|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 70030
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$49.67 |
| Rate for Payer: Aetna Commercial |
$40.94
|
| Rate for Payer: Aetna Medicare |
$31.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.99
|
| Rate for Payer: BCBS MAPPO |
$30.55
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$30.55
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Cofinity Commercial |
$43.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.60
|
| Rate for Payer: Nomi Health Commercial |
$36.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$30.55
|
| Rate for Payer: PHP Commercial |
$42.77
|
| Rate for Payer: PHP Medicare Advantage |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.67
|
| Rate for Payer: Priority Health Medicare |
$30.55
|
| Rate for Payer: Priority Health SBD |
$49.67
|
| Rate for Payer: Priority Health Tiered Network |
$49.67
|
| Rate for Payer: Railroad Medicare Medicare |
$30.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.64
|
| Rate for Payer: UHC Core |
$43.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.55
|
| Rate for Payer: UHC Exchange |
$43.64
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 73551
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$44.66 |
| Rate for Payer: Aetna Commercial |
$36.77
|
| Rate for Payer: Aetna Medicare |
$28.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.51
|
| Rate for Payer: BCBS MAPPO |
$27.44
|
| Rate for Payer: BCN Commercial |
$44.32
|
| Rate for Payer: BCN Medicare Advantage |
$27.44
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$39.51
|
| Rate for Payer: Cofinity Commercial |
$36.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.18
|
| Rate for Payer: Nomi Health Commercial |
$32.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$27.44
|
| Rate for Payer: PHP Commercial |
$38.42
|
| Rate for Payer: PHP Medicare Advantage |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$44.66
|
| Rate for Payer: Priority Health Medicare |
$27.44
|
| Rate for Payer: Priority Health SBD |
$44.66
|
| Rate for Payer: Priority Health Tiered Network |
$44.66
|
| Rate for Payer: Railroad Medicare Medicare |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.14
|
| Rate for Payer: UHC Core |
$41.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.44
|
| Rate for Payer: UHC Exchange |
$41.14
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$65.00
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$53.68 |
| Rate for Payer: Aetna Commercial |
$44.62
|
| Rate for Payer: Aetna Commercial |
$44.62
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.62
|
| Rate for Payer: BCBS MAPPO |
$33.30
|
| Rate for Payer: BCBS MAPPO |
$33.30
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Commercial |
$53.29
|
| Rate for Payer: BCN Medicare Advantage |
$33.30
|
| Rate for Payer: BCN Medicare Advantage |
$33.30
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$47.95
|
| Rate for Payer: Cofinity Commercial |
$47.95
|
| Rate for Payer: Cofinity Commercial |
$44.62
|
| Rate for Payer: Cofinity Commercial |
$44.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.63
|
| Rate for Payer: Nomi Health Commercial |
$39.96
|
| Rate for Payer: Nomi Health Commercial |
$39.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$33.30
|
| Rate for Payer: PACE SWMI |
$33.30
|
| Rate for Payer: PHP Commercial |
$46.62
|
| Rate for Payer: PHP Commercial |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$33.30
|
| Rate for Payer: PHP Medicare Advantage |
$33.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$53.68
|
| Rate for Payer: Priority Health Medicare |
$33.30
|
| Rate for Payer: Priority Health Medicare |
$33.30
|
| Rate for Payer: Priority Health SBD |
$53.68
|
| Rate for Payer: Priority Health SBD |
$53.68
|
| Rate for Payer: Priority Health Tiered Network |
$53.68
|
| Rate for Payer: Priority Health Tiered Network |
$53.68
|
| Rate for Payer: Railroad Medicare Medicare |
$33.30
|
| Rate for Payer: Railroad Medicare Medicare |
$33.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.60
|
| Rate for Payer: UHC Core |
$48.60
|
| Rate for Payer: UHC Core |
$48.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.30
|
| Rate for Payer: UHC Exchange |
$48.60
|
| Rate for Payer: UHC Exchange |
$48.60
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
| Rate for Payer: UMR Bronson Commercial |
$29.90
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 73620
|
| Min. Negotiated Rate |
$26.83 |
| Max. Negotiated Rate |
$60.00 |
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: Aetna Commercial |
$35.95
|
| Rate for Payer: Aetna Medicare |
$27.90
|
| Rate for Payer: Aetna Medicare |
$27.90
|
| Rate for Payer: Aetna Medicare |
$27.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.95
|
| Rate for Payer: BCBS MAPPO |
$26.83
|
| Rate for Payer: BCBS MAPPO |
$26.83
|
| Rate for Payer: BCBS MAPPO |
$26.83
|
| Rate for Payer: BCN Commercial |
$42.33
|
| Rate for Payer: BCN Commercial |
$42.33
|
| Rate for Payer: BCN Commercial |
$42.33
|
| Rate for Payer: BCN Medicare Advantage |
$26.83
|
| Rate for Payer: BCN Medicare Advantage |
$26.83
|
| Rate for Payer: BCN Medicare Advantage |
$26.83
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$38.64
|
| Rate for Payer: Cofinity Commercial |
$38.64
|
| Rate for Payer: Cofinity Commercial |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$38.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.51
|
| Rate for Payer: Nomi Health Commercial |
$32.20
|
| Rate for Payer: Nomi Health Commercial |
$32.20
|
| Rate for Payer: Nomi Health Commercial |
$32.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$26.83
|
| Rate for Payer: PACE SWMI |
$26.83
|
| Rate for Payer: PACE SWMI |
$26.83
|
| Rate for Payer: PHP Commercial |
$37.56
|
| Rate for Payer: PHP Commercial |
$37.56
|
| Rate for Payer: PHP Commercial |
$37.56
|
| Rate for Payer: PHP Medicare Advantage |
$26.83
|
| Rate for Payer: PHP Medicare Advantage |
$26.83
|
| Rate for Payer: PHP Medicare Advantage |
$26.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.64
|
| Rate for Payer: Priority Health Medicare |
$26.83
|
| Rate for Payer: Priority Health Medicare |
$26.83
|
| Rate for Payer: Priority Health Medicare |
$26.83
|
| Rate for Payer: Priority Health SBD |
$42.64
|
| Rate for Payer: Priority Health SBD |
$42.64
|
| Rate for Payer: Priority Health SBD |
$42.64
|
| Rate for Payer: Priority Health Tiered Network |
$42.64
|
| Rate for Payer: Priority Health Tiered Network |
$42.64
|
| Rate for Payer: Priority Health Tiered Network |
$42.64
|
| Rate for Payer: Railroad Medicare Medicare |
$26.83
|
| Rate for Payer: Railroad Medicare Medicare |
$26.83
|
| Rate for Payer: Railroad Medicare Medicare |
$26.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.18
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: UHC Core |
$39.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.83
|
| Rate for Payer: UHC Exchange |
$39.18
|
| Rate for Payer: UHC Exchange |
$39.18
|
| Rate for Payer: UHC Exchange |
$39.18
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$32.02 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Aetna Commercial |
$42.91
|
| Rate for Payer: Aetna Commercial |
$42.91
|
| Rate for Payer: Aetna Commercial |
$42.91
|
| Rate for Payer: Aetna Medicare |
$33.30
|
| Rate for Payer: Aetna Medicare |
$33.30
|
| Rate for Payer: Aetna Medicare |
$33.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.91
|
| Rate for Payer: BCBS MAPPO |
$32.02
|
| Rate for Payer: BCBS MAPPO |
$32.02
|
| Rate for Payer: BCBS MAPPO |
$32.02
|
| Rate for Payer: BCN Commercial |
$50.80
|
| Rate for Payer: BCN Commercial |
$50.80
|
| Rate for Payer: BCN Commercial |
$50.80
|
| Rate for Payer: BCN Medicare Advantage |
$32.02
|
| Rate for Payer: BCN Medicare Advantage |
$32.02
|
| Rate for Payer: BCN Medicare Advantage |
$32.02
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$46.11
|
| Rate for Payer: Cofinity Commercial |
$46.11
|
| Rate for Payer: Cofinity Commercial |
$42.91
|
| Rate for Payer: Cofinity Commercial |
$42.91
|
| Rate for Payer: Cofinity Commercial |
$42.91
|
| Rate for Payer: Cofinity Commercial |
$46.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.22
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.25
|
| Rate for Payer: PACE SWMI |
$32.02
|
| Rate for Payer: PACE SWMI |
$32.02
|
| Rate for Payer: PACE SWMI |
$32.02
|
| Rate for Payer: PHP Commercial |
$44.83
|
| Rate for Payer: PHP Commercial |
$44.83
|
| Rate for Payer: PHP Commercial |
$44.83
|
| Rate for Payer: PHP Medicare Advantage |
$32.02
|
| Rate for Payer: PHP Medicare Advantage |
$32.02
|
| Rate for Payer: PHP Medicare Advantage |
$32.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.17
|
| Rate for Payer: Priority Health Medicare |
$32.02
|
| Rate for Payer: Priority Health Medicare |
$32.02
|
| Rate for Payer: Priority Health Medicare |
$32.02
|
| Rate for Payer: Priority Health SBD |
$51.17
|
| Rate for Payer: Priority Health SBD |
$51.17
|
| Rate for Payer: Priority Health SBD |
$51.17
|
| Rate for Payer: Priority Health Tiered Network |
$51.17
|
| Rate for Payer: Priority Health Tiered Network |
$51.17
|
| Rate for Payer: Priority Health Tiered Network |
$51.17
|
| Rate for Payer: Railroad Medicare Medicare |
$32.02
|
| Rate for Payer: Railroad Medicare Medicare |
$32.02
|
| Rate for Payer: Railroad Medicare Medicare |
$32.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.04
|
| Rate for Payer: UHC Core |
$47.04
|
| Rate for Payer: UHC Core |
$47.04
|
| Rate for Payer: UHC Core |
$47.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.02
|
| Rate for Payer: UHC Exchange |
$47.04
|
| Rate for Payer: UHC Exchange |
$47.04
|
| Rate for Payer: UHC Exchange |
$47.04
|
| Rate for Payer: UMR Bronson Commercial |
$40.48
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$98.00
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$39.40 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Aetna Commercial |
$52.80
|
| Rate for Payer: Aetna Commercial |
$52.80
|
| Rate for Payer: Aetna Commercial |
$52.80
|
| Rate for Payer: Aetna Medicare |
$40.98
|
| Rate for Payer: Aetna Medicare |
$40.98
|
| Rate for Payer: Aetna Medicare |
$40.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.80
|
| Rate for Payer: BCBS MAPPO |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$39.40
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Medicare Advantage |
$39.40
|
| Rate for Payer: BCN Medicare Advantage |
$39.40
|
| Rate for Payer: BCN Medicare Advantage |
$39.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$56.74
|
| Rate for Payer: Cofinity Commercial |
$56.74
|
| Rate for Payer: Cofinity Commercial |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$56.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.34
|
| Rate for Payer: Nomi Health Commercial |
$47.28
|
| Rate for Payer: Nomi Health Commercial |
$47.28
|
| Rate for Payer: Nomi Health Commercial |
$47.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$39.40
|
| Rate for Payer: PACE SWMI |
$39.40
|
| Rate for Payer: PACE SWMI |
$39.40
|
| Rate for Payer: PHP Commercial |
$55.16
|
| Rate for Payer: PHP Commercial |
$55.16
|
| Rate for Payer: PHP Commercial |
$55.16
|
| Rate for Payer: PHP Medicare Advantage |
$39.40
|
| Rate for Payer: PHP Medicare Advantage |
$39.40
|
| Rate for Payer: PHP Medicare Advantage |
$39.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$61.21
|
| Rate for Payer: Priority Health Medicare |
$39.40
|
| Rate for Payer: Priority Health Medicare |
$39.40
|
| Rate for Payer: Priority Health Medicare |
$39.40
|
| Rate for Payer: Priority Health SBD |
$61.21
|
| Rate for Payer: Priority Health SBD |
$61.21
|
| Rate for Payer: Priority Health SBD |
$61.21
|
| Rate for Payer: Priority Health Tiered Network |
$61.21
|
| Rate for Payer: Priority Health Tiered Network |
$61.21
|
| Rate for Payer: Priority Health Tiered Network |
$61.21
|
| Rate for Payer: Railroad Medicare Medicare |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$39.40
|
| Rate for Payer: Railroad Medicare Medicare |
$39.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.00
|
| Rate for Payer: UHC Core |
$55.00
|
| Rate for Payer: UHC Core |
$55.00
|
| Rate for Payer: UHC Core |
$55.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.40
|
| Rate for Payer: UHC Exchange |
$55.00
|
| Rate for Payer: UHC Exchange |
$55.00
|
| Rate for Payer: UHC Exchange |
$55.00
|
| Rate for Payer: UMR Bronson Commercial |
$45.08
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 70100
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$58.20 |
| Rate for Payer: Aetna Commercial |
$50.34
|
| Rate for Payer: Aetna Medicare |
$39.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: BCBS MAPPO |
$37.57
|
| Rate for Payer: BCN Commercial |
$57.76
|
| Rate for Payer: BCN Medicare Advantage |
$37.57
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cofinity Commercial |
$50.34
|
| Rate for Payer: Cofinity Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.33
|
| Rate for Payer: Nomi Health Commercial |
$45.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.25
|
| Rate for Payer: PACE SWMI |
$37.57
|
| Rate for Payer: PHP Commercial |
$52.60
|
| Rate for Payer: PHP Medicare Advantage |
$37.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$58.20
|
| Rate for Payer: Priority Health Medicare |
$37.57
|
| Rate for Payer: Priority Health SBD |
$58.20
|
| Rate for Payer: Priority Health Tiered Network |
$58.20
|
| Rate for Payer: Railroad Medicare Medicare |
$37.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.56
|
| Rate for Payer: UHC Core |
$51.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.57
|
| Rate for Payer: UHC Exchange |
$51.56
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 70360
|
| Min. Negotiated Rate |
$15.64 |
| Max. Negotiated Rate |
$47.17 |
| Rate for Payer: Aetna Commercial |
$38.90
|
| Rate for Payer: Aetna Medicare |
$30.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.80
|
| Rate for Payer: BCBS MAPPO |
$29.03
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Medicare Advantage |
$29.03
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$41.80
|
| Rate for Payer: Cofinity Commercial |
$38.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.93
|
| Rate for Payer: Nomi Health Commercial |
$34.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$29.03
|
| Rate for Payer: PHP Commercial |
$40.64
|
| Rate for Payer: PHP Medicare Advantage |
$29.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.17
|
| Rate for Payer: Priority Health Medicare |
$29.03
|
| Rate for Payer: Priority Health SBD |
$47.17
|
| Rate for Payer: Priority Health Tiered Network |
$47.17
|
| Rate for Payer: Railroad Medicare Medicare |
$29.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.20
|
| Rate for Payer: UHC Core |
$43.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.03
|
| Rate for Payer: UHC Exchange |
$43.20
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
CHG RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPLETE
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 77075
|
| Min. Negotiated Rate |
$27.14 |
| Max. Negotiated Rate |
$149.02 |
| Rate for Payer: Aetna Commercial |
$122.32
|
| Rate for Payer: Aetna Medicare |
$94.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.44
|
| Rate for Payer: BCBS MAPPO |
$91.28
|
| Rate for Payer: BCN Commercial |
$147.90
|
| Rate for Payer: BCN Medicare Advantage |
$91.28
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$131.44
|
| Rate for Payer: Cofinity Commercial |
$122.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.41
|
| Rate for Payer: Nomi Health Commercial |
$109.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$91.28
|
| Rate for Payer: PHP Commercial |
$127.79
|
| Rate for Payer: PHP Medicare Advantage |
$91.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$149.02
|
| Rate for Payer: Priority Health Medicare |
$91.28
|
| Rate for Payer: Priority Health SBD |
$149.02
|
| Rate for Payer: Priority Health Tiered Network |
$149.02
|
| Rate for Payer: Railroad Medicare Medicare |
$91.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$134.47
|
| Rate for Payer: UHC Core |
$134.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.28
|
| Rate for Payer: UHC Exchange |
$134.47
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 72170
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$92.25 |
| Rate for Payer: Aetna Commercial |
$35.17
|
| Rate for Payer: Aetna Commercial |
$35.17
|
| Rate for Payer: Aetna Commercial |
$35.17
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: Aetna Medicare |
$27.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCBS MAPPO |
$26.25
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: BCN Commercial |
$41.83
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: BCN Medicare Advantage |
$26.25
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$35.17
|
| Rate for Payer: Cofinity Commercial |
$35.17
|
| Rate for Payer: Cofinity Commercial |
$37.80
|
| Rate for Payer: Cofinity Commercial |
$35.17
|
| Rate for Payer: Cofinity Commercial |
$37.80
|
| Rate for Payer: Cofinity Commercial |
$37.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.88
|
| Rate for Payer: Nomi Health Commercial |
$31.50
|
| Rate for Payer: Nomi Health Commercial |
$31.50
|
| Rate for Payer: Nomi Health Commercial |
$31.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PACE SWMI |
$26.25
|
| Rate for Payer: PHP Commercial |
$36.75
|
| Rate for Payer: PHP Commercial |
$36.75
|
| Rate for Payer: PHP Commercial |
$36.75
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: PHP Medicare Advantage |
$26.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.14
|
| Rate for Payer: Priority Health Medicare |
$26.25
|
| Rate for Payer: Priority Health Medicare |
$26.25
|
| Rate for Payer: Priority Health Medicare |
$26.25
|
| Rate for Payer: Priority Health SBD |
$42.14
|
| Rate for Payer: Priority Health SBD |
$42.14
|
| Rate for Payer: Priority Health SBD |
$42.14
|
| Rate for Payer: Priority Health Tiered Network |
$42.14
|
| Rate for Payer: Priority Health Tiered Network |
$42.14
|
| Rate for Payer: Priority Health Tiered Network |
$42.14
|
| Rate for Payer: Railroad Medicare Medicare |
$26.25
|
| Rate for Payer: Railroad Medicare Medicare |
$26.25
|
| Rate for Payer: Railroad Medicare Medicare |
$26.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.20
|
| Rate for Payer: UHC Core |
$40.20
|
| Rate for Payer: UHC Core |
$40.20
|
| Rate for Payer: UHC Core |
$40.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.25
|
| Rate for Payer: UHC Exchange |
$40.20
|
| Rate for Payer: UHC Exchange |
$40.20
|
| Rate for Payer: UHC Exchange |
$40.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
| Rate for Payer: UMR Bronson Commercial |
$56.58
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
CHG RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 72200
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$50.67 |
| Rate for Payer: Aetna Commercial |
$42.13
|
| Rate for Payer: Aetna Medicare |
$32.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.27
|
| Rate for Payer: BCBS MAPPO |
$31.44
|
| Rate for Payer: BCN Commercial |
$50.29
|
| Rate for Payer: BCN Medicare Advantage |
$31.44
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$45.27
|
| Rate for Payer: Cofinity Commercial |
$42.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.58
|
| Rate for Payer: Nomi Health Commercial |
$37.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$31.44
|
| Rate for Payer: PHP Commercial |
$44.02
|
| Rate for Payer: PHP Medicare Advantage |
$31.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.67
|
| Rate for Payer: Priority Health Medicare |
$31.44
|
| Rate for Payer: Priority Health SBD |
$50.67
|
| Rate for Payer: Priority Health Tiered Network |
$50.67
|
| Rate for Payer: Railroad Medicare Medicare |
$31.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.12
|
| Rate for Payer: UHC Core |
$45.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.44
|
| Rate for Payer: UHC Exchange |
$45.12
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
CHG RADIOLOGIC EXAMINATION SKULL 4< VIEWS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 70250
|
| Min. Negotiated Rate |
$22.54 |
| Max. Negotiated Rate |
$54.18 |
| Rate for Payer: Aetna Commercial |
$44.62
|
| Rate for Payer: Aetna Commercial |
$44.62
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Aetna Medicare |
$34.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.62
|
| Rate for Payer: BCBS MAPPO |
$33.30
|
| Rate for Payer: BCBS MAPPO |
$33.30
|
| Rate for Payer: BCN Commercial |
$53.78
|
| Rate for Payer: BCN Commercial |
$53.78
|
| Rate for Payer: BCN Medicare Advantage |
$33.30
|
| Rate for Payer: BCN Medicare Advantage |
$33.30
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$44.62
|
| Rate for Payer: Cofinity Commercial |
$47.95
|
| Rate for Payer: Cofinity Commercial |
$47.95
|
| Rate for Payer: Cofinity Commercial |
$44.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.63
|
| Rate for Payer: Nomi Health Commercial |
$39.96
|
| Rate for Payer: Nomi Health Commercial |
$39.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: PACE SWMI |
$33.30
|
| Rate for Payer: PACE SWMI |
$33.30
|
| Rate for Payer: PHP Commercial |
$46.62
|
| Rate for Payer: PHP Commercial |
$46.62
|
| Rate for Payer: PHP Medicare Advantage |
$33.30
|
| Rate for Payer: PHP Medicare Advantage |
$33.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$54.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$54.18
|
| Rate for Payer: Priority Health Medicare |
$33.30
|
| Rate for Payer: Priority Health Medicare |
$33.30
|
| Rate for Payer: Priority Health SBD |
$54.18
|
| Rate for Payer: Priority Health SBD |
$54.18
|
| Rate for Payer: Priority Health Tiered Network |
$54.18
|
| Rate for Payer: Priority Health Tiered Network |
$54.18
|
| Rate for Payer: Railroad Medicare Medicare |
$33.30
|
| Rate for Payer: Railroad Medicare Medicare |
$33.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.08
|
| Rate for Payer: UHC Core |
$50.08
|
| Rate for Payer: UHC Core |
$50.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.30
|
| Rate for Payer: UHC Exchange |
$50.08
|
| Rate for Payer: UHC Exchange |
$50.08
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
|
|
CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 73590
|
| Min. Negotiated Rate |
$29.27 |
| Max. Negotiated Rate |
$65.25 |
| Rate for Payer: Aetna Commercial |
$39.22
|
| Rate for Payer: Aetna Commercial |
$39.22
|
| Rate for Payer: Aetna Commercial |
$39.22
|
| Rate for Payer: Aetna Medicare |
$30.44
|
| Rate for Payer: Aetna Medicare |
$30.44
|
| Rate for Payer: Aetna Medicare |
$30.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.22
|
| Rate for Payer: BCBS MAPPO |
$29.27
|
| Rate for Payer: BCBS MAPPO |
$29.27
|
| Rate for Payer: BCBS MAPPO |
$29.27
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Commercial |
$47.31
|
| Rate for Payer: BCN Medicare Advantage |
$29.27
|
| Rate for Payer: BCN Medicare Advantage |
$29.27
|
| Rate for Payer: BCN Medicare Advantage |
$29.27
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cofinity Commercial |
$42.15
|
| Rate for Payer: Cofinity Commercial |
$42.15
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$39.22
|
| Rate for Payer: Cofinity Commercial |
$42.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.20
|
| Rate for Payer: Nomi Health Commercial |
$35.12
|
| Rate for Payer: Nomi Health Commercial |
$35.12
|
| Rate for Payer: Nomi Health Commercial |
$35.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: PACE SWMI |
$29.27
|
| Rate for Payer: PACE SWMI |
$29.27
|
| Rate for Payer: PACE SWMI |
$29.27
|
| Rate for Payer: PHP Commercial |
$40.98
|
| Rate for Payer: PHP Commercial |
$40.98
|
| Rate for Payer: PHP Commercial |
$40.98
|
| Rate for Payer: PHP Medicare Advantage |
$29.27
|
| Rate for Payer: PHP Medicare Advantage |
$29.27
|
| Rate for Payer: PHP Medicare Advantage |
$29.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.67
|
| Rate for Payer: Priority Health Medicare |
$29.27
|
| Rate for Payer: Priority Health Medicare |
$29.27
|
| Rate for Payer: Priority Health Medicare |
$29.27
|
| Rate for Payer: Priority Health SBD |
$47.67
|
| Rate for Payer: Priority Health SBD |
$47.67
|
| Rate for Payer: Priority Health SBD |
$47.67
|
| Rate for Payer: Priority Health Tiered Network |
$47.67
|
| Rate for Payer: Priority Health Tiered Network |
$47.67
|
| Rate for Payer: Priority Health Tiered Network |
$47.67
|
| Rate for Payer: Railroad Medicare Medicare |
$29.27
|
| Rate for Payer: Railroad Medicare Medicare |
$29.27
|
| Rate for Payer: Railroad Medicare Medicare |
$29.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.11
|
| Rate for Payer: UHC Core |
$43.11
|
| Rate for Payer: UHC Core |
$43.11
|
| Rate for Payer: UHC Core |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.27
|
| Rate for Payer: UHC Exchange |
$43.11
|
| Rate for Payer: UHC Exchange |
$43.11
|
| Rate for Payer: UHC Exchange |
$43.11
|
| Rate for Payer: UMR Bronson Commercial |
$40.02
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 73564
|
| Min. Negotiated Rate |
$28.98 |
| Max. Negotiated Rate |
$71.24 |
| Rate for Payer: Aetna Commercial |
$61.49
|
| Rate for Payer: Aetna Commercial |
$61.49
|
| Rate for Payer: Aetna Commercial |
$61.49
|
| Rate for Payer: Aetna Medicare |
$47.73
|
| Rate for Payer: Aetna Medicare |
$47.73
|
| Rate for Payer: Aetna Medicare |
$47.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.49
|
| Rate for Payer: BCBS MAPPO |
$45.89
|
| Rate for Payer: BCBS MAPPO |
$45.89
|
| Rate for Payer: BCBS MAPPO |
$45.89
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Commercial |
$70.71
|
| Rate for Payer: BCN Medicare Advantage |
$45.89
|
| Rate for Payer: BCN Medicare Advantage |
$45.89
|
| Rate for Payer: BCN Medicare Advantage |
$45.89
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$66.08
|
| Rate for Payer: Cofinity Commercial |
$66.08
|
| Rate for Payer: Cofinity Commercial |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$66.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.48
|
| Rate for Payer: Nomi Health Commercial |
$55.07
|
| Rate for Payer: Nomi Health Commercial |
$55.07
|
| Rate for Payer: Nomi Health Commercial |
$55.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$45.89
|
| Rate for Payer: PACE SWMI |
$45.89
|
| Rate for Payer: PACE SWMI |
$45.89
|
| Rate for Payer: PHP Commercial |
$64.25
|
| Rate for Payer: PHP Commercial |
$64.25
|
| Rate for Payer: PHP Commercial |
$64.25
|
| Rate for Payer: PHP Medicare Advantage |
$45.89
|
| Rate for Payer: PHP Medicare Advantage |
$45.89
|
| Rate for Payer: PHP Medicare Advantage |
$45.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$71.24
|
| Rate for Payer: Priority Health Medicare |
$45.89
|
| Rate for Payer: Priority Health Medicare |
$45.89
|
| Rate for Payer: Priority Health Medicare |
$45.89
|
| Rate for Payer: Priority Health SBD |
$71.24
|
| Rate for Payer: Priority Health SBD |
$71.24
|
| Rate for Payer: Priority Health SBD |
$71.24
|
| Rate for Payer: Priority Health Tiered Network |
$71.24
|
| Rate for Payer: Priority Health Tiered Network |
$71.24
|
| Rate for Payer: Priority Health Tiered Network |
$71.24
|
| Rate for Payer: Railroad Medicare Medicare |
$45.89
|
| Rate for Payer: Railroad Medicare Medicare |
$45.89
|
| Rate for Payer: Railroad Medicare Medicare |
$45.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.57
|
| Rate for Payer: UHC Core |
$61.57
|
| Rate for Payer: UHC Core |
$61.57
|
| Rate for Payer: UHC Core |
$61.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$45.89
|
| Rate for Payer: UHC Exchange |
$61.57
|
| Rate for Payer: UHC Exchange |
$61.57
|
| Rate for Payer: UHC Exchange |
$61.57
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
| Rate for Payer: UMR Bronson Commercial |
$53.36
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
CHG RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 72190
|
| Min. Negotiated Rate |
$26.22 |
| Max. Negotiated Rate |
$63.22 |
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: Aetna Commercial |
$54.35
|
| Rate for Payer: Aetna Medicare |
$42.18
|
| Rate for Payer: Aetna Medicare |
$42.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.35
|
| Rate for Payer: BCBS MAPPO |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$40.56
|
| Rate for Payer: BCN Commercial |
$62.75
|
| Rate for Payer: BCN Commercial |
$62.75
|
| Rate for Payer: BCN Medicare Advantage |
$40.56
|
| Rate for Payer: BCN Medicare Advantage |
$40.56
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Cofinity Commercial |
$54.35
|
| Rate for Payer: Cofinity Commercial |
$54.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.62
|
| Rate for Payer: Nomi Health Commercial |
$48.67
|
| Rate for Payer: Nomi Health Commercial |
$48.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$40.56
|
| Rate for Payer: PACE SWMI |
$40.56
|
| Rate for Payer: PHP Commercial |
$56.78
|
| Rate for Payer: PHP Commercial |
$56.78
|
| Rate for Payer: PHP Medicare Advantage |
$40.56
|
| Rate for Payer: PHP Medicare Advantage |
$40.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$63.22
|
| Rate for Payer: Priority Health Medicare |
$40.56
|
| Rate for Payer: Priority Health Medicare |
$40.56
|
| Rate for Payer: Priority Health SBD |
$63.22
|
| Rate for Payer: Priority Health SBD |
$63.22
|
| Rate for Payer: Priority Health Tiered Network |
$63.22
|
| Rate for Payer: Priority Health Tiered Network |
$63.22
|
| Rate for Payer: Railroad Medicare Medicare |
$40.56
|
| Rate for Payer: Railroad Medicare Medicare |
$40.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.28
|
| Rate for Payer: UHC Core |
$57.28
|
| Rate for Payer: UHC Core |
$57.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.56
|
| Rate for Payer: UHC Exchange |
$57.28
|
| Rate for Payer: UHC Exchange |
$57.28
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
CHG RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 72202
|
| Min. Negotiated Rate |
$23.92 |
| Max. Negotiated Rate |
$59.21 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$37.61
|
| Rate for Payer: Aetna Medicare |
$37.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.45
|
| Rate for Payer: BCBS MAPPO |
$36.16
|
| Rate for Payer: BCBS MAPPO |
$36.16
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.16
|
| Rate for Payer: BCN Medicare Advantage |
$36.16
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$52.07
|
| Rate for Payer: Cofinity Commercial |
$52.07
|
| Rate for Payer: Cofinity Commercial |
$48.45
|
| Rate for Payer: Cofinity Commercial |
$48.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.78
|
| Rate for Payer: Nomi Health Commercial |
$43.39
|
| Rate for Payer: Nomi Health Commercial |
$43.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.75
|
| Rate for Payer: PACE SWMI |
$36.16
|
| Rate for Payer: PACE SWMI |
$36.16
|
| Rate for Payer: PHP Commercial |
$50.62
|
| Rate for Payer: PHP Commercial |
$50.62
|
| Rate for Payer: PHP Medicare Advantage |
$36.16
|
| Rate for Payer: PHP Medicare Advantage |
$36.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59.21
|
| Rate for Payer: Priority Health Medicare |
$36.16
|
| Rate for Payer: Priority Health Medicare |
$36.16
|
| Rate for Payer: Priority Health SBD |
$59.21
|
| Rate for Payer: Priority Health SBD |
$59.21
|
| Rate for Payer: Priority Health Tiered Network |
$59.21
|
| Rate for Payer: Priority Health Tiered Network |
$59.21
|
| Rate for Payer: Railroad Medicare Medicare |
$36.16
|
| Rate for Payer: Railroad Medicare Medicare |
$36.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.75
|
| Rate for Payer: UHC Core |
$53.75
|
| Rate for Payer: UHC Core |
$53.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.16
|
| Rate for Payer: UHC Exchange |
$53.75
|
| Rate for Payer: UHC Exchange |
$53.75
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
|
|
CHG RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 70260
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna Commercial |
$54.78
|
| Rate for Payer: Aetna Medicare |
$42.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.87
|
| Rate for Payer: BCBS MAPPO |
$40.88
|
| Rate for Payer: BCN Commercial |
$66.73
|
| Rate for Payer: BCN Medicare Advantage |
$40.88
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$54.78
|
| Rate for Payer: Cofinity Commercial |
$58.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.97
|
| Rate for Payer: Nomi Health Commercial |
$49.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$40.88
|
| Rate for Payer: PHP Commercial |
$57.23
|
| Rate for Payer: PHP Medicare Advantage |
$40.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$67.23
|
| Rate for Payer: Priority Health Medicare |
$40.88
|
| Rate for Payer: Priority Health SBD |
$67.23
|
| Rate for Payer: Priority Health Tiered Network |
$67.23
|
| Rate for Payer: Railroad Medicare Medicare |
$40.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.34
|
| Rate for Payer: UHC Core |
$62.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.88
|
| Rate for Payer: UHC Exchange |
$62.34
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
CHG RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$243.00
|
|
|
Service Code
|
HCPCS 74250
|
| Min. Negotiated Rate |
$110.68 |
| Max. Negotiated Rate |
$182.25 |
| Rate for Payer: Aetna Commercial |
$148.31
|
| Rate for Payer: Aetna Medicare |
$115.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.38
|
| Rate for Payer: BCBS MAPPO |
$110.68
|
| Rate for Payer: BCN Commercial |
$179.28
|
| Rate for Payer: BCN Medicare Advantage |
$110.68
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cofinity Commercial |
$159.38
|
| Rate for Payer: Cofinity Commercial |
$148.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$121.75
|
| Rate for Payer: Nomi Health Commercial |
$132.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$182.25
|
| Rate for Payer: PACE SWMI |
$110.68
|
| Rate for Payer: PHP Commercial |
$154.95
|
| Rate for Payer: PHP Medicare Advantage |
$110.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$180.63
|
| Rate for Payer: Priority Health Medicare |
$110.68
|
| Rate for Payer: Priority Health SBD |
$180.63
|
| Rate for Payer: Priority Health Tiered Network |
$180.63
|
| Rate for Payer: Railroad Medicare Medicare |
$110.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.64
|
| Rate for Payer: UHC Core |
$171.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$110.68
|
| Rate for Payer: UHC Exchange |
$171.64
|
| Rate for Payer: UMR Bronson Commercial |
$111.78
|
|
|
CHG RADN RX DELIVERY COMPLX 11-19 MEV
|
Professional
|
Both
|
$489.00
|
|
|
Service Code
|
HCPCS 77414
|
| Min. Negotiated Rate |
$195.60 |
| Max. Negotiated Rate |
$366.75 |
| Rate for Payer: Aetna Medicare |
$244.50
|
| Rate for Payer: BCBS Complete |
$195.60
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.75
|
| Rate for Payer: UMR Bronson Commercial |
$224.94
|
|
|
CHG RADN RX DELIVERY COMPLX 6-10 MEV
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
HCPCS 77413
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$326.25 |
| Rate for Payer: Aetna Medicare |
$217.50
|
| Rate for Payer: BCBS Complete |
$174.00
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$326.25
|
| Rate for Payer: UMR Bronson Commercial |
$200.10
|
|
|
CHG RADN RX DELIVERY SIMPLE 11-19 MEV
|
Professional
|
Both
|
$269.00
|
|
|
Service Code
|
HCPCS 77404
|
| Min. Negotiated Rate |
$107.60 |
| Max. Negotiated Rate |
$201.75 |
| Rate for Payer: Aetna Medicare |
$134.50
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.75
|
| Rate for Payer: UMR Bronson Commercial |
$123.74
|
|
|
CHG RADN RX DELIVERY SIMPLE 6-10 MEV
|
Professional
|
Both
|
$241.00
|
|
|
Service Code
|
HCPCS 77403
|
| Min. Negotiated Rate |
$96.40 |
| Max. Negotiated Rate |
$180.75 |
| Rate for Payer: Aetna Medicare |
$120.50
|
| Rate for Payer: BCBS Complete |
$96.40
|
| Rate for Payer: Cash Price |
$192.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.75
|
| Rate for Payer: UMR Bronson Commercial |
$110.86
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,1 CHANNEL
|
Professional
|
Both
|
$318.00
|
|
|
Service Code
|
HCPCS 77785
|
| Min. Negotiated Rate |
$127.20 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Aetna Medicare |
$159.00
|
| Rate for Payer: Aetna Medicare |
$235.00
|
| Rate for Payer: BCBS Complete |
$188.00
|
| Rate for Payer: BCBS Complete |
$127.20
|
| Rate for Payer: Cash Price |
$254.40
|
| Rate for Payer: Cash Price |
$376.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.50
|
| Rate for Payer: UMR Bronson Commercial |
$146.28
|
| Rate for Payer: UMR Bronson Commercial |
$216.20
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,2-12 CHANNEL
|
Professional
|
Both
|
$702.00
|
|
|
Service Code
|
HCPCS 77786
|
| Min. Negotiated Rate |
$280.80 |
| Max. Negotiated Rate |
$526.50 |
| Rate for Payer: Aetna Medicare |
$351.00
|
| Rate for Payer: Aetna Medicare |
$517.50
|
| Rate for Payer: BCBS Complete |
$414.00
|
| Rate for Payer: BCBS Complete |
$280.80
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$828.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$776.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.50
|
| Rate for Payer: UMR Bronson Commercial |
$322.92
|
| Rate for Payer: UMR Bronson Commercial |
$476.10
|
|
|
CHG REPAIR,ILIAC ANRYSM/PSEUDO/AV MALF/TRAUMA W/ ENDOPROSTHESIS
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 75954
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$170.25 |
| Rate for Payer: Aetna Medicare |
$113.50
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$170.25
|
| Rate for Payer: UMR Bronson Commercial |
$104.42
|
|
