|
CHG DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 71270
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$298.58 |
| Rate for Payer: Aetna Commercial |
$241.47
|
| Rate for Payer: Aetna Medicare |
$187.41
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCBS MAPPO |
$180.20
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: BCN Medicare Advantage |
$180.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$259.49
|
| Rate for Payer: Cofinity Commercial |
$241.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.20
|
| Rate for Payer: Mclaren Medicaid |
$37.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.21
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Nomi Health Commercial |
$216.24
|
| Rate for Payer: PACE SWMI |
$180.20
|
| Rate for Payer: PHP Medicare Advantage |
$180.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health HMO/PPO |
$89.82
|
| Rate for Payer: Priority Health Medicare |
$182.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.20
|
| Rate for Payer: UHC Exchange |
$180.20
|
| Rate for Payer: UHC Medicare Advantage |
$180.20
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
|
|
CHG DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 71260
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$253.14 |
| Rate for Payer: Aetna Commercial |
$205.86
|
| Rate for Payer: Aetna Medicare |
$159.78
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCBS MAPPO |
$153.63
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: BCN Medicare Advantage |
$153.63
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cofinity Commercial |
$221.23
|
| Rate for Payer: Cofinity Commercial |
$205.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.63
|
| Rate for Payer: Mclaren Medicaid |
$34.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.31
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Nomi Health Commercial |
$184.36
|
| Rate for Payer: PACE SWMI |
$153.63
|
| Rate for Payer: PHP Medicare Advantage |
$153.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health HMO/PPO |
$84.17
|
| Rate for Payer: Priority Health Medicare |
$155.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.63
|
| Rate for Payer: UHC Exchange |
$153.63
|
| Rate for Payer: UHC Medicare Advantage |
$153.63
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
|
|
CHG DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 71250
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$201.83 |
| Rate for Payer: Aetna Commercial |
$164.77
|
| Rate for Payer: Aetna Medicare |
$127.88
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$122.96
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$122.96
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$164.77
|
| Rate for Payer: Cofinity Commercial |
$177.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.96
|
| Rate for Payer: Mclaren Medicaid |
$32.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.11
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$147.55
|
| Rate for Payer: PACE SWMI |
$122.96
|
| Rate for Payer: PHP Medicare Advantage |
$122.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO |
$78.02
|
| Rate for Payer: Priority Health Medicare |
$124.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.96
|
| Rate for Payer: UHC Exchange |
$122.96
|
| Rate for Payer: UHC Medicare Advantage |
$122.96
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
CHG DIGITAL BREAST TOMOSYNTHESIS UNILATERAL
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 77061
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$146.59 |
| Rate for Payer: Aetna Commercial |
$146.59
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCN Commercial |
$84.16
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health HMO/PPO |
$58.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.52
|
|
|
CHG DISKOGRAPY LUMBAR RS&I
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 72295
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$2,771.99 |
| Rate for Payer: Aetna Commercial |
$134.87
|
| Rate for Payer: Aetna Medicare |
$104.68
|
| Rate for Payer: BCBS Complete |
$26.39
|
| Rate for Payer: BCBS MAPPO |
$100.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,771.99
|
| Rate for Payer: BCN Commercial |
$162.73
|
| Rate for Payer: BCN Medicare Advantage |
$100.65
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Cofinity Commercial |
$134.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.65
|
| Rate for Payer: Mclaren Medicaid |
$25.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.68
|
| Rate for Payer: Meridian Medicaid |
$26.39
|
| Rate for Payer: Nomi Health Commercial |
$120.78
|
| Rate for Payer: PACE SWMI |
$100.65
|
| Rate for Payer: PHP Medicare Advantage |
$100.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO |
$60.06
|
| Rate for Payer: Priority Health Medicare |
$101.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$60.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$100.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.65
|
| Rate for Payer: UHC Exchange |
$100.65
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UHCCP Medicaid |
$25.13
|
|
|
CHG DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 76828
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$563.70 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$45.99
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$563.70
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$44.22
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$63.68
|
| Rate for Payer: Cofinity Commercial |
$59.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.22
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.43
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Nomi Health Commercial |
$53.06
|
| Rate for Payer: PACE SWMI |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$44.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health HMO/PPO |
$40.03
|
| Rate for Payer: Priority Health Medicare |
$44.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.22
|
| Rate for Payer: UHC Exchange |
$44.22
|
| Rate for Payer: UHC Medicare Advantage |
$44.22
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
CHG DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 76827
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$506.11 |
| Rate for Payer: Aetna Commercial |
$83.92
|
| Rate for Payer: Aetna Medicare |
$65.14
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$62.63
|
| Rate for Payer: BCBS Trust/PPO |
$506.11
|
| Rate for Payer: BCN Commercial |
$102.13
|
| Rate for Payer: BCN Medicare Advantage |
$62.63
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cofinity Commercial |
$90.19
|
| Rate for Payer: Cofinity Commercial |
$83.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.63
|
| Rate for Payer: Mclaren Medicaid |
$17.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.76
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$75.16
|
| Rate for Payer: PACE SWMI |
$62.63
|
| Rate for Payer: PHP Medicare Advantage |
$62.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: Priority Health HMO/PPO |
$42.09
|
| Rate for Payer: Priority Health Medicare |
$63.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.63
|
| Rate for Payer: UHC Exchange |
$62.63
|
| Rate for Payer: UHC Medicare Advantage |
$62.63
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
|
|
CHG DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 76821
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$192.30 |
| Rate for Payer: Aetna Commercial |
$106.89
|
| Rate for Payer: Aetna Medicare |
$82.96
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$79.77
|
| Rate for Payer: BCBS Trust/PPO |
$192.30
|
| Rate for Payer: BCN Commercial |
$129.99
|
| Rate for Payer: BCN Medicare Advantage |
$79.77
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$114.87
|
| Rate for Payer: Cofinity Commercial |
$106.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.77
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.76
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Nomi Health Commercial |
$95.72
|
| Rate for Payer: PACE SWMI |
$79.77
|
| Rate for Payer: PHP Medicare Advantage |
$79.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO |
$50.81
|
| Rate for Payer: Priority Health Medicare |
$80.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$50.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.77
|
| Rate for Payer: UHC Exchange |
$79.77
|
| Rate for Payer: UHC Medicare Advantage |
$79.77
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
CHG DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 76820
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$536.22 |
| Rate for Payer: Aetna Commercial |
$54.28
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$40.51
|
| Rate for Payer: BCBS Trust/PPO |
$536.22
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: BCN Medicare Advantage |
$40.51
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cofinity Commercial |
$58.33
|
| Rate for Payer: Cofinity Commercial |
$54.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.51
|
| Rate for Payer: Mclaren Medicaid |
$14.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.54
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Nomi Health Commercial |
$48.61
|
| Rate for Payer: PACE SWMI |
$40.51
|
| Rate for Payer: PHP Medicare Advantage |
$40.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO |
$35.93
|
| Rate for Payer: Priority Health Medicare |
$40.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.51
|
| Rate for Payer: UHC Exchange |
$40.51
|
| Rate for Payer: UHC Medicare Advantage |
$40.51
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
|
CHG DRUG SCREEN LIST A ANY NMBR NON TLC DEVICES
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 80300
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
CHG DRUG SCREEN MULT CLASSES
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 80100
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
|
|
CHG DRUG SCREEN, QUAL,1+ DRUG CLASS,NON-CHROMOTOGRAPHIC,EACH
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 80104
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$25.35 |
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
CHG DRUG SCREEN SINGL CLASS
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 80101
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$20.15 |
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
|
|
CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 80305
|
| Min. Negotiated Rate |
$9.45 |
| Max. Negotiated Rate |
$2,169.73 |
| Rate for Payer: Aetna Commercial |
$16.88
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,169.73
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$16.88
|
| Rate for Payer: Cofinity Commercial |
$18.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Nomi Health Commercial |
$15.12
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO |
$12.65
|
| Rate for Payer: Priority Health Medicare |
$12.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$12.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
|
|
CHG DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 80307
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$2,739.76 |
| Rate for Payer: Aetna Commercial |
$83.27
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,739.76
|
| Rate for Payer: BCN Commercial |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$89.48
|
| Rate for Payer: Cofinity Commercial |
$83.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Nomi Health Commercial |
$74.57
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health HMO/PPO |
$62.25
|
| Rate for Payer: Priority Health Medicare |
$62.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
|
|
CHG DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 80306
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$1,676.30 |
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Medicare |
$17.83
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCN Commercial |
$12.86
|
| Rate for Payer: BCN Medicare Advantage |
$17.14
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$24.68
|
| Rate for Payer: Cofinity Commercial |
$22.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.00
|
| Rate for Payer: Nomi Health Commercial |
$20.57
|
| Rate for Payer: PACE SWMI |
$17.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO |
$16.98
|
| Rate for Payer: Priority Health Medicare |
$17.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.14
|
| Rate for Payer: UHC Exchange |
$17.14
|
| Rate for Payer: UHC Medicare Advantage |
$17.14
|
|
|
CHG DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 77081
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$1,182.34 |
| Rate for Payer: Aetna Commercial |
$38.90
|
| Rate for Payer: Aetna Commercial |
$38.90
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$29.03
|
| Rate for Payer: BCBS MAPPO |
$29.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,182.34
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Medicare Advantage |
$29.03
|
| Rate for Payer: BCN Medicare Advantage |
$29.03
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.03
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: PACE SWMI |
$29.03
|
| Rate for Payer: PACE SWMI |
$29.03
|
| Rate for Payer: PHP Medicare Advantage |
$29.03
|
| Rate for Payer: PHP Medicare Advantage |
$29.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO |
$14.37
|
| Rate for Payer: Priority Health HMO/PPO |
$14.37
|
| Rate for Payer: Priority Health Medicare |
$29.32
|
| Rate for Payer: Priority Health Medicare |
$29.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.03
|
| Rate for Payer: UHC Exchange |
$29.03
|
| Rate for Payer: UHC Exchange |
$29.03
|
| Rate for Payer: UHC Medicare Advantage |
$29.03
|
| Rate for Payer: UHC Medicare Advantage |
$29.03
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
|
|
CHG DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 77080
|
| Min. Negotiated Rate |
$5.96 |
| Max. Negotiated Rate |
$6,131.98 |
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Commercial |
$47.60
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: Aetna Medicare |
$36.94
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS Complete |
$6.26
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS MAPPO |
$35.52
|
| Rate for Payer: BCBS Trust/PPO |
$6,131.98
|
| Rate for Payer: BCBS Trust/PPO |
$6,131.98
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: BCN Medicare Advantage |
$35.52
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Cofinity Commercial |
$47.60
|
| Rate for Payer: Cofinity Commercial |
$51.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.52
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Mclaren Medicaid |
$5.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.30
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Meridian Medicaid |
$6.26
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: Nomi Health Commercial |
$42.62
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PACE SWMI |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: PHP Medicare Advantage |
$35.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health HMO/PPO |
$14.37
|
| Rate for Payer: Priority Health HMO/PPO |
$14.37
|
| Rate for Payer: Priority Health Medicare |
$35.88
|
| Rate for Payer: Priority Health Medicare |
$35.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.52
|
| Rate for Payer: UHC Exchange |
$35.52
|
| Rate for Payer: UHC Exchange |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
| Rate for Payer: UHC Medicare Advantage |
$35.52
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
| Rate for Payer: UHCCP Medicaid |
$5.96
|
|
|
CHG DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ
|
Professional
|
Both
|
$212.00
|
|
|
Service Code
|
HCPCS 76988
|
| Min. Negotiated Rate |
$38.34 |
| Max. Negotiated Rate |
$137.80 |
| Rate for Payer: Aetna Medicare |
$106.00
|
| Rate for Payer: BCBS Complete |
$40.26
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Mclaren Medicaid |
$38.34
|
| Rate for Payer: Meridian Medicaid |
$40.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.80
|
| Rate for Payer: Priority Health HMO/PPO |
$91.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.87
|
| Rate for Payer: UHCCP Medicaid |
$38.34
|
|
|
CHG ECHOENCEPHALOGRAPHY REAL TIME IMAGING
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 76506
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$1,651.99 |
| Rate for Payer: Aetna Commercial |
$132.51
|
| Rate for Payer: Aetna Medicare |
$102.85
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$98.89
|
| Rate for Payer: BCBS Trust/PPO |
$1,651.99
|
| Rate for Payer: BCN Commercial |
$166.64
|
| Rate for Payer: BCN Medicare Advantage |
$98.89
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$132.51
|
| Rate for Payer: Cofinity Commercial |
$142.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.89
|
| Rate for Payer: Mclaren Medicaid |
$19.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.83
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Nomi Health Commercial |
$118.67
|
| Rate for Payer: PACE SWMI |
$98.89
|
| Rate for Payer: PHP Medicare Advantage |
$98.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.00
|
| Rate for Payer: Priority Health HMO/PPO |
$47.21
|
| Rate for Payer: Priority Health Medicare |
$99.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.89
|
| Rate for Payer: UHC Exchange |
$98.89
|
| Rate for Payer: UHC Medicare Advantage |
$98.89
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
|
|
CHG ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING
|
Professional
|
Both
|
$278.00
|
|
|
Service Code
|
HCPCS 76825
|
| Min. Negotiated Rate |
$49.63 |
| Max. Negotiated Rate |
$384.59 |
| Rate for Payer: Aetna Commercial |
$310.10
|
| Rate for Payer: Aetna Medicare |
$240.68
|
| Rate for Payer: BCBS Complete |
$52.11
|
| Rate for Payer: BCBS MAPPO |
$231.42
|
| Rate for Payer: BCBS Trust/PPO |
$244.94
|
| Rate for Payer: BCN Commercial |
$384.59
|
| Rate for Payer: BCN Medicare Advantage |
$231.42
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Cofinity Commercial |
$333.24
|
| Rate for Payer: Cofinity Commercial |
$310.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$231.42
|
| Rate for Payer: Mclaren Medicaid |
$49.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$242.99
|
| Rate for Payer: Meridian Medicaid |
$52.11
|
| Rate for Payer: Nomi Health Commercial |
$277.70
|
| Rate for Payer: PACE SWMI |
$231.42
|
| Rate for Payer: PHP Medicare Advantage |
$231.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.70
|
| Rate for Payer: Priority Health HMO/PPO |
$120.10
|
| Rate for Payer: Priority Health Medicare |
$233.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$231.42
|
| Rate for Payer: UHC Exchange |
$231.42
|
| Rate for Payer: UHC Medicare Advantage |
$231.42
|
| Rate for Payer: UHCCP Medicaid |
$49.63
|
|
|
CHG ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 76826
|
| Min. Negotiated Rate |
$24.71 |
| Max. Negotiated Rate |
$273.66 |
| Rate for Payer: Aetna Commercial |
$185.68
|
| Rate for Payer: Aetna Medicare |
$144.11
|
| Rate for Payer: BCBS Complete |
$25.95
|
| Rate for Payer: BCBS MAPPO |
$138.57
|
| Rate for Payer: BCBS Trust/PPO |
$273.66
|
| Rate for Payer: BCN Commercial |
$230.17
|
| Rate for Payer: BCN Medicare Advantage |
$138.57
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$199.54
|
| Rate for Payer: Cofinity Commercial |
$185.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.57
|
| Rate for Payer: Mclaren Medicaid |
$24.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.50
|
| Rate for Payer: Meridian Medicaid |
$25.95
|
| Rate for Payer: Nomi Health Commercial |
$166.28
|
| Rate for Payer: PACE SWMI |
$138.57
|
| Rate for Payer: PHP Medicare Advantage |
$138.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$59.53
|
| Rate for Payer: Priority Health Medicare |
$139.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.57
|
| Rate for Payer: UHC Exchange |
$138.57
|
| Rate for Payer: UHC Medicare Advantage |
$138.57
|
| Rate for Payer: UHCCP Medicaid |
$24.71
|
|
|
CHG ENDOVASC REPAIR AAA
|
Professional
|
Both
|
$512.00
|
|
|
Service Code
|
HCPCS 75952
|
| Min. Negotiated Rate |
$204.80 |
| Max. Negotiated Rate |
$332.80 |
| Rate for Payer: Aetna Medicare |
$256.00
|
| Rate for Payer: BCBS Complete |
$204.80
|
| Rate for Payer: Cash Price |
$409.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.80
|
|
|
CHG EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I
|
Professional
|
Both
|
$593.00
|
|
|
Service Code
|
HCPCS 75957
|
| Min. Negotiated Rate |
$178.71 |
| Max. Negotiated Rate |
$629.42 |
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: Aetna Medicare |
$296.50
|
| Rate for Payer: BCBS Complete |
$187.65
|
| Rate for Payer: BCBS Trust/PPO |
$399.39
|
| Rate for Payer: BCN Commercial |
$629.42
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Cash Price |
$474.40
|
| Rate for Payer: Mclaren Medicaid |
$178.71
|
| Rate for Payer: Meridian Medicaid |
$187.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$385.45
|
| Rate for Payer: Priority Health HMO/PPO |
$431.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$431.15
|
| Rate for Payer: UHCCP Medicaid |
$178.71
|
|
|
CHG EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I
|
Professional
|
Both
|
$693.00
|
|
|
Service Code
|
HCPCS 75956
|
| Min. Negotiated Rate |
$208.53 |
| Max. Negotiated Rate |
$691.96 |
| Rate for Payer: Aetna Commercial |
$403.09
|
| Rate for Payer: Aetna Medicare |
$346.50
|
| Rate for Payer: BCBS Complete |
$218.96
|
| Rate for Payer: BCBS Trust/PPO |
$514.56
|
| Rate for Payer: BCN Commercial |
$691.96
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Cash Price |
$554.40
|
| Rate for Payer: Mclaren Medicaid |
$208.53
|
| Rate for Payer: Meridian Medicaid |
$218.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.45
|
| Rate for Payer: Priority Health HMO/PPO |
$501.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$501.97
|
| Rate for Payer: UHCCP Medicaid |
$208.53
|
|
