|
CHG CT MAXILLOFACIAL W/CONTRAST MATERIAL
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 70487
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$230.66 |
| Rate for Payer: Aetna Commercial |
$187.98
|
| Rate for Payer: Aetna Medicare |
$145.89
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$140.28
|
| Rate for Payer: BCN Commercial |
$230.66
|
| Rate for Payer: BCN Medicare Advantage |
$140.28
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$202.00
|
| Rate for Payer: Cofinity Commercial |
$187.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.28
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.29
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$168.34
|
| Rate for Payer: PACE SWMI |
$140.28
|
| Rate for Payer: PHP Medicare Advantage |
$140.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: Priority Health HMO/PPO |
$81.09
|
| Rate for Payer: Priority Health Medicare |
$141.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.28
|
| Rate for Payer: UHC Exchange |
$140.28
|
| Rate for Payer: UHC Medicare Advantage |
$140.28
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
CHG CT MAXILLOFACIAL W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 70486
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$194.49 |
| Rate for Payer: Aetna Commercial |
$157.84
|
| Rate for Payer: Aetna Medicare |
$122.50
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$117.79
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$117.79
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$157.84
|
| Rate for Payer: Cofinity Commercial |
$169.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.79
|
| Rate for Payer: Mclaren Medicaid |
$25.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.68
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$141.35
|
| Rate for Payer: PACE SWMI |
$117.79
|
| Rate for Payer: PHP Medicare Advantage |
$117.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health HMO/PPO |
$61.60
|
| Rate for Payer: Priority Health Medicare |
$118.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.79
|
| Rate for Payer: UHC Exchange |
$117.79
|
| Rate for Payer: UHC Medicare Advantage |
$117.79
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
|
|
CHG CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 70488
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$280.99 |
| Rate for Payer: Aetna Commercial |
$226.93
|
| Rate for Payer: Aetna Medicare |
$176.12
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$169.35
|
| Rate for Payer: BCN Commercial |
$280.99
|
| Rate for Payer: BCN Medicare Advantage |
$169.35
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$243.86
|
| Rate for Payer: Cofinity Commercial |
$226.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.35
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.82
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$203.22
|
| Rate for Payer: PACE SWMI |
$169.35
|
| Rate for Payer: PHP Medicare Advantage |
$169.35
|
| 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 |
$171.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.35
|
| Rate for Payer: UHC Exchange |
$169.35
|
| Rate for Payer: UHC Medicare Advantage |
$169.35
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 70481
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$274.63 |
| Rate for Payer: Aetna Commercial |
$221.93
|
| Rate for Payer: Aetna Medicare |
$172.24
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$165.62
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$165.62
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$221.93
|
| Rate for Payer: Cofinity Commercial |
$238.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.62
|
| Rate for Payer: Mclaren Medicaid |
$33.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.90
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$198.74
|
| Rate for Payer: PACE SWMI |
$165.62
|
| Rate for Payer: PHP Medicare Advantage |
$165.62
|
| 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 |
$167.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$81.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.62
|
| Rate for Payer: UHC Exchange |
$165.62
|
| Rate for Payer: UHC Medicare Advantage |
$165.62
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 70480
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$240.43 |
| Rate for Payer: Aetna Commercial |
$196.97
|
| Rate for Payer: Aetna Medicare |
$152.87
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$146.99
|
| Rate for Payer: BCN Commercial |
$240.43
|
| Rate for Payer: BCN Medicare Advantage |
$146.99
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$211.67
|
| Rate for Payer: Cofinity Commercial |
$196.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.99
|
| Rate for Payer: Mclaren Medicaid |
$38.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.34
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$176.39
|
| Rate for Payer: PACE SWMI |
$146.99
|
| Rate for Payer: PHP Medicare Advantage |
$146.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO |
$92.90
|
| Rate for Payer: Priority Health Medicare |
$148.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.99
|
| Rate for Payer: UHC Exchange |
$146.99
|
| Rate for Payer: UHC Medicare Advantage |
$146.99
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 70482
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$320.57 |
| Rate for Payer: Aetna Commercial |
$258.12
|
| Rate for Payer: Aetna Medicare |
$200.34
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$192.63
|
| Rate for Payer: BCN Commercial |
$320.57
|
| Rate for Payer: BCN Medicare Advantage |
$192.63
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Cofinity Commercial |
$277.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.63
|
| Rate for Payer: Mclaren Medicaid |
$37.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.26
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$231.16
|
| Rate for Payer: PACE SWMI |
$192.63
|
| Rate for Payer: PHP Medicare Advantage |
$192.63
|
| 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 |
$194.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.63
|
| Rate for Payer: UHC Exchange |
$192.63
|
| Rate for Payer: UHC Medicare Advantage |
$192.63
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
|
CHG CT PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 72193
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$351.36 |
| Rate for Payer: Aetna Commercial |
$277.73
|
| Rate for Payer: Aetna Medicare |
$215.55
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$207.26
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$207.26
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$298.45
|
| Rate for Payer: Cofinity Commercial |
$277.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.26
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.62
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$248.71
|
| Rate for Payer: PACE SWMI |
$207.26
|
| Rate for Payer: PHP Medicare Advantage |
$207.26
|
| 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 |
$209.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.26
|
| Rate for Payer: UHC Exchange |
$207.26
|
| Rate for Payer: UHC Medicare Advantage |
$207.26
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
CHG CT PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 72192
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$201.83 |
| Rate for Payer: Aetna Commercial |
$164.81
|
| Rate for Payer: Aetna Medicare |
$127.91
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$122.99
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$122.99
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$164.81
|
| Rate for Payer: Cofinity Commercial |
$177.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.99
|
| Rate for Payer: Mclaren Medicaid |
$32.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.14
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: PACE SWMI |
$122.99
|
| Rate for Payer: PHP Medicare Advantage |
$122.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO |
$78.53
|
| Rate for Payer: Priority Health Medicare |
$124.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.99
|
| Rate for Payer: UHC Exchange |
$122.99
|
| Rate for Payer: UHC Medicare Advantage |
$122.99
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
|
|
CHG CT PELVIS W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72194
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$387.52 |
| Rate for Payer: Aetna Commercial |
$306.39
|
| Rate for Payer: Aetna Medicare |
$237.80
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$228.65
|
| Rate for Payer: BCN Commercial |
$387.52
|
| Rate for Payer: BCN Medicare Advantage |
$228.65
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$329.26
|
| Rate for Payer: Cofinity Commercial |
$306.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.65
|
| Rate for Payer: Mclaren Medicaid |
$36.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.08
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$274.38
|
| Rate for Payer: PACE SWMI |
$228.65
|
| Rate for Payer: PHP Medicare Advantage |
$228.65
|
| 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 |
$87.26
|
| Rate for Payer: Priority Health Medicare |
$230.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$228.65
|
| Rate for Payer: UHC Exchange |
$228.65
|
| Rate for Payer: UHC Medicare Advantage |
$228.65
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
CHG CT SOFT TISSUE NECK W/CONTRAST MATERIAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 70491
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$280.50 |
| Rate for Payer: Aetna Commercial |
$227.36
|
| Rate for Payer: Aetna Medicare |
$176.46
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS MAPPO |
$169.67
|
| Rate for Payer: BCN Commercial |
$280.50
|
| Rate for Payer: BCN Medicare Advantage |
$169.67
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$227.36
|
| Rate for Payer: Cofinity Commercial |
$244.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.67
|
| Rate for Payer: Mclaren Medicaid |
$41.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.15
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Nomi Health Commercial |
$203.60
|
| Rate for Payer: PACE SWMI |
$169.67
|
| Rate for Payer: PHP Medicare Advantage |
$169.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO |
$99.58
|
| Rate for Payer: Priority Health Medicare |
$171.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.67
|
| Rate for Payer: UHC Exchange |
$169.67
|
| Rate for Payer: UHC Medicare Advantage |
$169.67
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
|
|
CHG CT SOFT TISSUE NECK W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 70490
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$227.73 |
| Rate for Payer: Aetna Commercial |
$186.19
|
| Rate for Payer: Aetna Medicare |
$144.51
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$138.95
|
| Rate for Payer: BCN Commercial |
$227.73
|
| Rate for Payer: BCN Medicare Advantage |
$138.95
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$200.09
|
| Rate for Payer: Cofinity Commercial |
$186.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.95
|
| Rate for Payer: Mclaren Medicaid |
$38.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.90
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$166.74
|
| Rate for Payer: PACE SWMI |
$138.95
|
| Rate for Payer: PHP Medicare Advantage |
$138.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO |
$92.39
|
| Rate for Payer: Priority Health Medicare |
$140.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.95
|
| Rate for Payer: UHC Exchange |
$138.95
|
| Rate for Payer: UHC Medicare Advantage |
$138.95
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
CHG CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 70492
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$337.19 |
| Rate for Payer: Aetna Commercial |
$272.62
|
| Rate for Payer: Aetna Medicare |
$211.59
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$203.45
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$203.45
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$292.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.45
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.62
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Nomi Health Commercial |
$244.14
|
| Rate for Payer: PACE SWMI |
$203.45
|
| Rate for Payer: PHP Medicare Advantage |
$203.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health HMO/PPO |
$116.00
|
| Rate for Payer: Priority Health Medicare |
$205.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.45
|
| Rate for Payer: UHC Exchange |
$203.45
|
| Rate for Payer: UHC Medicare Advantage |
$203.45
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
CHG CT THORACIC SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 72129
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$258.02 |
| Rate for Payer: Aetna Commercial |
$210.15
|
| Rate for Payer: Aetna Medicare |
$163.10
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$156.83
|
| Rate for Payer: BCN Commercial |
$258.02
|
| Rate for Payer: BCN Medicare Advantage |
$156.83
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$225.84
|
| Rate for Payer: Cofinity Commercial |
$210.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.83
|
| Rate for Payer: Mclaren Medicaid |
$36.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.67
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Nomi Health Commercial |
$188.20
|
| Rate for Payer: PACE SWMI |
$156.83
|
| Rate for Payer: PHP Medicare Advantage |
$156.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO |
$88.27
|
| Rate for Payer: Priority Health Medicare |
$158.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.83
|
| Rate for Payer: UHC Exchange |
$156.83
|
| Rate for Payer: UHC Medicare Advantage |
$156.83
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
|
|
CHG CT THORACIC SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72128
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$196.45 |
| 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 |
$196.45
|
| 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 THORACIC SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 72130
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$302.98 |
| Rate for Payer: Aetna Commercial |
$244.70
|
| Rate for Payer: Aetna Medicare |
$189.91
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$182.61
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: BCN Medicare Advantage |
$182.61
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$262.96
|
| Rate for Payer: Cofinity Commercial |
$244.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$182.61
|
| Rate for Payer: Mclaren Medicaid |
$38.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$191.74
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Nomi Health Commercial |
$219.13
|
| Rate for Payer: PACE SWMI |
$182.61
|
| Rate for Payer: PHP Medicare Advantage |
$182.61
|
| 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 |
$184.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$182.61
|
| Rate for Payer: UHC Exchange |
$182.61
|
| Rate for Payer: UHC Medicare Advantage |
$182.61
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
CHG CT UPPER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 73201
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$306.89 |
| Rate for Payer: Aetna Commercial |
$245.35
|
| Rate for Payer: Aetna Medicare |
$190.42
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$183.10
|
| Rate for Payer: BCN Commercial |
$306.89
|
| Rate for Payer: BCN Medicare Advantage |
$183.10
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$263.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.10
|
| Rate for Payer: Mclaren Medicaid |
$34.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$192.26
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$219.72
|
| Rate for Payer: PACE SWMI |
$183.10
|
| Rate for Payer: PHP Medicare Advantage |
$183.10
|
| 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 |
$184.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$183.10
|
| Rate for Payer: UHC Exchange |
$183.10
|
| Rate for Payer: UHC Medicare Advantage |
$183.10
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
CHG CT UPPER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 73200
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$245.80 |
| Rate for Payer: Aetna Commercial |
$197.62
|
| Rate for Payer: Aetna Medicare |
$153.38
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$147.48
|
| Rate for Payer: BCN Commercial |
$245.80
|
| Rate for Payer: BCN Medicare Advantage |
$147.48
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$212.37
|
| Rate for Payer: Cofinity Commercial |
$197.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.48
|
| Rate for Payer: Mclaren Medicaid |
$29.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.85
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$176.98
|
| Rate for Payer: PACE SWMI |
$147.48
|
| Rate for Payer: PHP Medicare Advantage |
$147.48
|
| 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 |
$148.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$147.48
|
| Rate for Payer: UHC Exchange |
$147.48
|
| Rate for Payer: UHC Medicare Advantage |
$147.48
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 73202
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$380.68 |
| Rate for Payer: Aetna Commercial |
$301.37
|
| Rate for Payer: Aetna Medicare |
$233.90
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$224.90
|
| Rate for Payer: BCN Commercial |
$380.68
|
| Rate for Payer: BCN Medicare Advantage |
$224.90
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$301.37
|
| Rate for Payer: Cofinity Commercial |
$323.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$224.90
|
| Rate for Payer: Mclaren Medicaid |
$36.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$236.14
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Nomi Health Commercial |
$269.88
|
| Rate for Payer: PACE SWMI |
$224.90
|
| Rate for Payer: PHP Medicare Advantage |
$224.90
|
| 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 |
$227.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$224.90
|
| Rate for Payer: UHC Exchange |
$224.90
|
| Rate for Payer: UHC Medicare Advantage |
$224.90
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
CHG CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 87070
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$2,125.88 |
| Rate for Payer: Aetna Commercial |
$11.55
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,125.88
|
| Rate for Payer: BCN Commercial |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Cofinity Commercial |
$11.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: Nomi Health Commercial |
$10.34
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO |
$8.65
|
| Rate for Payer: Priority Health Medicare |
$8.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Exchange |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.62
|
|
|
CHG CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 87081
|
| Min. Negotiated Rate |
$4.97 |
| Max. Negotiated Rate |
$2,824.29 |
| Rate for Payer: Aetna Commercial |
$8.88
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$2,824.29
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Cofinity Commercial |
$8.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Nomi Health Commercial |
$7.96
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO |
$6.66
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.63
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
|
|
CHG CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 87086
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$2,635.16 |
| Rate for Payer: Aetna Commercial |
$10.81
|
| Rate for Payer: Aetna Medicare |
$8.39
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: BCBS MAPPO |
$8.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.16
|
| Rate for Payer: BCN Commercial |
$6.05
|
| Rate for Payer: BCN Medicare Advantage |
$8.07
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cofinity Commercial |
$11.62
|
| Rate for Payer: Cofinity Commercial |
$10.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Nomi Health Commercial |
$9.68
|
| Rate for Payer: PACE SWMI |
$8.07
|
| Rate for Payer: PHP Medicare Advantage |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
| Rate for Payer: Priority Health HMO/PPO |
$7.99
|
| Rate for Payer: Priority Health Medicare |
$8.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.07
|
| Rate for Payer: UHC Exchange |
$8.07
|
| Rate for Payer: UHC Medicare Advantage |
$8.07
|
|
|
CHG CYSTOGRAPHY MINIMUM 3 VIEWS RS&I
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 74430
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$1,300.67 |
| Rate for Payer: Aetna Commercial |
$50.54
|
| Rate for Payer: Aetna Medicare |
$39.23
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$37.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.67
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: BCN Medicare Advantage |
$37.72
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$54.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.72
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.61
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Nomi Health Commercial |
$45.26
|
| Rate for Payer: PACE SWMI |
$37.72
|
| Rate for Payer: PHP Medicare Advantage |
$37.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health HMO/PPO |
$23.10
|
| Rate for Payer: Priority Health Medicare |
$38.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.72
|
| Rate for Payer: UHC Exchange |
$37.72
|
| Rate for Payer: UHC Medicare Advantage |
$37.72
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
|
|
CHG CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 88141
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$30.73
|
| Rate for Payer: Aetna Medicare |
$23.85
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS MAPPO |
$22.93
|
| Rate for Payer: BCBS Trust/PPO |
$168.00
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: BCN Medicare Advantage |
$22.93
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$30.73
|
| Rate for Payer: Cofinity Commercial |
$33.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.93
|
| Rate for Payer: Mclaren Medicaid |
$15.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.08
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Nomi Health Commercial |
$27.52
|
| Rate for Payer: PACE SWMI |
$22.93
|
| Rate for Payer: PHP Medicare Advantage |
$22.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO |
$37.14
|
| Rate for Payer: Priority Health Medicare |
$23.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.93
|
| Rate for Payer: UHC Exchange |
$22.93
|
| Rate for Payer: UHC Medicare Advantage |
$22.93
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
|
|
CHG CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 88142
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$129.43 |
| Rate for Payer: Aetna Commercial |
$27.15
|
| Rate for Payer: Aetna Medicare |
$21.07
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$15.20
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$27.15
|
| Rate for Payer: Cofinity Commercial |
$29.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: Nomi Health Commercial |
$24.31
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO |
$31.47
|
| Rate for Payer: Priority Health Medicare |
$20.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.26
|
| Rate for Payer: UHC Exchange |
$20.26
|
| Rate for Payer: UHC Medicare Advantage |
$20.26
|
|
|
CHG DEXA,BONE DENSITY,VERTEB FRACT
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 77082
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$12.35 |
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
|
