|
CHG ANGIO ARCH ANGIOGRAM W CATH
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 75650
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$206.25 |
| Rate for Payer: Aetna Medicare |
$137.50
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.25
|
| Rate for Payer: UMR Bronson Commercial |
$126.50
|
|
|
CHG ANGIO AV SHUNT COMPLETE EVAL
|
Professional
|
Both
|
$522.00
|
|
|
Service Code
|
HCPCS 75791
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$391.50 |
| Rate for Payer: Aetna Medicare |
$261.00
|
| Rate for Payer: Aetna Medicare |
$158.50
|
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS Complete |
$208.80
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.75
|
| Rate for Payer: UMR Bronson Commercial |
$145.82
|
| Rate for Payer: UMR Bronson Commercial |
$240.12
|
|
|
CHG ANGIOGRAPHY EXTREMITY BILATERAL RS&I
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 75716
|
| Min. Negotiated Rate |
$93.84 |
| Max. Negotiated Rate |
$252.85 |
| Rate for Payer: Aetna Commercial |
$208.71
|
| Rate for Payer: Aetna Medicare |
$161.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.28
|
| Rate for Payer: BCBS MAPPO |
$155.75
|
| Rate for Payer: BCN Commercial |
$242.52
|
| Rate for Payer: BCN Medicare Advantage |
$155.75
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$224.28
|
| Rate for Payer: Cofinity Commercial |
$208.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.32
|
| Rate for Payer: Nomi Health Commercial |
$186.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: PACE SWMI |
$155.75
|
| Rate for Payer: PHP Commercial |
$218.05
|
| Rate for Payer: PHP Medicare Advantage |
$155.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$244.35
|
| Rate for Payer: Priority Health Medicare |
$155.75
|
| Rate for Payer: Priority Health SBD |
$244.35
|
| Rate for Payer: Priority Health Tiered Network |
$244.35
|
| Rate for Payer: Railroad Medicare Medicare |
$155.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.85
|
| Rate for Payer: UHC Core |
$252.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.75
|
| Rate for Payer: UHC Exchange |
$252.85
|
| Rate for Payer: UMR Bronson Commercial |
$93.84
|
|
|
CHG ANGIOGRAPHY EXTREMITY UNILATERAL RS&I
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 75710
|
| Min. Negotiated Rate |
$143.09 |
| Max. Negotiated Rate |
$332.25 |
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Medicare |
$148.81
|
| Rate for Payer: Aetna Medicare |
$148.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.74
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCN Commercial |
$221.10
|
| Rate for Payer: BCN Commercial |
$221.10
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.40
|
| Rate for Payer: Nomi Health Commercial |
$171.71
|
| Rate for Payer: Nomi Health Commercial |
$171.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PHP Commercial |
$200.33
|
| Rate for Payer: PHP Commercial |
$200.33
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$222.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$222.77
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health SBD |
$222.77
|
| Rate for Payer: Priority Health SBD |
$222.77
|
| Rate for Payer: Priority Health Tiered Network |
$222.77
|
| Rate for Payer: Priority Health Tiered Network |
$222.77
|
| Rate for Payer: Railroad Medicare Medicare |
$143.09
|
| Rate for Payer: Railroad Medicare Medicare |
$143.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.69
|
| Rate for Payer: UHC Core |
$236.69
|
| Rate for Payer: UHC Core |
$236.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.09
|
| Rate for Payer: UHC Exchange |
$236.69
|
| Rate for Payer: UHC Exchange |
$236.69
|
| Rate for Payer: UMR Bronson Commercial |
$86.02
|
| Rate for Payer: UMR Bronson Commercial |
$203.78
|
|
|
CHG ANGIOGRAPHY INTERNAL MAMMARY RS&I
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 75756
|
| Min. Negotiated Rate |
$90.16 |
| Max. Negotiated Rate |
$244.35 |
| Rate for Payer: Aetna Commercial |
$210.50
|
| Rate for Payer: Aetna Medicare |
$163.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.21
|
| Rate for Payer: BCBS MAPPO |
$157.09
|
| Rate for Payer: BCN Commercial |
$242.52
|
| Rate for Payer: BCN Medicare Advantage |
$157.09
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$210.50
|
| Rate for Payer: Cofinity Commercial |
$226.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.80
|
| Rate for Payer: Nomi Health Commercial |
$188.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.00
|
| Rate for Payer: PACE SWMI |
$157.09
|
| Rate for Payer: PHP Commercial |
$219.93
|
| Rate for Payer: PHP Medicare Advantage |
$157.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$244.35
|
| Rate for Payer: Priority Health Medicare |
$157.09
|
| Rate for Payer: Priority Health SBD |
$244.35
|
| Rate for Payer: Priority Health Tiered Network |
$244.35
|
| Rate for Payer: Railroad Medicare Medicare |
$157.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.00
|
| Rate for Payer: UHC Core |
$233.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.09
|
| Rate for Payer: UHC Exchange |
$233.00
|
| Rate for Payer: UMR Bronson Commercial |
$90.16
|
|
|
CHG ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I
|
Professional
|
Both
|
$329.00
|
|
|
Service Code
|
HCPCS 75736
|
| Min. Negotiated Rate |
$134.84 |
| Max. Negotiated Rate |
$246.75 |
| Rate for Payer: Aetna Commercial |
$180.69
|
| Rate for Payer: Aetna Medicare |
$140.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.17
|
| Rate for Payer: BCBS MAPPO |
$134.84
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$134.84
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cofinity Commercial |
$194.17
|
| Rate for Payer: Cofinity Commercial |
$180.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.32
|
| Rate for Payer: Nomi Health Commercial |
$161.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.75
|
| Rate for Payer: PACE SWMI |
$134.84
|
| Rate for Payer: PHP Commercial |
$188.78
|
| Rate for Payer: PHP Medicare Advantage |
$134.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$217.25
|
| Rate for Payer: Priority Health Medicare |
$134.84
|
| Rate for Payer: Priority Health SBD |
$217.25
|
| Rate for Payer: Priority Health Tiered Network |
$217.25
|
| Rate for Payer: Railroad Medicare Medicare |
$134.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.67
|
| Rate for Payer: UHC Core |
$214.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.84
|
| Rate for Payer: UHC Exchange |
$214.67
|
| Rate for Payer: UMR Bronson Commercial |
$151.34
|
|
|
CHG ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 75741
|
| Min. Negotiated Rate |
$59.34 |
| Max. Negotiated Rate |
$204.59 |
| Rate for Payer: Aetna Commercial |
$162.56
|
| Rate for Payer: Aetna Medicare |
$126.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.69
|
| Rate for Payer: BCBS MAPPO |
$121.31
|
| Rate for Payer: BCN Commercial |
$192.72
|
| Rate for Payer: BCN Medicare Advantage |
$121.31
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$162.56
|
| Rate for Payer: Cofinity Commercial |
$174.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.44
|
| Rate for Payer: Nomi Health Commercial |
$145.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$121.31
|
| Rate for Payer: PHP Commercial |
$169.83
|
| Rate for Payer: PHP Medicare Advantage |
$121.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$194.17
|
| Rate for Payer: Priority Health Medicare |
$121.31
|
| Rate for Payer: Priority Health SBD |
$194.17
|
| Rate for Payer: Priority Health Tiered Network |
$194.17
|
| Rate for Payer: Railroad Medicare Medicare |
$121.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$204.59
|
| Rate for Payer: UHC Core |
$204.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.31
|
| Rate for Payer: UHC Exchange |
$204.59
|
| Rate for Payer: UMR Bronson Commercial |
$59.34
|
|
|
CHG ANGIOGRAPHY SPINAL SELECTIVE RS&I
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 75705
|
| Min. Negotiated Rate |
$206.54 |
| Max. Negotiated Rate |
$396.59 |
| Rate for Payer: Aetna Commercial |
$369.05
|
| Rate for Payer: Aetna Medicare |
$286.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.59
|
| Rate for Payer: BCBS MAPPO |
$275.41
|
| Rate for Payer: BCN Commercial |
$383.44
|
| Rate for Payer: BCN Medicare Advantage |
$275.41
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$396.59
|
| Rate for Payer: Cofinity Commercial |
$369.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$302.95
|
| Rate for Payer: Nomi Health Commercial |
$330.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.75
|
| Rate for Payer: PACE SWMI |
$275.41
|
| Rate for Payer: PHP Commercial |
$385.57
|
| Rate for Payer: PHP Medicare Advantage |
$275.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$386.34
|
| Rate for Payer: Priority Health Medicare |
$275.41
|
| Rate for Payer: Priority Health SBD |
$386.34
|
| Rate for Payer: Priority Health Tiered Network |
$386.34
|
| Rate for Payer: Railroad Medicare Medicare |
$275.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$360.19
|
| Rate for Payer: UHC Core |
$360.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.41
|
| Rate for Payer: UHC Exchange |
$360.19
|
| Rate for Payer: UMR Bronson Commercial |
$206.54
|
|
|
CHG ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 75726
|
| Min. Negotiated Rate |
$129.26 |
| Max. Negotiated Rate |
$265.64 |
| Rate for Payer: Aetna Commercial |
$214.67
|
| Rate for Payer: Aetna Medicare |
$166.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.69
|
| Rate for Payer: BCBS MAPPO |
$160.20
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: BCN Medicare Advantage |
$160.20
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$214.67
|
| Rate for Payer: Cofinity Commercial |
$230.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.22
|
| Rate for Payer: Nomi Health Commercial |
$192.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.75
|
| Rate for Payer: PACE SWMI |
$160.20
|
| Rate for Payer: PHP Commercial |
$224.28
|
| Rate for Payer: PHP Medicare Advantage |
$160.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$256.88
|
| Rate for Payer: Priority Health Medicare |
$160.20
|
| Rate for Payer: Priority Health SBD |
$256.88
|
| Rate for Payer: Priority Health Tiered Network |
$256.88
|
| Rate for Payer: Railroad Medicare Medicare |
$160.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.64
|
| Rate for Payer: UHC Core |
$265.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.20
|
| Rate for Payer: UHC Exchange |
$265.64
|
| Rate for Payer: UMR Bronson Commercial |
$129.26
|
|
|
CHG ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 75898
|
| Min. Negotiated Rate |
$76.82 |
| Max. Negotiated Rate |
$2,356.66 |
| Rate for Payer: Aetna Commercial |
$345.02
|
| Rate for Payer: Aetna Medicare |
$267.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$370.77
|
| Rate for Payer: BCBS MAPPO |
$257.48
|
| Rate for Payer: BCN Commercial |
$134.96
|
| Rate for Payer: BCN Medicare Advantage |
$257.48
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$370.77
|
| Rate for Payer: Cofinity Commercial |
$345.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.23
|
| Rate for Payer: Nomi Health Commercial |
$308.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$257.48
|
| Rate for Payer: PHP Commercial |
$360.47
|
| Rate for Payer: PHP Medicare Advantage |
$257.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$202.70
|
| Rate for Payer: Priority Health Medicare |
$257.48
|
| Rate for Payer: Priority Health SBD |
$202.70
|
| Rate for Payer: Priority Health Tiered Network |
$202.70
|
| Rate for Payer: Railroad Medicare Medicare |
$257.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,356.66
|
| Rate for Payer: UHC Core |
$2,356.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.48
|
| Rate for Payer: UHC Exchange |
$2,356.66
|
| Rate for Payer: UMR Bronson Commercial |
$76.82
|
|
|
CHG ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 75774
|
| Min. Negotiated Rate |
$90.34 |
| Max. Negotiated Rate |
$233.25 |
| Rate for Payer: Aetna Commercial |
$121.06
|
| Rate for Payer: Aetna Medicare |
$93.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.09
|
| Rate for Payer: BCBS MAPPO |
$90.34
|
| Rate for Payer: BCN Commercial |
$142.92
|
| Rate for Payer: BCN Medicare Advantage |
$90.34
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$130.09
|
| Rate for Payer: Cofinity Commercial |
$121.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.37
|
| Rate for Payer: Nomi Health Commercial |
$108.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.25
|
| Rate for Payer: PACE SWMI |
$90.34
|
| Rate for Payer: PHP Commercial |
$126.48
|
| Rate for Payer: PHP Medicare Advantage |
$90.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$143.99
|
| Rate for Payer: Priority Health Medicare |
$90.34
|
| Rate for Payer: Priority Health SBD |
$143.99
|
| Rate for Payer: Priority Health Tiered Network |
$143.99
|
| Rate for Payer: Railroad Medicare Medicare |
$90.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.54
|
| Rate for Payer: UHC Core |
$154.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.34
|
| Rate for Payer: UHC Exchange |
$154.54
|
| Rate for Payer: UMR Bronson Commercial |
$143.06
|
|
|
CHG AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I
|
Professional
|
Both
|
$489.00
|
|
|
Service Code
|
HCPCS 75630
|
| Min. Negotiated Rate |
$149.43 |
| Max. Negotiated Rate |
$366.75 |
| Rate for Payer: Aetna Commercial |
$200.24
|
| Rate for Payer: Aetna Commercial |
$200.24
|
| Rate for Payer: Aetna Medicare |
$155.41
|
| Rate for Payer: Aetna Medicare |
$155.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.24
|
| Rate for Payer: BCBS MAPPO |
$149.43
|
| Rate for Payer: BCBS MAPPO |
$149.43
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Medicare Advantage |
$149.43
|
| Rate for Payer: BCN Medicare Advantage |
$149.43
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cofinity Commercial |
$200.24
|
| Rate for Payer: Cofinity Commercial |
$215.18
|
| Rate for Payer: Cofinity Commercial |
$215.18
|
| Rate for Payer: Cofinity Commercial |
$200.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.37
|
| Rate for Payer: Nomi Health Commercial |
$179.32
|
| Rate for Payer: Nomi Health Commercial |
$179.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.75
|
| Rate for Payer: PACE SWMI |
$149.43
|
| Rate for Payer: PACE SWMI |
$149.43
|
| Rate for Payer: PHP Commercial |
$209.20
|
| Rate for Payer: PHP Commercial |
$209.20
|
| Rate for Payer: PHP Medicare Advantage |
$149.43
|
| Rate for Payer: PHP Medicare Advantage |
$149.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$234.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$234.81
|
| Rate for Payer: Priority Health Medicare |
$149.43
|
| Rate for Payer: Priority Health Medicare |
$149.43
|
| Rate for Payer: Priority Health SBD |
$234.81
|
| Rate for Payer: Priority Health SBD |
$234.81
|
| Rate for Payer: Priority Health Tiered Network |
$234.81
|
| Rate for Payer: Priority Health Tiered Network |
$234.81
|
| Rate for Payer: Railroad Medicare Medicare |
$149.43
|
| Rate for Payer: Railroad Medicare Medicare |
$149.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.55
|
| Rate for Payer: UHC Core |
$246.55
|
| Rate for Payer: UHC Core |
$246.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.43
|
| Rate for Payer: UHC Exchange |
$246.55
|
| Rate for Payer: UHC Exchange |
$246.55
|
| Rate for Payer: UMR Bronson Commercial |
$224.94
|
| Rate for Payer: UMR Bronson Commercial |
$138.92
|
|
|
CHG AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$118.00
|
|
|
Service Code
|
HCPCS 75625
|
| Min. Negotiated Rate |
$54.28 |
| Max. Negotiated Rate |
$200.18 |
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: Aetna Medicare |
$124.81
|
| Rate for Payer: Aetna Medicare |
$124.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.81
|
| Rate for Payer: BCBS MAPPO |
$120.01
|
| Rate for Payer: BCBS MAPPO |
$120.01
|
| Rate for Payer: BCN Commercial |
$187.24
|
| Rate for Payer: BCN Commercial |
$187.24
|
| Rate for Payer: BCN Medicare Advantage |
$120.01
|
| Rate for Payer: BCN Medicare Advantage |
$120.01
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Cofinity Commercial |
$160.81
|
| Rate for Payer: Cofinity Commercial |
$160.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.01
|
| Rate for Payer: Nomi Health Commercial |
$144.01
|
| Rate for Payer: Nomi Health Commercial |
$144.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$120.01
|
| Rate for Payer: PACE SWMI |
$120.01
|
| Rate for Payer: PHP Commercial |
$168.01
|
| Rate for Payer: PHP Commercial |
$168.01
|
| Rate for Payer: PHP Medicare Advantage |
$120.01
|
| Rate for Payer: PHP Medicare Advantage |
$120.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$188.65
|
| Rate for Payer: Priority Health Medicare |
$120.01
|
| Rate for Payer: Priority Health Medicare |
$120.01
|
| Rate for Payer: Priority Health SBD |
$188.65
|
| Rate for Payer: Priority Health SBD |
$188.65
|
| Rate for Payer: Priority Health Tiered Network |
$188.65
|
| Rate for Payer: Priority Health Tiered Network |
$188.65
|
| Rate for Payer: Railroad Medicare Medicare |
$120.01
|
| Rate for Payer: Railroad Medicare Medicare |
$120.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$200.18
|
| Rate for Payer: UHC Core |
$200.18
|
| Rate for Payer: UHC Core |
$200.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.01
|
| Rate for Payer: UHC Exchange |
$200.18
|
| Rate for Payer: UHC Exchange |
$200.18
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
| Rate for Payer: UMR Bronson Commercial |
$54.28
|
|
|
CHG AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 75605
|
| Min. Negotiated Rate |
$114.63 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$153.60
|
| Rate for Payer: Aetna Medicare |
$119.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.07
|
| Rate for Payer: BCBS MAPPO |
$114.63
|
| Rate for Payer: BCN Commercial |
$179.77
|
| Rate for Payer: BCN Medicare Advantage |
$114.63
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$165.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.09
|
| Rate for Payer: Nomi Health Commercial |
$137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.75
|
| Rate for Payer: PACE SWMI |
$114.63
|
| Rate for Payer: PHP Commercial |
$160.48
|
| Rate for Payer: PHP Medicare Advantage |
$114.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$181.12
|
| Rate for Payer: Priority Health Medicare |
$114.63
|
| Rate for Payer: Priority Health SBD |
$181.12
|
| Rate for Payer: Priority Health Tiered Network |
$181.12
|
| Rate for Payer: Railroad Medicare Medicare |
$114.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.11
|
| Rate for Payer: UHC Core |
$186.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.63
|
| Rate for Payer: UHC Exchange |
$186.11
|
| Rate for Payer: UMR Bronson Commercial |
$125.58
|
|
|
CHG AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 75600
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$280.45 |
| Rate for Payer: Aetna Commercial |
$219.72
|
| Rate for Payer: Aetna Medicare |
$170.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$219.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.12
|
| Rate for Payer: BCBS MAPPO |
$163.97
|
| Rate for Payer: BCN Commercial |
$258.95
|
| Rate for Payer: BCN Medicare Advantage |
$163.97
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$236.12
|
| Rate for Payer: Cofinity Commercial |
$219.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.37
|
| Rate for Payer: Nomi Health Commercial |
$196.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PACE SWMI |
$163.97
|
| Rate for Payer: PHP Commercial |
$229.56
|
| Rate for Payer: PHP Medicare Advantage |
$163.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$260.90
|
| Rate for Payer: Priority Health Medicare |
$163.97
|
| Rate for Payer: Priority Health SBD |
$260.90
|
| Rate for Payer: Priority Health Tiered Network |
$260.90
|
| Rate for Payer: Railroad Medicare Medicare |
$163.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.45
|
| Rate for Payer: UHC Core |
$280.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.97
|
| Rate for Payer: UHC Exchange |
$280.45
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
|
|
CHG AQMBF PET REST AND PHARMACOLOGIC STRESS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 78434
|
| Min. Negotiated Rate |
$28.52 |
| Max. Negotiated Rate |
$308.07 |
| Rate for Payer: Aetna Commercial |
$239.63
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.63
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$308.07
|
| Rate for Payer: Priority Health SBD |
$308.07
|
| Rate for Payer: Priority Health Tiered Network |
$308.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.59
|
| Rate for Payer: UHC Core |
$230.59
|
| Rate for Payer: UHC Exchange |
$230.59
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
CHG ASSAY OF LEAD
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 83655
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCN Commercial |
$9.08
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$16.23
|
| Rate for Payer: Cofinity Commercial |
$17.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Nomi Health Commercial |
$14.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$16.95
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.44
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health SBD |
$12.44
|
| Rate for Payer: Priority Health Tiered Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.09
|
| Rate for Payer: UHC Core |
$5.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.11
|
| Rate for Payer: UHC Exchange |
$5.09
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
|
CHG ASSAY OF PHOSPHATASE ALKALINE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 84075
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.46
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Nomi Health Commercial |
$6.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.38
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$5.38
|
| Rate for Payer: Priority Health Tiered Network |
$5.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.18
|
| Rate for Payer: UHC Core |
$2.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$2.18
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
CHG ASSAY OF PROGESTERONE
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 84144
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$72.75 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: Aetna Medicare |
$21.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.04
|
| Rate for Payer: BCBS MAPPO |
$20.86
|
| Rate for Payer: BCN Commercial |
$15.65
|
| Rate for Payer: BCN Medicare Advantage |
$20.86
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$30.04
|
| Rate for Payer: Cofinity Commercial |
$27.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.95
|
| Rate for Payer: Nomi Health Commercial |
$25.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.75
|
| Rate for Payer: PACE SWMI |
$20.86
|
| Rate for Payer: PHP Commercial |
$29.20
|
| Rate for Payer: PHP Medicare Advantage |
$20.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.52
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: Priority Health SBD |
$21.52
|
| Rate for Payer: Priority Health Tiered Network |
$21.52
|
| Rate for Payer: Railroad Medicare Medicare |
$20.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.76
|
| Rate for Payer: UHC Core |
$8.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.86
|
| Rate for Payer: UHC Exchange |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$44.62
|
|
|
CHG ASSAY OF PYRUVATE KINASE
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 84220
|
| Min. Negotiated Rate |
$3.96 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.59
|
| Rate for Payer: BCBS Complete |
$39.20
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCN Commercial |
$7.08
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.38
|
| Rate for Payer: Nomi Health Commercial |
$11.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.50
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$13.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health SBD |
$9.75
|
| Rate for Payer: Priority Health Tiered Network |
$9.75
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.96
|
| Rate for Payer: UHC Core |
$3.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.44
|
| Rate for Payer: UHC Exchange |
$3.96
|
| Rate for Payer: UMR Bronson Commercial |
$45.08
|
|
|
CHG ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 84588
|
| Min. Negotiated Rate |
$14.25 |
| Max. Negotiated Rate |
$61.50 |
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna Medicare |
$35.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.87
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCN Commercial |
$25.46
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$48.87
|
| Rate for Payer: Cofinity Commercial |
$45.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.33
|
| Rate for Payer: Nomi Health Commercial |
$40.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.50
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Commercial |
$47.52
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.30
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health SBD |
$35.30
|
| Rate for Payer: Priority Health Tiered Network |
$35.30
|
| Rate for Payer: Railroad Medicare Medicare |
$33.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.25
|
| Rate for Payer: UHC Core |
$14.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.94
|
| Rate for Payer: UHC Exchange |
$14.25
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
CHG BALLOON ANGIOPLASTY VISCERAL
|
Professional
|
Both
|
$165.00
|
|
|
Service Code
|
HCPCS 75966
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Aetna Medicare |
$82.50
|
| Rate for Payer: BCBS Complete |
$66.00
|
| Rate for Payer: Cash Price |
$132.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.75
|
| Rate for Payer: UMR Bronson Commercial |
$75.90
|
|
|
CHG BALLOON ANGIO VENOUS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 75978
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$39.75 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna Medicare |
$204.50
|
| Rate for Payer: BCBS Complete |
$163.60
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
| Rate for Payer: UMR Bronson Commercial |
$188.14
|
|
|
CHG BASIC RADIATION DOSIMETRY CALCULATION
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 77300
|
| Min. Negotiated Rate |
$35.42 |
| Max. Negotiated Rate |
$101.35 |
| Rate for Payer: Aetna Commercial |
$84.86
|
| Rate for Payer: Aetna Commercial |
$84.86
|
| Rate for Payer: Aetna Medicare |
$65.86
|
| Rate for Payer: Aetna Medicare |
$65.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$63.33
|
| Rate for Payer: BCBS MAPPO |
$63.33
|
| Rate for Payer: BCN Commercial |
$100.60
|
| Rate for Payer: BCN Commercial |
$100.60
|
| Rate for Payer: BCN Medicare Advantage |
$63.33
|
| Rate for Payer: BCN Medicare Advantage |
$63.33
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$84.86
|
| Rate for Payer: Cofinity Commercial |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$84.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.66
|
| Rate for Payer: Nomi Health Commercial |
$76.00
|
| Rate for Payer: Nomi Health Commercial |
$76.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: PACE SWMI |
$63.33
|
| Rate for Payer: PACE SWMI |
$63.33
|
| Rate for Payer: PHP Commercial |
$88.66
|
| Rate for Payer: PHP Commercial |
$88.66
|
| Rate for Payer: PHP Medicare Advantage |
$63.33
|
| Rate for Payer: PHP Medicare Advantage |
$63.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$101.35
|
| Rate for Payer: Priority Health Medicare |
$63.33
|
| Rate for Payer: Priority Health Medicare |
$63.33
|
| Rate for Payer: Priority Health SBD |
$101.35
|
| Rate for Payer: Priority Health SBD |
$101.35
|
| Rate for Payer: Priority Health Tiered Network |
$101.35
|
| Rate for Payer: Priority Health Tiered Network |
$101.35
|
| Rate for Payer: Railroad Medicare Medicare |
$63.33
|
| Rate for Payer: Railroad Medicare Medicare |
$63.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.40
|
| Rate for Payer: UHC Core |
$95.40
|
| Rate for Payer: UHC Core |
$95.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$63.33
|
| Rate for Payer: UHC Exchange |
$95.40
|
| Rate for Payer: UHC Exchange |
$95.40
|
| Rate for Payer: UMR Bronson Commercial |
$62.10
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
|
|
CHG BILIRUBIN TOTAL
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 82247
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$6.73
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.23
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$6.73
|
| Rate for Payer: Cofinity Commercial |
$7.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.52
|
| Rate for Payer: Nomi Health Commercial |
$6.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$7.03
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.38
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health SBD |
$5.38
|
| Rate for Payer: Priority Health Tiered Network |
$5.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.11
|
| Rate for Payer: UHC Core |
$2.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.02
|
| Rate for Payer: UHC Exchange |
$2.11
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
|
