|
CHG MRA NECK W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 70549
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$2,120.07 |
| Rate for Payer: Aetna Commercial |
$423.71
|
| Rate for Payer: Aetna Medicare |
$328.85
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$316.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,120.07
|
| Rate for Payer: BCN Commercial |
$527.29
|
| Rate for Payer: BCN Medicare Advantage |
$316.20
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$423.71
|
| Rate for Payer: Cofinity Commercial |
$455.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.20
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.01
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$379.44
|
| Rate for Payer: PACE SWMI |
$316.20
|
| Rate for Payer: PHP Medicare Advantage |
$316.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO |
$129.33
|
| Rate for Payer: Priority Health Medicare |
$319.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$129.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$316.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.20
|
| Rate for Payer: UHC Exchange |
$316.20
|
| Rate for Payer: UHC Medicare Advantage |
$316.20
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG MRI ABDOMEN W/O CONTRAST FLWD BY W/CONTRAST
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 74183
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$518.49 |
| Rate for Payer: Aetna Commercial |
$416.11
|
| Rate for Payer: Aetna Medicare |
$322.95
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$310.53
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: BCN Medicare Advantage |
$310.53
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$447.16
|
| Rate for Payer: Cofinity Commercial |
$416.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.53
|
| Rate for Payer: Mclaren Medicaid |
$66.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.06
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Nomi Health Commercial |
$372.64
|
| Rate for Payer: PACE SWMI |
$310.53
|
| Rate for Payer: PHP Medicare Advantage |
$310.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO |
$158.09
|
| Rate for Payer: Priority Health Medicare |
$313.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$310.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.53
|
| Rate for Payer: UHC Exchange |
$310.53
|
| Rate for Payer: UHC Medicare Advantage |
$310.53
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
CHG MRI ABDOMEN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 74181
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$299.56 |
| Rate for Payer: Aetna Commercial |
$241.60
|
| Rate for Payer: Aetna Medicare |
$187.51
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$180.30
|
| Rate for Payer: BCN Commercial |
$299.56
|
| Rate for Payer: BCN Medicare Advantage |
$180.30
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$259.63
|
| Rate for Payer: Cofinity Commercial |
$241.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.30
|
| Rate for Payer: Mclaren Medicaid |
$43.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.32
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Nomi Health Commercial |
$216.36
|
| Rate for Payer: PACE SWMI |
$180.30
|
| Rate for Payer: PHP Medicare Advantage |
$180.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.15
|
| Rate for Payer: Priority Health HMO/PPO |
$105.22
|
| Rate for Payer: Priority Health Medicare |
$182.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.30
|
| Rate for Payer: UHC Exchange |
$180.30
|
| Rate for Payer: UHC Medicare Advantage |
$180.30
|
| Rate for Payer: UHCCP Medicaid |
$43.67
|
|
|
CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 73721
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$308.36 |
| Rate for Payer: Aetna Commercial |
$250.65
|
| Rate for Payer: Aetna Medicare |
$194.53
|
| Rate for Payer: BCBS Complete |
$42.71
|
| Rate for Payer: BCBS MAPPO |
$187.05
|
| Rate for Payer: BCN Commercial |
$308.36
|
| Rate for Payer: BCN Medicare Advantage |
$187.05
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$250.65
|
| Rate for Payer: Cofinity Commercial |
$269.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.05
|
| Rate for Payer: Mclaren Medicaid |
$40.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.40
|
| Rate for Payer: Meridian Medicaid |
$42.71
|
| Rate for Payer: Nomi Health Commercial |
$224.46
|
| Rate for Payer: PACE SWMI |
$187.05
|
| Rate for Payer: PHP Medicare Advantage |
$187.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$98.03
|
| Rate for Payer: Priority Health Medicare |
$188.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.05
|
| Rate for Payer: UHC Exchange |
$187.05
|
| Rate for Payer: UHC Medicare Advantage |
$187.05
|
| Rate for Payer: UHCCP Medicaid |
$40.68
|
|
|
CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 73723
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$592.77 |
| Rate for Payer: Aetna Commercial |
$470.81
|
| Rate for Payer: Aetna Medicare |
$365.40
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$351.35
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: BCN Medicare Advantage |
$351.35
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$505.94
|
| Rate for Payer: Cofinity Commercial |
$470.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.35
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.92
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$421.62
|
| Rate for Payer: PACE SWMI |
$351.35
|
| Rate for Payer: PHP Medicare Advantage |
$351.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO |
$155.01
|
| Rate for Payer: Priority Health Medicare |
$354.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$351.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.35
|
| Rate for Payer: UHC Exchange |
$351.35
|
| Rate for Payer: UHC Medicare Advantage |
$351.35
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
CHG MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 73222
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$480.37 |
| Rate for Payer: Aetna Commercial |
$380.53
|
| Rate for Payer: Aetna Medicare |
$295.34
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$283.98
|
| Rate for Payer: BCN Commercial |
$480.37
|
| Rate for Payer: BCN Medicare Advantage |
$283.98
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$380.53
|
| Rate for Payer: Cofinity Commercial |
$408.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.98
|
| Rate for Payer: Mclaren Medicaid |
$48.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.18
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Nomi Health Commercial |
$340.78
|
| Rate for Payer: PACE SWMI |
$283.98
|
| Rate for Payer: PHP Medicare Advantage |
$283.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.70
|
| Rate for Payer: Priority Health HMO/PPO |
$117.54
|
| Rate for Payer: Priority Health Medicare |
$286.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$117.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$283.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.98
|
| Rate for Payer: UHC Exchange |
$283.98
|
| Rate for Payer: UHC Medicare Advantage |
$283.98
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
|
|
CHG MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 73221
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$308.85 |
| Rate for Payer: Aetna Commercial |
$251.05
|
| Rate for Payer: Aetna Medicare |
$194.84
|
| Rate for Payer: BCBS Complete |
$42.71
|
| Rate for Payer: BCBS MAPPO |
$187.35
|
| Rate for Payer: BCN Commercial |
$308.85
|
| Rate for Payer: BCN Medicare Advantage |
$187.35
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Cofinity Commercial |
$251.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.35
|
| Rate for Payer: Mclaren Medicaid |
$40.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.72
|
| Rate for Payer: Meridian Medicaid |
$42.71
|
| Rate for Payer: Nomi Health Commercial |
$224.82
|
| Rate for Payer: PACE SWMI |
$187.35
|
| Rate for Payer: PHP Medicare Advantage |
$187.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$98.03
|
| Rate for Payer: Priority Health Medicare |
$189.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.35
|
| Rate for Payer: UHC Exchange |
$187.35
|
| Rate for Payer: UHC Medicare Advantage |
$187.35
|
| Rate for Payer: UHCCP Medicaid |
$40.68
|
|
|
CHG MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 73223
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$594.72 |
| Rate for Payer: Aetna Commercial |
$471.99
|
| Rate for Payer: Aetna Medicare |
$366.32
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$352.23
|
| Rate for Payer: BCN Commercial |
$594.72
|
| Rate for Payer: BCN Medicare Advantage |
$352.23
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$471.99
|
| Rate for Payer: Cofinity Commercial |
$507.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.23
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.84
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$422.68
|
| Rate for Payer: PACE SWMI |
$352.23
|
| Rate for Payer: PHP Medicare Advantage |
$352.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO |
$155.52
|
| Rate for Payer: Priority Health Medicare |
$355.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$155.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$352.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.23
|
| Rate for Payer: UHC Exchange |
$352.23
|
| Rate for Payer: UHC Medicare Advantage |
$352.23
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
CHG MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 70552
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Aetna Commercial |
$333.49
|
| Rate for Payer: Aetna Medicare |
$258.82
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$248.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$413.42
|
| Rate for Payer: BCN Medicare Advantage |
$248.87
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$358.37
|
| Rate for Payer: Cofinity Commercial |
$333.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.87
|
| Rate for Payer: Mclaren Medicaid |
$53.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.31
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Nomi Health Commercial |
$298.64
|
| Rate for Payer: PACE SWMI |
$248.87
|
| Rate for Payer: PHP Medicare Advantage |
$248.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO |
$128.32
|
| Rate for Payer: Priority Health Medicare |
$251.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.87
|
| Rate for Payer: UHC Exchange |
$248.87
|
| Rate for Payer: UHC Medicare Advantage |
$248.87
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
|
|
CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 70551
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$2,070.41 |
| Rate for Payer: Aetna Commercial |
$242.86
|
| Rate for Payer: Aetna Medicare |
$188.49
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$181.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,070.41
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: BCN Medicare Advantage |
$181.24
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$260.99
|
| Rate for Payer: Cofinity Commercial |
$242.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.24
|
| Rate for Payer: Mclaren Medicaid |
$44.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.30
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Nomi Health Commercial |
$217.49
|
| Rate for Payer: PACE SWMI |
$181.24
|
| Rate for Payer: PHP Medicare Advantage |
$181.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health HMO/PPO |
$106.76
|
| Rate for Payer: Priority Health Medicare |
$183.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.24
|
| Rate for Payer: UHC Exchange |
$181.24
|
| Rate for Payer: UHC Medicare Advantage |
$181.24
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
|
|
CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 70553
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$968.37 |
| Rate for Payer: Aetna Commercial |
$394.07
|
| Rate for Payer: Aetna Medicare |
$305.84
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$294.08
|
| Rate for Payer: BCBS Trust/PPO |
$968.37
|
| Rate for Payer: BCN Commercial |
$486.73
|
| Rate for Payer: BCN Medicare Advantage |
$294.08
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$394.07
|
| Rate for Payer: Cofinity Commercial |
$423.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.08
|
| Rate for Payer: Mclaren Medicaid |
$69.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.78
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Nomi Health Commercial |
$352.90
|
| Rate for Payer: PACE SWMI |
$294.08
|
| Rate for Payer: PHP Medicare Advantage |
$294.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health HMO/PPO |
$164.75
|
| Rate for Payer: Priority Health Medicare |
$297.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$164.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.08
|
| Rate for Payer: UHC Exchange |
$294.08
|
| Rate for Payer: UHC Medicare Advantage |
$294.08
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
|
|
CHG MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 73718
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$342.07 |
| Rate for Payer: Aetna Commercial |
$273.44
|
| Rate for Payer: Aetna Medicare |
$212.22
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$204.06
|
| Rate for Payer: BCN Commercial |
$342.07
|
| Rate for Payer: BCN Medicare Advantage |
$204.06
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$293.85
|
| Rate for Payer: Cofinity Commercial |
$273.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.06
|
| Rate for Payer: Mclaren Medicaid |
$40.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.26
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Nomi Health Commercial |
$244.87
|
| Rate for Payer: PACE SWMI |
$204.06
|
| Rate for Payer: PHP Medicare Advantage |
$204.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO |
$97.00
|
| Rate for Payer: Priority Health Medicare |
$206.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.06
|
| Rate for Payer: UHC Exchange |
$204.06
|
| Rate for Payer: UHC Medicare Advantage |
$204.06
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
|
|
CHG MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 73720
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$517.02 |
| Rate for Payer: Aetna Commercial |
$414.73
|
| Rate for Payer: Aetna Medicare |
$321.88
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$309.50
|
| Rate for Payer: BCN Commercial |
$517.02
|
| Rate for Payer: BCN Medicare Advantage |
$309.50
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$445.68
|
| Rate for Payer: Cofinity Commercial |
$414.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.50
|
| Rate for Payer: Mclaren Medicaid |
$64.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.98
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$371.40
|
| Rate for Payer: PACE SWMI |
$309.50
|
| Rate for Payer: PHP Medicare Advantage |
$309.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO |
$154.50
|
| Rate for Payer: Priority Health Medicare |
$312.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.50
|
| Rate for Payer: UHC Exchange |
$309.50
|
| Rate for Payer: UHC Medicare Advantage |
$309.50
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
|
|
CHG MRI ORBIT FACE &/NECK W/O CONTRAST
|
Professional
|
Both
|
$130.00
|
|
|
Service Code
|
HCPCS 70540
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$345.99 |
| Rate for Payer: Aetna Commercial |
$277.39
|
| Rate for Payer: Aetna Medicare |
$215.29
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS MAPPO |
$207.01
|
| Rate for Payer: BCN Commercial |
$345.99
|
| Rate for Payer: BCN Medicare Advantage |
$207.01
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cash Price |
$104.00
|
| Rate for Payer: Cofinity Commercial |
$277.39
|
| Rate for Payer: Cofinity Commercial |
$298.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.01
|
| Rate for Payer: Mclaren Medicaid |
$40.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.36
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Nomi Health Commercial |
$248.41
|
| Rate for Payer: PACE SWMI |
$207.01
|
| Rate for Payer: PHP Medicare Advantage |
$207.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.50
|
| Rate for Payer: Priority Health HMO/PPO |
$97.00
|
| Rate for Payer: Priority Health Medicare |
$209.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$207.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.01
|
| Rate for Payer: UHC Exchange |
$207.01
|
| Rate for Payer: UHC Medicare Advantage |
$207.01
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
|
|
CHG MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 70543
|
| Min. Negotiated Rate |
$64.75 |
| Max. Negotiated Rate |
$518.97 |
| Rate for Payer: Aetna Commercial |
$417.10
|
| Rate for Payer: Aetna Medicare |
$323.72
|
| Rate for Payer: BCBS Complete |
$67.99
|
| Rate for Payer: BCBS MAPPO |
$311.27
|
| Rate for Payer: BCN Commercial |
$518.97
|
| Rate for Payer: BCN Medicare Advantage |
$311.27
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$448.23
|
| Rate for Payer: Cofinity Commercial |
$417.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$311.27
|
| Rate for Payer: Mclaren Medicaid |
$64.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.83
|
| Rate for Payer: Meridian Medicaid |
$67.99
|
| Rate for Payer: Nomi Health Commercial |
$373.52
|
| Rate for Payer: PACE SWMI |
$311.27
|
| Rate for Payer: PHP Medicare Advantage |
$311.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO |
$154.50
|
| Rate for Payer: Priority Health Medicare |
$314.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$154.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$311.27
|
| Rate for Payer: UHC Exchange |
$311.27
|
| Rate for Payer: UHC Medicare Advantage |
$311.27
|
| Rate for Payer: UHCCP Medicaid |
$64.75
|
|
|
CHG MRI PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$142.00
|
|
|
Service Code
|
HCPCS 72195
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$350.38 |
| Rate for Payer: Aetna Commercial |
$280.69
|
| Rate for Payer: Aetna Medicare |
$217.85
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$209.47
|
| Rate for Payer: BCN Commercial |
$350.38
|
| Rate for Payer: BCN Medicare Advantage |
$209.47
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$280.69
|
| Rate for Payer: Cofinity Commercial |
$301.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$209.47
|
| Rate for Payer: Mclaren Medicaid |
$43.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$219.94
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Nomi Health Commercial |
$251.36
|
| Rate for Payer: PACE SWMI |
$209.47
|
| Rate for Payer: PHP Medicare Advantage |
$209.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health HMO/PPO |
$105.73
|
| Rate for Payer: Priority Health Medicare |
$211.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$209.47
|
| Rate for Payer: UHC Exchange |
$209.47
|
| Rate for Payer: UHC Medicare Advantage |
$209.47
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
|
|
CHG MRI PELVIS W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$214.00
|
|
|
Service Code
|
HCPCS 72197
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$516.53 |
| Rate for Payer: Aetna Commercial |
$414.53
|
| Rate for Payer: Aetna Medicare |
$321.72
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$309.35
|
| Rate for Payer: BCN Commercial |
$516.53
|
| Rate for Payer: BCN Medicare Advantage |
$309.35
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cash Price |
$171.20
|
| Rate for Payer: Cofinity Commercial |
$445.46
|
| Rate for Payer: Cofinity Commercial |
$414.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.35
|
| Rate for Payer: Mclaren Medicaid |
$66.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.82
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Nomi Health Commercial |
$371.22
|
| Rate for Payer: PACE SWMI |
$309.35
|
| Rate for Payer: PHP Medicare Advantage |
$309.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.10
|
| Rate for Payer: Priority Health HMO/PPO |
$158.09
|
| Rate for Payer: Priority Health Medicare |
$312.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$309.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.35
|
| Rate for Payer: UHC Exchange |
$309.35
|
| Rate for Payer: UHC Medicare Advantage |
$309.35
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
|
|
CHG MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 72141
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$3,028.22 |
| Rate for Payer: Aetna Commercial |
$235.76
|
| Rate for Payer: Aetna Medicare |
$182.98
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$175.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,028.22
|
| Rate for Payer: BCN Commercial |
$290.27
|
| Rate for Payer: BCN Medicare Advantage |
$175.94
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$253.35
|
| Rate for Payer: Cofinity Commercial |
$235.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.94
|
| Rate for Payer: Mclaren Medicaid |
$44.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.74
|
| Rate for Payer: Meridian Medicaid |
$46.75
|
| Rate for Payer: Nomi Health Commercial |
$211.13
|
| Rate for Payer: PACE SWMI |
$175.94
|
| Rate for Payer: PHP Medicare Advantage |
$175.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.30
|
| Rate for Payer: Priority Health HMO/PPO |
$106.76
|
| Rate for Payer: Priority Health Medicare |
$177.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$175.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.94
|
| Rate for Payer: UHC Exchange |
$175.94
|
| Rate for Payer: UHC Medicare Advantage |
$175.94
|
| Rate for Payer: UHCCP Medicaid |
$44.52
|
|
|
CHG MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 72156
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$3,620.44 |
| Rate for Payer: Aetna Commercial |
$395.25
|
| Rate for Payer: Aetna Medicare |
$306.76
|
| Rate for Payer: BCBS Complete |
$72.69
|
| Rate for Payer: BCBS MAPPO |
$294.96
|
| Rate for Payer: BCBS Trust/PPO |
$3,620.44
|
| Rate for Payer: BCN Commercial |
$489.17
|
| Rate for Payer: BCN Medicare Advantage |
$294.96
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$424.74
|
| Rate for Payer: Cofinity Commercial |
$395.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.96
|
| Rate for Payer: Mclaren Medicaid |
$69.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.71
|
| Rate for Payer: Meridian Medicaid |
$72.69
|
| Rate for Payer: Nomi Health Commercial |
$353.95
|
| Rate for Payer: PACE SWMI |
$294.96
|
| Rate for Payer: PHP Medicare Advantage |
$294.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.10
|
| Rate for Payer: Priority Health HMO/PPO |
$165.28
|
| Rate for Payer: Priority Health Medicare |
$297.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.96
|
| Rate for Payer: UHC Exchange |
$294.96
|
| Rate for Payer: UHC Medicare Advantage |
$294.96
|
| Rate for Payer: UHCCP Medicaid |
$69.23
|
|
|
CHG MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL
|
Professional
|
Both
|
$327.00
|
|
|
Service Code
|
HCPCS 72149
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$3,237.95 |
| Rate for Payer: Aetna Commercial |
$333.31
|
| Rate for Payer: Aetna Medicare |
$258.69
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$248.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,237.95
|
| Rate for Payer: BCN Commercial |
$413.42
|
| Rate for Payer: BCN Medicare Advantage |
$248.74
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cash Price |
$261.60
|
| Rate for Payer: Cofinity Commercial |
$358.19
|
| Rate for Payer: Cofinity Commercial |
$333.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.74
|
| Rate for Payer: Mclaren Medicaid |
$53.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.18
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$298.49
|
| Rate for Payer: PACE SWMI |
$248.74
|
| Rate for Payer: PHP Medicare Advantage |
$248.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.55
|
| Rate for Payer: Priority Health HMO/PPO |
$128.83
|
| Rate for Payer: Priority Health Medicare |
$251.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.74
|
| Rate for Payer: UHC Exchange |
$248.74
|
| Rate for Payer: UHC Medicare Advantage |
$248.74
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 72148
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$3,385.35 |
| Rate for Payer: Aetna Commercial |
$236.55
|
| Rate for Payer: Aetna Medicare |
$183.59
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$176.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,385.35
|
| Rate for Payer: BCN Commercial |
$291.25
|
| Rate for Payer: BCN Medicare Advantage |
$176.53
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cofinity Commercial |
$254.20
|
| Rate for Payer: Cofinity Commercial |
$236.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.53
|
| Rate for Payer: Mclaren Medicaid |
$44.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.36
|
| Rate for Payer: Meridian Medicaid |
$46.75
|
| Rate for Payer: Nomi Health Commercial |
$211.84
|
| Rate for Payer: PACE SWMI |
$176.53
|
| Rate for Payer: PHP Medicare Advantage |
$176.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health HMO/PPO |
$107.27
|
| Rate for Payer: Priority Health Medicare |
$178.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.53
|
| Rate for Payer: UHC Exchange |
$176.53
|
| Rate for Payer: UHC Medicare Advantage |
$176.53
|
| Rate for Payer: UHCCP Medicaid |
$44.52
|
|
|
CHG MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 72158
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$3,525.87 |
| Rate for Payer: Aetna Commercial |
$394.46
|
| Rate for Payer: Aetna Medicare |
$306.14
|
| Rate for Payer: BCBS Complete |
$72.69
|
| Rate for Payer: BCBS MAPPO |
$294.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,525.87
|
| Rate for Payer: BCN Commercial |
$488.19
|
| Rate for Payer: BCN Medicare Advantage |
$294.37
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$423.89
|
| Rate for Payer: Cofinity Commercial |
$394.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.37
|
| Rate for Payer: Mclaren Medicaid |
$69.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$309.09
|
| Rate for Payer: Meridian Medicaid |
$72.69
|
| Rate for Payer: Nomi Health Commercial |
$353.24
|
| Rate for Payer: PACE SWMI |
$294.37
|
| Rate for Payer: PHP Medicare Advantage |
$294.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO |
$165.28
|
| Rate for Payer: Priority Health Medicare |
$297.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.37
|
| Rate for Payer: UHC Exchange |
$294.37
|
| Rate for Payer: UHC Medicare Advantage |
$294.37
|
| Rate for Payer: UHCCP Medicaid |
$69.23
|
|
|
CHG MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL
|
Professional
|
Both
|
$272.00
|
|
|
Service Code
|
HCPCS 72146
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$2,911.46 |
| Rate for Payer: Aetna Commercial |
$236.15
|
| Rate for Payer: Aetna Medicare |
$183.28
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$176.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,911.46
|
| Rate for Payer: BCN Commercial |
$290.27
|
| Rate for Payer: BCN Medicare Advantage |
$176.23
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$253.77
|
| Rate for Payer: Cofinity Commercial |
$236.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$176.23
|
| Rate for Payer: Mclaren Medicaid |
$44.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$185.04
|
| Rate for Payer: Meridian Medicaid |
$46.75
|
| Rate for Payer: Nomi Health Commercial |
$211.48
|
| Rate for Payer: PACE SWMI |
$176.23
|
| Rate for Payer: PHP Medicare Advantage |
$176.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.80
|
| Rate for Payer: Priority Health HMO/PPO |
$106.76
|
| Rate for Payer: Priority Health Medicare |
$177.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$176.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$176.23
|
| Rate for Payer: UHC Exchange |
$176.23
|
| Rate for Payer: UHC Medicare Advantage |
$176.23
|
| Rate for Payer: UHCCP Medicaid |
$44.52
|
|
|
CHG MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 72157
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$3,439.76 |
| Rate for Payer: Aetna Commercial |
$396.04
|
| Rate for Payer: Aetna Medicare |
$307.37
|
| Rate for Payer: BCBS Complete |
$72.69
|
| Rate for Payer: BCBS MAPPO |
$295.55
|
| Rate for Payer: BCBS Trust/PPO |
$3,439.76
|
| Rate for Payer: BCN Commercial |
$490.14
|
| Rate for Payer: BCN Medicare Advantage |
$295.55
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$425.59
|
| Rate for Payer: Cofinity Commercial |
$396.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$295.55
|
| Rate for Payer: Mclaren Medicaid |
$69.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$310.33
|
| Rate for Payer: Meridian Medicaid |
$72.69
|
| Rate for Payer: Nomi Health Commercial |
$354.66
|
| Rate for Payer: PACE SWMI |
$295.55
|
| Rate for Payer: PHP Medicare Advantage |
$295.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.50
|
| Rate for Payer: Priority Health HMO/PPO |
$165.28
|
| Rate for Payer: Priority Health Medicare |
$298.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$295.55
|
| Rate for Payer: UHC Exchange |
$295.55
|
| Rate for Payer: UHC Medicare Advantage |
$295.55
|
| Rate for Payer: UHCCP Medicaid |
$69.23
|
|
|
CHG MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 73218
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$466.69 |
| Rate for Payer: Aetna Commercial |
$367.92
|
| Rate for Payer: Aetna Medicare |
$285.55
|
| Rate for Payer: BCBS Complete |
$42.71
|
| Rate for Payer: BCBS MAPPO |
$274.57
|
| Rate for Payer: BCN Commercial |
$466.69
|
| Rate for Payer: BCN Medicare Advantage |
$274.57
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$395.38
|
| Rate for Payer: Cofinity Commercial |
$367.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$274.57
|
| Rate for Payer: Mclaren Medicaid |
$40.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$288.30
|
| Rate for Payer: Meridian Medicaid |
$42.71
|
| Rate for Payer: Nomi Health Commercial |
$329.48
|
| Rate for Payer: PACE SWMI |
$274.57
|
| Rate for Payer: PHP Medicare Advantage |
$274.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO |
$98.03
|
| Rate for Payer: Priority Health Medicare |
$277.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$98.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$274.57
|
| Rate for Payer: UHC Exchange |
$274.57
|
| Rate for Payer: UHC Medicare Advantage |
$274.57
|
| Rate for Payer: UHCCP Medicaid |
$40.68
|
|
