Aetna Commercial |
$82.61
|
| Rate for Payer: Aetna Commercial |
$82.61
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$61.65
|
| Rate for Payer: BCBS MAPPO |
$61.65
|
| Rate for Payer: BCN Medicare Advantage |
$61.65
|
| Rate for Payer: BCN Medicare Advantage |
$61.65
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Cofinity Commercial |
$82.61
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Cofinity Commercial |
$82.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.73
|
| Rate for Payer: Nomi Health Commercial |
$73.98
|
| Rate for Payer: Nomi Health Commercial |
$73.98
|
| Rate for Payer: PACE SWMI |
$61.65
|
| Rate for Payer: PACE SWMI |
$61.65
|
| Rate for Payer: PHP Medicare Advantage |
$61.65
|
| Rate for Payer: PHP Medicare Advantage |
$61.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$62.27
|
| Rate for Payer: Priority Health Medicare |
$62.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.65
|
| Rate for Payer: UHC Exchange |
$61.65
|
| Rate for Payer: UHC Exchange |
$61.65
|
| Rate for Payer: UHC Medicare Advantage |
$61.65
|
| Rate for Payer: UHC Medicare Advantage |
$61.65
|
|
|
CHG BILIRUBIN TOTAL
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 82247
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Commercial |
$6.73
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$6.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Nomi Health Commercial |
$6.02
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
|
|
CHG BILIRUBIN TOTAL TRANSCUTANEOUS
|
Professional
|
Both
|
$13.00
|
|
|
Service Code
|
HCPCS 88720
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: Aetna Commercial |
$6.73
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$6.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Nomi Health Commercial |
$6.02
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
|
|
CHG BLOOD COUNT HEMOGLOBIN
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 85018
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.41
|
| Rate for Payer: Cofinity Commercial |
$3.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Nomi Health Commercial |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$2.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.37
|
| Rate for Payer: UHC Exchange |
$2.37
|
| Rate for Payer: UHC Medicare Advantage |
$2.37
|
|
|
CHG BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 82274
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$21.33
|
| Rate for Payer: Aetna Medicare |
$16.56
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$21.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$19.10
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.92
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
|
|
CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS 82272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$5.67
|
| Rate for Payer: Aetna Medicare |
$4.40
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$4.23
|
| Rate for Payer: BCN Medicare Advantage |
$4.23
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Cofinity Commercial |
$5.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.44
|
| Rate for Payer: Nomi Health Commercial |
$5.08
|
| Rate for Payer: PACE SWMI |
$4.23
|
| Rate for Payer: PHP Medicare Advantage |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.23
|
| Rate for Payer: UHC Exchange |
$4.23
|
| Rate for Payer: UHC Medicare Advantage |
$4.23
|
|
|
CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82270
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Aetna Commercial |
$5.87
|
| Rate for Payer: Aetna Medicare |
$4.56
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Nomi Health Commercial |
$5.26
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.38
|
| Rate for Payer: UHC Exchange |
$4.38
|
| Rate for Payer: UHC Medicare Advantage |
$4.38
|
|
|
CHG BONE AGE STUDIES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 77072
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$33.71 |
| Rate for Payer: Aetna Commercial |
$31.37
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$33.71
|
| Rate for Payer: Cofinity Commercial |
$31.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Nomi Health Commercial |
$28.09
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.41
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
|
|
CHG BONE LENGTH STUDIES
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 77073
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$59.16 |
| Rate for Payer: Aetna Commercial |
$55.05
|
| Rate for Payer: Aetna Commercial |
$55.05
|
| Rate for Payer: Aetna Medicare |
$42.72
|
| Rate for Payer: Aetna Medicare |
$42.72
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS Complete |
$53.60
|
| Rate for Payer: BCBS MAPPO |
$41.08
|
| Rate for Payer: BCBS MAPPO |
$41.08
|
| Rate for Payer: BCN Medicare Advantage |
$41.08
|
| Rate for Payer: BCN Medicare Advantage |
$41.08
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$59.16
|
| Rate for Payer: Cofinity Commercial |
$59.16
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.13
|
| Rate for Payer: Nomi Health Commercial |
$49.30
|
| Rate for Payer: Nomi Health Commercial |
$49.30
|
| Rate for Payer: PACE SWMI |
$41.08
|
| Rate for Payer: PACE SWMI |
$41.08
|
| Rate for Payer: PHP Medicare Advantage |
$41.08
|
| Rate for Payer: PHP Medicare Advantage |
$41.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Medicare |
$41.49
|
| Rate for Payer: Priority Health Medicare |
$41.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.08
|
| Rate for Payer: UHC Exchange |
$41.08
|
| Rate for Payer: UHC Exchange |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$41.08
|
|
|
CHG BRACHYTHER DOSE PLAN COMPLX
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 77328
|
| Min. Negotiated Rate |
$123.60 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna Medicare |
$263.00
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.90
|
|
|
CHG BRACHYTHER DOSE PLAN SIMPLE
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 77326
|
| Min. Negotiated Rate |
$111.60 |
| Max. Negotiated Rate |
$181.35 |
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
|
|
CHG BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL
|
Professional
|
Both
|
$709.00
|
|
|
Service Code
|
HCPCS 77318
|
| Min. Negotiated Rate |
$283.60 |
| Max. Negotiated Rate |
$605.26 |
| Rate for Payer: Aetna Commercial |
$563.23
|
| Rate for Payer: Aetna Commercial |
$563.23
|
| Rate for Payer: Aetna Medicare |
$437.13
|
| Rate for Payer: Aetna Medicare |
$437.13
|
| Rate for Payer: BCBS Complete |
$257.20
|
| Rate for Payer: BCBS Complete |
$283.60
|
| Rate for Payer: BCBS MAPPO |
$420.32
|
| Rate for Payer: BCBS MAPPO |
$420.32
|
| Rate for Payer: BCN Medicare Advantage |
$420.32
|
| Rate for Payer: BCN Medicare Advantage |
$420.32
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Cofinity Commercial |
$563.23
|
| Rate for Payer: Cofinity Commercial |
$563.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.34
|
| Rate for Payer: Nomi Health Commercial |
$504.38
|
| Rate for Payer: Nomi Health Commercial |
$504.38
|
| Rate for Payer: PACE SWMI |
$420.32
|
| Rate for Payer: PACE SWMI |
$420.32
|
| Rate for Payer: PHP Medicare Advantage |
$420.32
|
| Rate for Payer: PHP Medicare Advantage |
$420.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health Medicare |
$424.52
|
| Rate for Payer: Priority Health Medicare |
$424.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$420.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.32
|
| Rate for Payer: UHC Exchange |
$420.32
|
| Rate for Payer: UHC Exchange |
$420.32
|
| Rate for Payer: UHC Medicare Advantage |
$420.32
|
| Rate for Payer: UHC Medicare Advantage |
$420.32
|
|
|
CHG CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 78472
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$267.70 |
| Rate for Payer: Aetna Commercial |
$249.11
|
| Rate for Payer: Aetna Medicare |
$193.34
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: BCBS MAPPO |
$185.90
|
| Rate for Payer: BCN Medicare Advantage |
$185.90
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$267.70
|
| Rate for Payer: Cofinity Commercial |
$249.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.19
|
| Rate for Payer: Nomi Health Commercial |
$223.08
|
| Rate for Payer: PACE SWMI |
$185.90
|
| Rate for Payer: PHP Medicare Advantage |
$185.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health Medicare |
$187.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.90
|
| Rate for Payer: UHC Exchange |
$185.90
|
| Rate for Payer: UHC Medicare Advantage |
$185.90
|
|
|
CHG CELL COUNT MISCELLANEOUS BODY FLUIDS
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 89050
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Cofinity Commercial |
$6.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: Nomi Health Commercial |
$5.66
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Medicare |
$4.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.72
|
| Rate for Payer: UHC Exchange |
$4.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.72
|
|
|
CHG CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 78630
|
| Min. Negotiated Rate |
$263.20 |
| Max. Negotiated Rate |
$427.70 |
| Rate for Payer: Aetna Commercial |
$360.49
|
| Rate for Payer: Aetna Medicare |
$279.78
|
| Rate for Payer: BCBS Complete |
$263.20
|
| Rate for Payer: BCBS MAPPO |
$269.02
|
| Rate for Payer: BCN Medicare Advantage |
$269.02
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$387.39
|
| Rate for Payer: Cofinity Commercial |
$360.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.47
|
| Rate for Payer: Nomi Health Commercial |
$322.82
|
| Rate for Payer: PACE SWMI |
$269.02
|
| Rate for Payer: PHP Medicare Advantage |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.70
|
| Rate for Payer: Priority Health Medicare |
$271.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$269.02
|
| Rate for Payer: UHC Exchange |
$269.02
|
| Rate for Payer: UHC Medicare Advantage |
$269.02
|
|
|
CHG CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 75984
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$124.26 |
| Rate for Payer: Aetna Commercial |
$115.63
|
| Rate for Payer: Aetna Commercial |
$115.63
|
| Rate for Payer: Aetna Medicare |
$89.74
|
| Rate for Payer: Aetna Medicare |
$89.74
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS MAPPO |
$86.29
|
| Rate for Payer: BCBS MAPPO |
$86.29
|
| Rate for Payer: BCN Medicare Advantage |
$86.29
|
| Rate for Payer: BCN Medicare Advantage |
$86.29
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$124.26
|
| Rate for Payer: Cofinity Commercial |
$124.26
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.60
|
| Rate for Payer: Nomi Health Commercial |
$103.55
|
| Rate for Payer: Nomi Health Commercial |
$103.55
|
| Rate for Payer: PACE SWMI |
$86.29
|
| Rate for Payer: PACE SWMI |
$86.29
|
| Rate for Payer: PHP Medicare Advantage |
$86.29
|
| Rate for Payer: PHP Medicare Advantage |
$86.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health Medicare |
$87.15
|
| Rate for Payer: Priority Health Medicare |
$87.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.29
|
| Rate for Payer: UHC Exchange |
$86.29
|
| Rate for Payer: UHC Exchange |
$86.29
|
| Rate for Payer: UHC Medicare Advantage |
$86.29
|
| Rate for Payer: UHC Medicare Advantage |
$86.29
|
|
|
CHG CHEST X-RAY 1 VW
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 71010
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
|
|
CHG CHEST X-RAY 2 VW
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 71020
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Medicare |
$22.00
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
CHG CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 74300
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$18.20 |
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
|
|
CHG CHOLESTEROL SERUM/WHOLE BLOOD TOTAL
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82465
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Aetna Commercial |
$5.83
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.26
|
| Rate for Payer: Cofinity Commercial |
$5.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Nomi Health Commercial |
$5.22
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$4.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.35
|
| Rate for Payer: UHC Exchange |
$4.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.35
|
|
|
CHG COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 71271
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$183.12 |
| Rate for Payer: Aetna Commercial |
$170.41
|
| Rate for Payer: Aetna Medicare |
$132.26
|
| Rate for Payer: BCBS Complete |
$44.80
|
| Rate for Payer: BCBS MAPPO |
$127.17
|
| Rate for Payer: BCN Medicare Advantage |
$127.17
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$183.12
|
| Rate for Payer: Cofinity Commercial |
$170.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.53
|
| Rate for Payer: Nomi Health Commercial |
$152.60
|
| Rate for Payer: PACE SWMI |
$127.17
|
| Rate for Payer: PHP Medicare Advantage |
$127.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health Medicare |
$128.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.17
|
| Rate for Payer: UHC Exchange |
$127.17
|
| Rate for Payer: UHC Medicare Advantage |
$127.17
|
|
