|
CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 70498
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$419.28 |
| Rate for Payer: Aetna Commercial |
$340.08
|
| Rate for Payer: Aetna Medicare |
$263.94
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$253.79
|
| Rate for Payer: BCN Commercial |
$419.28
|
| Rate for Payer: BCN Medicare Advantage |
$253.79
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$340.08
|
| Rate for Payer: Cofinity Commercial |
$365.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.79
|
| Rate for Payer: Mclaren Medicaid |
$52.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.48
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$304.55
|
| Rate for Payer: PACE SWMI |
$253.79
|
| Rate for Payer: PHP Medicare Advantage |
$253.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO |
$125.74
|
| Rate for Payer: Priority Health Medicare |
$256.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.79
|
| Rate for Payer: UHC Exchange |
$253.79
|
| Rate for Payer: UHC Medicare Advantage |
$253.79
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 72191
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$464.73 |
| Rate for Payer: Aetna Commercial |
$374.50
|
| Rate for Payer: Aetna Medicare |
$290.66
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$279.48
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$279.48
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$402.45
|
| Rate for Payer: Cofinity Commercial |
$374.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.48
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.45
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$335.38
|
| Rate for Payer: PACE SWMI |
$279.48
|
| Rate for Payer: PHP Medicare Advantage |
$279.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO |
$128.83
|
| Rate for Payer: Priority Health Medicare |
$282.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.48
|
| Rate for Payer: UHC Exchange |
$279.48
|
| Rate for Payer: UHC Medicare Advantage |
$279.48
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG CT ANGIOGRAPHY UPPER EXTREMITY
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 73206
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$453.00 |
| Rate for Payer: Aetna Commercial |
$365.93
|
| Rate for Payer: Aetna Medicare |
$284.00
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$273.08
|
| Rate for Payer: BCN Commercial |
$453.00
|
| Rate for Payer: BCN Medicare Advantage |
$273.08
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$365.93
|
| Rate for Payer: Cofinity Commercial |
$393.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.08
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.73
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$327.70
|
| Rate for Payer: PACE SWMI |
$273.08
|
| Rate for Payer: PHP Medicare Advantage |
$273.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO |
$128.83
|
| Rate for Payer: Priority Health Medicare |
$275.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.08
|
| Rate for Payer: UHC Exchange |
$273.08
|
| Rate for Payer: UHC Medicare Advantage |
$273.08
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG CT CERVICAL SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72126
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$256.07 |
| Rate for Payer: Aetna Commercial |
$208.06
|
| Rate for Payer: Aetna Medicare |
$161.48
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$155.27
|
| Rate for Payer: BCN Commercial |
$256.07
|
| Rate for Payer: BCN Medicare Advantage |
$155.27
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$223.59
|
| Rate for Payer: Cofinity Commercial |
$208.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.27
|
| Rate for Payer: Mclaren Medicaid |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.03
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$186.32
|
| Rate for Payer: PACE SWMI |
$155.27
|
| Rate for Payer: PHP Medicare Advantage |
$155.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$87.76
|
| Rate for Payer: Priority Health Medicare |
$156.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.27
|
| Rate for Payer: UHC Exchange |
$155.27
|
| Rate for Payer: UHC Medicare Advantage |
$155.27
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
CHG CT CERVICAL SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72125
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$196.45 |
| Rate for Payer: Aetna Commercial |
$160.79
|
| Rate for Payer: Aetna Medicare |
$124.79
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.99
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$119.99
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$160.79
|
| Rate for Payer: Cofinity Commercial |
$172.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.99
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.99
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$143.99
|
| Rate for Payer: PACE SWMI |
$119.99
|
| Rate for Payer: PHP Medicare Advantage |
$119.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO |
$71.85
|
| Rate for Payer: Priority Health Medicare |
$121.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.99
|
| Rate for Payer: UHC Exchange |
$119.99
|
| Rate for Payer: UHC Medicare Advantage |
$119.99
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72127
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$300.05 |
| Rate for Payer: Aetna Commercial |
$241.94
|
| Rate for Payer: Aetna Medicare |
$187.77
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$180.55
|
| Rate for Payer: BCN Commercial |
$300.05
|
| Rate for Payer: BCN Medicare Advantage |
$180.55
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$259.99
|
| Rate for Payer: Cofinity Commercial |
$241.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.55
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.58
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$216.66
|
| Rate for Payer: PACE SWMI |
$180.55
|
| Rate for Payer: PHP Medicare Advantage |
$180.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$91.36
|
| Rate for Payer: Priority Health Medicare |
$182.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.55
|
| Rate for Payer: UHC Exchange |
$180.55
|
| Rate for Payer: UHC Medicare Advantage |
$180.55
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
|
CHG CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 74263
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$1,004.72 |
| Rate for Payer: Aetna Commercial |
$864.31
|
| Rate for Payer: Aetna Medicare |
$670.81
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$645.01
|
| Rate for Payer: BCN Commercial |
$1,004.72
|
| Rate for Payer: BCN Medicare Advantage |
$645.01
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$864.31
|
| Rate for Payer: Cofinity Commercial |
$928.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.01
|
| Rate for Payer: Mclaren Medicaid |
$71.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.26
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Nomi Health Commercial |
$774.01
|
| Rate for Payer: PACE SWMI |
$645.01
|
| Rate for Payer: PHP Medicare Advantage |
$645.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO |
$164.75
|
| Rate for Payer: Priority Health Medicare |
$651.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$645.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$645.01
|
| Rate for Payer: UHC Exchange |
$645.01
|
| Rate for Payer: UHC Medicare Advantage |
$645.01
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 74262
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$718.36 |
| Rate for Payer: Aetna Commercial |
$566.24
|
| Rate for Payer: Aetna Medicare |
$439.47
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$422.57
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$422.57
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$608.50
|
| Rate for Payer: Cofinity Commercial |
$566.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.57
|
| Rate for Payer: Mclaren Medicaid |
$75.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.70
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Nomi Health Commercial |
$507.08
|
| Rate for Payer: PACE SWMI |
$422.57
|
| Rate for Payer: PHP Medicare Advantage |
$422.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO |
$180.16
|
| Rate for Payer: Priority Health Medicare |
$426.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$422.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$422.57
|
| Rate for Payer: UHC Exchange |
$422.57
|
| Rate for Payer: UHC Medicare Advantage |
$422.57
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$4,266.02 |
| Rate for Payer: Aetna Commercial |
$504.66
|
| Rate for Payer: Aetna Commercial |
$504.66
|
| Rate for Payer: Aetna Medicare |
$391.67
|
| Rate for Payer: Aetna Medicare |
$391.67
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS MAPPO |
$376.61
|
| Rate for Payer: BCBS MAPPO |
$376.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Medicare Advantage |
$376.61
|
| Rate for Payer: BCN Medicare Advantage |
$376.61
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$504.66
|
| Rate for Payer: Cofinity Commercial |
$504.66
|
| Rate for Payer: Cofinity Commercial |
$542.32
|
| Rate for Payer: Cofinity Commercial |
$542.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.61
|
| Rate for Payer: Mclaren Medicaid |
$72.42
|
| Rate for Payer: Mclaren Medicaid |
$72.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.44
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Nomi Health Commercial |
$451.93
|
| Rate for Payer: Nomi Health Commercial |
$451.93
|
| Rate for Payer: PACE SWMI |
$376.61
|
| Rate for Payer: PACE SWMI |
$376.61
|
| Rate for Payer: PHP Medicare Advantage |
$376.61
|
| Rate for Payer: PHP Medicare Advantage |
$376.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health HMO/PPO |
$172.46
|
| Rate for Payer: Priority Health HMO/PPO |
$172.46
|
| Rate for Payer: Priority Health Medicare |
$380.38
|
| Rate for Payer: Priority Health Medicare |
$380.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$172.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$376.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.61
|
| Rate for Payer: UHC Exchange |
$376.61
|
| Rate for Payer: UHC Exchange |
$376.61
|
| Rate for Payer: UHC Medicare Advantage |
$376.61
|
| Rate for Payer: UHC Medicare Advantage |
$376.61
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
|
|
CHG CT GUIDANCE &MONITORING VISC TISS ABLATION
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 77013
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$711.03 |
| Rate for Payer: Aetna Commercial |
$620.14
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCN Commercial |
$711.03
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Mclaren Medicaid |
$115.45
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.05
|
| Rate for Payer: Priority Health HMO/PPO |
$275.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.61
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
|
|
CHG CT GUIDANCE NEEDLE PLACEMENT
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 77012
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$801.43 |
| Rate for Payer: Aetna Commercial |
$156.07
|
| Rate for Payer: Aetna Medicare |
$121.13
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$116.47
|
| Rate for Payer: BCBS Trust/PPO |
$801.43
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: BCN Medicare Advantage |
$116.47
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$167.72
|
| Rate for Payer: Cofinity Commercial |
$156.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.47
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.29
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Nomi Health Commercial |
$139.76
|
| Rate for Payer: PACE SWMI |
$116.47
|
| Rate for Payer: PHP Medicare Advantage |
$116.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health HMO/PPO |
$105.22
|
| Rate for Payer: Priority Health Medicare |
$117.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$116.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.47
|
| Rate for Payer: UHC Exchange |
$116.47
|
| Rate for Payer: UHC Medicare Advantage |
$116.47
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
|
CHG CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 77014
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$1,757.13 |
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.13
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Mclaren Medicaid |
$28.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO |
$68.26
|
| Rate for Payer: Priority Health HMO/PPO |
$68.26
|
| Rate for Payer: Priority Health Medicare |
$109.44
|
| Rate for Payer: Priority Health Medicare |
$109.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Exchange |
$108.36
|
| Rate for Payer: UHC Exchange |
$108.36
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
|
|
CHG CT GUIDANCE STEREOTACTIC LOCALIZATION
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 77011
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$328.39 |
| Rate for Payer: Aetna Commercial |
$263.82
|
| Rate for Payer: Aetna Commercial |
$263.82
|
| Rate for Payer: Aetna Medicare |
$204.76
|
| Rate for Payer: Aetna Medicare |
$204.76
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS MAPPO |
$196.88
|
| Rate for Payer: BCBS MAPPO |
$196.88
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Medicare Advantage |
$196.88
|
| Rate for Payer: BCN Medicare Advantage |
$196.88
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Cofinity Commercial |
$283.51
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Cofinity Commercial |
$283.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.88
|
| Rate for Payer: Mclaren Medicaid |
$38.98
|
| Rate for Payer: Mclaren Medicaid |
$38.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.72
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Nomi Health Commercial |
$236.26
|
| Rate for Payer: Nomi Health Commercial |
$236.26
|
| Rate for Payer: PACE SWMI |
$196.88
|
| Rate for Payer: PACE SWMI |
$196.88
|
| Rate for Payer: PHP Medicare Advantage |
$196.88
|
| Rate for Payer: PHP Medicare Advantage |
$196.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.90
|
| Rate for Payer: Priority Health HMO/PPO |
$93.41
|
| Rate for Payer: Priority Health HMO/PPO |
$93.41
|
| Rate for Payer: Priority Health Medicare |
$198.85
|
| Rate for Payer: Priority Health Medicare |
$198.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.88
|
| Rate for Payer: UHC Exchange |
$196.88
|
| Rate for Payer: UHC Exchange |
$196.88
|
| Rate for Payer: UHC Medicare Advantage |
$196.88
|
| Rate for Payer: UHC Medicare Advantage |
$196.88
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
|
|
CHG CT HEAD/BRAIN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 70460
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$224.30 |
| Rate for Payer: Aetna Commercial |
$183.63
|
| Rate for Payer: Aetna Medicare |
$142.52
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$137.04
|
| Rate for Payer: BCN Commercial |
$224.30
|
| Rate for Payer: BCN Medicare Advantage |
$137.04
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$197.34
|
| Rate for Payer: Cofinity Commercial |
$183.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.04
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.89
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: PACE SWMI |
$137.04
|
| Rate for Payer: PHP Medicare Advantage |
$137.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO |
$81.61
|
| Rate for Payer: Priority Health Medicare |
$138.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.04
|
| Rate for Payer: UHC Exchange |
$137.04
|
| Rate for Payer: UHC Medicare Advantage |
$137.04
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 70450
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$160.77 |
| Rate for Payer: Aetna Commercial |
$132.18
|
| Rate for Payer: Aetna Medicare |
$102.59
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$98.64
|
| Rate for Payer: BCN Commercial |
$160.77
|
| Rate for Payer: BCN Medicare Advantage |
$98.64
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$132.18
|
| Rate for Payer: Cofinity Commercial |
$142.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.64
|
| Rate for Payer: Mclaren Medicaid |
$25.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.57
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Nomi Health Commercial |
$118.37
|
| Rate for Payer: PACE SWMI |
$98.64
|
| Rate for Payer: PHP Medicare Advantage |
$98.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health HMO/PPO |
$61.07
|
| Rate for Payer: Priority Health Medicare |
$99.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.64
|
| Rate for Payer: UHC Exchange |
$98.64
|
| Rate for Payer: UHC Medicare Advantage |
$98.64
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
|
|
CHG CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 70470
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$263.88 |
| Rate for Payer: Aetna Commercial |
$214.29
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$159.92
|
| Rate for Payer: BCN Commercial |
$263.88
|
| Rate for Payer: BCN Medicare Advantage |
$159.92
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$230.28
|
| Rate for Payer: Cofinity Commercial |
$214.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.92
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.92
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Nomi Health Commercial |
$191.90
|
| Rate for Payer: PACE SWMI |
$159.92
|
| Rate for Payer: PHP Medicare Advantage |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO |
$91.87
|
| Rate for Payer: Priority Health Medicare |
$161.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.92
|
| Rate for Payer: UHC Exchange |
$159.92
|
| Rate for Payer: UHC Medicare Advantage |
$159.92
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
CHG CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 75572
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$343.54 |
| Rate for Payer: Aetna Commercial |
$281.92
|
| Rate for Payer: Aetna Medicare |
$218.81
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$210.39
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$210.39
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$281.92
|
| Rate for Payer: Cofinity Commercial |
$302.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.39
|
| Rate for Payer: Mclaren Medicaid |
$51.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.91
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Nomi Health Commercial |
$252.47
|
| Rate for Payer: PACE SWMI |
$210.39
|
| Rate for Payer: PHP Medicare Advantage |
$210.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.35
|
| Rate for Payer: Priority Health HMO/PPO |
$124.72
|
| Rate for Payer: Priority Health Medicare |
$212.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.39
|
| Rate for Payer: UHC Exchange |
$210.39
|
| Rate for Payer: UHC Medicare Advantage |
$210.39
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
|
|
CHG CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 75571
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$151.00 |
| Rate for Payer: Aetna Commercial |
$123.63
|
| Rate for Payer: Aetna Medicare |
$95.95
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$92.26
|
| Rate for Payer: BCN Commercial |
$151.00
|
| Rate for Payer: BCN Medicare Advantage |
$92.26
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$132.85
|
| Rate for Payer: Cofinity Commercial |
$123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.26
|
| Rate for Payer: Mclaren Medicaid |
$17.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.87
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$110.71
|
| Rate for Payer: PACE SWMI |
$92.26
|
| Rate for Payer: PHP Medicare Advantage |
$92.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO |
$41.57
|
| Rate for Payer: Priority Health Medicare |
$93.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.26
|
| Rate for Payer: UHC Exchange |
$92.26
|
| Rate for Payer: UHC Medicare Advantage |
$92.26
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
|
|
CHG CT LIMITED/LOCALIZED FOLLOW UP STUDY
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 76380
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$954.11 |
| Rate for Payer: Aetna Commercial |
$161.62
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$173.68
|
| Rate for Payer: Cofinity Commercial |
$161.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Mclaren Medicaid |
$28.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Nomi Health Commercial |
$144.73
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO |
$68.78
|
| Rate for Payer: Priority Health Medicare |
$121.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Exchange |
$120.61
|
| Rate for Payer: UHC Medicare Advantage |
$120.61
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
|
|
CHG CT LOWER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 73701
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$253.14 |
| Rate for Payer: Aetna Commercial |
$205.46
|
| Rate for Payer: Aetna Medicare |
$159.46
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$153.33
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: BCN Medicare Advantage |
$153.33
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$205.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.33
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.00
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$184.00
|
| Rate for Payer: PACE SWMI |
$153.33
|
| Rate for Payer: PHP Medicare Advantage |
$153.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health HMO/PPO |
$83.66
|
| Rate for Payer: Priority Health Medicare |
$154.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.33
|
| Rate for Payer: UHC Exchange |
$153.33
|
| Rate for Payer: UHC Medicare Advantage |
$153.33
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
CHG CT LOWER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 73700
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$195.96 |
| Rate for Payer: Aetna Commercial |
$160.40
|
| Rate for Payer: Aetna Medicare |
$124.49
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.70
|
| Rate for Payer: BCN Commercial |
$195.96
|
| Rate for Payer: BCN Medicare Advantage |
$119.70
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$160.40
|
| Rate for Payer: Cofinity Commercial |
$172.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.70
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.68
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$143.64
|
| Rate for Payer: PACE SWMI |
$119.70
|
| Rate for Payer: PHP Medicare Advantage |
$119.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO |
$71.85
|
| Rate for Payer: Priority Health Medicare |
$120.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.70
|
| Rate for Payer: UHC Exchange |
$119.70
|
| Rate for Payer: UHC Medicare Advantage |
$119.70
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT LOWER EXTREMITY W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 73702
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$296.63 |
| Rate for Payer: Aetna Commercial |
$240.05
|
| Rate for Payer: Aetna Medicare |
$186.31
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$179.14
|
| Rate for Payer: BCN Commercial |
$296.63
|
| Rate for Payer: BCN Medicare Advantage |
$179.14
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$257.96
|
| Rate for Payer: Cofinity Commercial |
$240.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.14
|
| Rate for Payer: Mclaren Medicaid |
$36.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.10
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: PACE SWMI |
$179.14
|
| Rate for Payer: PHP Medicare Advantage |
$179.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$87.26
|
| Rate for Payer: Priority Health Medicare |
$180.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.14
|
| Rate for Payer: UHC Exchange |
$179.14
|
| Rate for Payer: UHC Medicare Advantage |
$179.14
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
CHG CT LUMBAR SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72132
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$256.56 |
| Rate for Payer: Aetna Commercial |
$208.85
|
| Rate for Payer: Aetna Medicare |
$162.09
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$155.86
|
| Rate for Payer: BCN Commercial |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$155.86
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$208.85
|
| Rate for Payer: Cofinity Commercial |
$224.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.86
|
| Rate for Payer: Mclaren Medicaid |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.65
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$187.03
|
| Rate for Payer: PACE SWMI |
$155.86
|
| Rate for Payer: PHP Medicare Advantage |
$155.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO |
$87.76
|
| Rate for Payer: Priority Health Medicare |
$157.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.86
|
| Rate for Payer: UHC Exchange |
$155.86
|
| Rate for Payer: UHC Medicare Advantage |
$155.86
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
CHG CT LUMBAR SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72131
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$195.47 |
| Rate for Payer: Aetna Commercial |
$160.01
|
| Rate for Payer: Aetna Medicare |
$124.19
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.41
|
| Rate for Payer: BCN Commercial |
$195.47
|
| Rate for Payer: BCN Medicare Advantage |
$119.41
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$171.95
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.41
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.38
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$143.29
|
| Rate for Payer: PACE SWMI |
$119.41
|
| Rate for Payer: PHP Medicare Advantage |
$119.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO |
$71.85
|
| Rate for Payer: Priority Health Medicare |
$120.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.41
|
| Rate for Payer: UHC Exchange |
$119.41
|
| Rate for Payer: UHC Medicare Advantage |
$119.41
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72133
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$301.02 |
| Rate for Payer: Aetna Commercial |
$242.34
|
| Rate for Payer: Aetna Medicare |
$188.08
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$180.85
|
| Rate for Payer: BCN Commercial |
$301.02
|
| Rate for Payer: BCN Medicare Advantage |
$180.85
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$242.34
|
| Rate for Payer: Cofinity Commercial |
$260.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.85
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.89
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$217.02
|
| Rate for Payer: PACE SWMI |
$180.85
|
| Rate for Payer: PHP Medicare Advantage |
$180.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$91.36
|
| Rate for Payer: Priority Health Medicare |
$182.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.85
|
| Rate for Payer: UHC Exchange |
$180.85
|
| Rate for Payer: UHC Medicare Advantage |
$180.85
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
