|
CHG BASIC RADIATION DOSIMETRY CALCULATION
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 77300
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$205.51 |
| Rate for Payer: Aetna Commercial |
$82.61
|
| Rate for Payer: Aetna Commercial |
$82.61
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: Aetna Medicare |
$64.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.78
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$61.65
|
| Rate for Payer: BCBS MAPPO |
$61.65
|
| Rate for Payer: BCBS Trust/PPO |
$205.51
|
| Rate for Payer: BCBS Trust/PPO |
$205.51
|
| Rate for Payer: BCN Commercial |
$96.27
|
| Rate for Payer: BCN Commercial |
$96.27
|
| Rate for Payer: BCN Medicare Advantage |
$61.65
|
| Rate for Payer: BCN Medicare Advantage |
$61.65
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Cofinity Commercial |
$82.61
|
| Rate for Payer: Cofinity Commercial |
$82.61
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.73
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Nomi Health Commercial |
$73.98
|
| Rate for Payer: Nomi Health Commercial |
$73.98
|
| Rate for Payer: PACE SWMI |
$61.65
|
| Rate for Payer: PACE SWMI |
$61.65
|
| Rate for Payer: PHP Commercial |
$86.31
|
| Rate for Payer: PHP Commercial |
$86.31
|
| Rate for Payer: PHP Medicare Advantage |
$61.65
|
| Rate for Payer: PHP Medicare Advantage |
$61.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$101.63
|
| Rate for Payer: Priority Health Medicare |
$61.65
|
| Rate for Payer: Priority Health Medicare |
$61.65
|
| Rate for Payer: Priority Health Narrow Network |
$101.63
|
| Rate for Payer: Priority Health Narrow Network |
$101.63
|
| Rate for Payer: Priority Health SBD |
$49.79
|
| Rate for Payer: Priority Health SBD |
$49.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.65
|
| Rate for Payer: UHC Medicare Advantage |
$61.65
|
| Rate for Payer: UHC Medicare Advantage |
$61.65
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
CHG BILIRUBIN TOTAL
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 82247
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$4,644.29 |
| 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 Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,644.29
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| 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: Nomi Health Commercial |
$6.02
|
| 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 |
$14.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.99
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$4.99
|
| Rate for Payer: Priority Health SBD |
$4.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
CHG BILIRUBIN TOTAL TRANSCUTANEOUS
|
Professional
|
Both
|
$13.00
|
|
|
Service Code
|
HCPCS 88720
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$1,883.39 |
| 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 Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,883.39
|
| Rate for Payer: BCN Commercial |
$3.77
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$6.73
|
| 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: Nomi Health Commercial |
$6.02
|
| 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 |
$8.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.73
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health Narrow Network |
$7.73
|
| Rate for Payer: Priority Health SBD |
$7.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UMR Bronson Commercial |
$5.98
|
|
|
CHG BLOOD COUNT HEMOGLOBIN
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 85018
|
| Min. Negotiated Rate |
$2.33 |
| Max. Negotiated Rate |
$4,885.72 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.41
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCBS Trust/PPO |
$4,885.72
|
| Rate for Payer: BCN Commercial |
$2.37
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.18
|
| Rate for Payer: Cofinity Commercial |
$3.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Nomi Health Commercial |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Commercial |
$3.32
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: Priority Health Narrow Network |
$2.33
|
| Rate for Payer: Priority Health SBD |
$2.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.37
|
| Rate for Payer: UHC Medicare Advantage |
$2.37
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 82274
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$2,456.07 |
| Rate for Payer: Aetna Commercial |
$21.33
|
| Rate for Payer: Aetna Medicare |
$16.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.92
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,456.07
|
| Rate for Payer: BCN Commercial |
$15.92
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$21.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$19.10
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$22.29
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.98
|
| Rate for Payer: Priority Health Medicare |
$15.92
|
| Rate for Payer: Priority Health Narrow Network |
$15.98
|
| Rate for Payer: Priority Health SBD |
$15.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.92
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS 82272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$5,089.64 |
| Rate for Payer: Aetna Commercial |
$5.67
|
| Rate for Payer: Aetna Medicare |
$4.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.09
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$4.23
|
| Rate for Payer: BCBS Trust/PPO |
$5,089.64
|
| Rate for Payer: BCN Commercial |
$4.23
|
| Rate for Payer: BCN Medicare Advantage |
$4.23
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$5.67
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.44
|
| Rate for Payer: Nomi Health Commercial |
$5.08
|
| Rate for Payer: PACE SWMI |
$4.23
|
| Rate for Payer: PHP Commercial |
$5.92
|
| Rate for Payer: PHP Medicare Advantage |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.23
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: Priority Health SBD |
$4.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.23
|
| Rate for Payer: UHC Medicare Advantage |
$4.23
|
| Rate for Payer: UMR Bronson Commercial |
$4.60
|
|
|
CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82270
|
| Min. Negotiated Rate |
$4.33 |
| Max. Negotiated Rate |
$3,891.99 |
| Rate for Payer: Aetna Commercial |
$5.87
|
| Rate for Payer: Aetna Medicare |
$4.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.31
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,891.99
|
| Rate for Payer: BCN Commercial |
$4.38
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Nomi Health Commercial |
$5.26
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Commercial |
$6.13
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: Priority Health SBD |
$4.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.38
|
| Rate for Payer: UHC Medicare Advantage |
$4.38
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG BONE AGE STUDIES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 77072
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$3,140.74 |
| Rate for Payer: Priority Health Medicare |
$23.41
|
| Rate for Payer: Aetna Commercial |
$31.37
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.71
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$3,140.74
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$31.37
|
| Rate for Payer: Cofinity Commercial |
$33.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Nomi Health Commercial |
$28.09
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$32.77
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.03
|
| Rate for Payer: Priority Health Narrow Network |
$40.03
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.41
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
CHG BONE LENGTH STUDIES
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 77073
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$3,610.40 |
| Rate for Payer: Aetna Commercial |
$55.05
|
| Rate for Payer: Aetna Commercial |
$55.05
|
| Rate for Payer: Aetna Medicare |
$42.72
|
| Rate for Payer: Aetna Medicare |
$42.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.16
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$41.08
|
| Rate for Payer: BCBS MAPPO |
$41.08
|
| Rate for Payer: BCBS Trust/PPO |
$3,610.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,610.40
|
| Rate for Payer: BCN Commercial |
$65.97
|
| Rate for Payer: BCN Commercial |
$65.97
|
| Rate for Payer: BCN Medicare Advantage |
$41.08
|
| Rate for Payer: BCN Medicare Advantage |
$41.08
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Cofinity Commercial |
$59.16
|
| Rate for Payer: Cofinity Commercial |
$59.16
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.13
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Nomi Health Commercial |
$49.30
|
| Rate for Payer: Nomi Health Commercial |
$49.30
|
| Rate for Payer: PACE SWMI |
$41.08
|
| Rate for Payer: PACE SWMI |
$41.08
|
| Rate for Payer: PHP Commercial |
$57.51
|
| Rate for Payer: PHP Commercial |
$57.51
|
| Rate for Payer: PHP Medicare Advantage |
$41.08
|
| Rate for Payer: PHP Medicare Advantage |
$41.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$69.80
|
| Rate for Payer: Priority Health Medicare |
$41.08
|
| Rate for Payer: Priority Health Medicare |
$41.08
|
| Rate for Payer: Priority Health Narrow Network |
$69.80
|
| Rate for Payer: Priority Health Narrow Network |
$69.80
|
| Rate for Payer: Priority Health SBD |
$20.01
|
| Rate for Payer: Priority Health SBD |
$20.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$41.08
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
| Rate for Payer: UMR Bronson Commercial |
$61.64
|
|
|
CHG BRACHYTHER DOSE PLAN COMPLX
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 77328
|
| Min. Negotiated Rate |
$123.60 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna Medicare |
$263.00
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: UMR Bronson Commercial |
$142.14
|
| Rate for Payer: UMR Bronson Commercial |
$241.96
|
|
|
CHG BRACHYTHER DOSE PLAN SIMPLE
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 77326
|
| Min. Negotiated Rate |
$111.60 |
| Max. Negotiated Rate |
$181.35 |
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: UMR Bronson Commercial |
$84.64
|
| Rate for Payer: UMR Bronson Commercial |
$128.34
|
|
|
CHG BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 77318
|
| Min. Negotiated Rate |
$98.19 |
| Max. Negotiated Rate |
$1,342.41 |
| Rate for Payer: Aetna Commercial |
$563.23
|
| Rate for Payer: Aetna Commercial |
$563.23
|
| Rate for Payer: Aetna Medicare |
$437.13
|
| Rate for Payer: Aetna Medicare |
$437.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.23
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS Complete |
$103.10
|
| Rate for Payer: BCBS MAPPO |
$420.32
|
| Rate for Payer: BCBS MAPPO |
$420.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,342.41
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Commercial |
$666.06
|
| Rate for Payer: BCN Medicare Advantage |
$420.32
|
| Rate for Payer: BCN Medicare Advantage |
$420.32
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Cofinity Commercial |
$563.23
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Cofinity Commercial |
$563.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.34
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Meridian Medicaid |
$103.10
|
| Rate for Payer: Nomi Health Commercial |
$504.38
|
| Rate for Payer: Nomi Health Commercial |
$504.38
|
| Rate for Payer: PACE SWMI |
$420.32
|
| Rate for Payer: PACE SWMI |
$420.32
|
| Rate for Payer: PHP Commercial |
$588.45
|
| Rate for Payer: PHP Commercial |
$588.45
|
| Rate for Payer: PHP Medicare Advantage |
$420.32
|
| Rate for Payer: PHP Medicare Advantage |
$420.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$707.27
|
| Rate for Payer: Priority Health Medicare |
$420.32
|
| Rate for Payer: Priority Health Medicare |
$420.32
|
| Rate for Payer: Priority Health Narrow Network |
$707.27
|
| Rate for Payer: Priority Health Narrow Network |
$707.27
|
| Rate for Payer: Priority Health SBD |
$231.99
|
| Rate for Payer: Priority Health SBD |
$231.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.32
|
| Rate for Payer: UHC Medicare Advantage |
$420.32
|
| Rate for Payer: UHC Medicare Advantage |
$420.32
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
| Rate for Payer: UHCCP Medicaid |
$98.19
|
| Rate for Payer: UMR Bronson Commercial |
$295.78
|
| Rate for Payer: UMR Bronson Commercial |
$326.14
|
|
|
CHG CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 78472
|
| Min. Negotiated Rate |
$28.76 |
| Max. Negotiated Rate |
$429.51 |
| Rate for Payer: Aetna Commercial |
$249.11
|
| Rate for Payer: Aetna Medicare |
$193.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.70
|
| Rate for Payer: BCBS Complete |
$30.20
|
| Rate for Payer: BCBS MAPPO |
$185.90
|
| Rate for Payer: BCBS Trust/PPO |
$429.51
|
| Rate for Payer: BCN Commercial |
$311.29
|
| Rate for Payer: BCN Medicare Advantage |
$185.90
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$267.70
|
| Rate for Payer: Cofinity Commercial |
$249.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.20
|
| Rate for Payer: Meridian Medicaid |
$30.20
|
| Rate for Payer: Nomi Health Commercial |
$223.08
|
| Rate for Payer: PACE SWMI |
$185.90
|
| Rate for Payer: PHP Commercial |
$260.26
|
| Rate for Payer: PHP Medicare Advantage |
$185.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.86
|
| Rate for Payer: Priority Health Medicare |
$185.90
|
| Rate for Payer: Priority Health Narrow Network |
$323.86
|
| Rate for Payer: Priority Health SBD |
$69.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.90
|
| Rate for Payer: UHC Medicare Advantage |
$185.90
|
| Rate for Payer: UHCCP Medicaid |
$28.76
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
CHG CELL COUNT MISCELLANEOUS BODY FLUIDS
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 89050
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$2,396.37 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$4.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.80
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCBS Trust/PPO |
$2,396.37
|
| Rate for Payer: BCN Commercial |
$3.54
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Cofinity Commercial |
$6.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: Nomi Health Commercial |
$5.66
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Commercial |
$6.61
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.22
|
| Rate for Payer: Priority Health Medicare |
$4.72
|
| Rate for Payer: Priority Health Narrow Network |
$7.22
|
| Rate for Payer: Priority Health SBD |
$7.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.72
|
| Rate for Payer: UMR Bronson Commercial |
$5.06
|
|
|
CHG CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 78630
|
| Min. Negotiated Rate |
$20.02 |
| Max. Negotiated Rate |
$694.71 |
| Rate for Payer: Aetna Commercial |
$360.49
|
| Rate for Payer: Aetna Medicare |
$279.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$360.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.39
|
| Rate for Payer: BCBS Complete |
$21.02
|
| Rate for Payer: BCBS MAPPO |
$269.02
|
| Rate for Payer: BCBS Trust/PPO |
$694.71
|
| Rate for Payer: BCN Commercial |
$459.36
|
| Rate for Payer: BCN Medicare Advantage |
$269.02
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$360.49
|
| Rate for Payer: Cofinity Commercial |
$387.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.47
|
| Rate for Payer: Meridian Medicaid |
$21.02
|
| Rate for Payer: Nomi Health Commercial |
$322.82
|
| Rate for Payer: PACE SWMI |
$269.02
|
| Rate for Payer: PHP Commercial |
$376.63
|
| Rate for Payer: PHP Medicare Advantage |
$269.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$473.73
|
| Rate for Payer: Priority Health Medicare |
$269.02
|
| Rate for Payer: Priority Health Narrow Network |
$473.73
|
| Rate for Payer: Priority Health SBD |
$47.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$269.02
|
| Rate for Payer: UHC Medicare Advantage |
$269.02
|
| Rate for Payer: UHCCP Medicaid |
$20.02
|
| Rate for Payer: UMR Bronson Commercial |
$302.68
|
|
|
CHG CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 75984
|
| Min. Negotiated Rate |
$23.86 |
| Max. Negotiated Rate |
$389.89 |
| Rate for Payer: Aetna Commercial |
$115.63
|
| Rate for Payer: Aetna Commercial |
$115.63
|
| Rate for Payer: Aetna Medicare |
$89.74
|
| Rate for Payer: Aetna Medicare |
$89.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.26
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS Complete |
$25.05
|
| Rate for Payer: BCBS MAPPO |
$86.29
|
| Rate for Payer: BCBS MAPPO |
$86.29
|
| Rate for Payer: BCBS Trust/PPO |
$389.89
|
| Rate for Payer: BCBS Trust/PPO |
$389.89
|
| Rate for Payer: BCN Commercial |
$140.74
|
| Rate for Payer: BCN Commercial |
$140.74
|
| Rate for Payer: BCN Medicare Advantage |
$86.29
|
| Rate for Payer: BCN Medicare Advantage |
$86.29
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Cofinity Commercial |
$124.26
|
| Rate for Payer: Cofinity Commercial |
$124.26
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.60
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Meridian Medicaid |
$25.05
|
| Rate for Payer: Nomi Health Commercial |
$103.55
|
| Rate for Payer: Nomi Health Commercial |
$103.55
|
| Rate for Payer: PACE SWMI |
$86.29
|
| Rate for Payer: PACE SWMI |
$86.29
|
| Rate for Payer: PHP Commercial |
$120.81
|
| Rate for Payer: PHP Commercial |
$120.81
|
| Rate for Payer: PHP Medicare Advantage |
$86.29
|
| Rate for Payer: PHP Medicare Advantage |
$86.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$146.79
|
| Rate for Payer: Priority Health Medicare |
$86.29
|
| Rate for Payer: Priority Health Medicare |
$86.29
|
| Rate for Payer: Priority Health Narrow Network |
$146.79
|
| Rate for Payer: Priority Health Narrow Network |
$146.79
|
| Rate for Payer: Priority Health SBD |
$57.48
|
| Rate for Payer: Priority Health SBD |
$57.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.29
|
| Rate for Payer: UHC Medicare Advantage |
$86.29
|
| Rate for Payer: UHC Medicare Advantage |
$86.29
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
| Rate for Payer: UHCCP Medicaid |
$23.86
|
| Rate for Payer: UMR Bronson Commercial |
$73.60
|
| Rate for Payer: UMR Bronson Commercial |
$63.48
|
|
|
CHG CHEST X-RAY 1 VW
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 71010
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: UMR Bronson Commercial |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$33.58
|
|
|
CHG CHEST X-RAY 2 VW
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 71020
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Medicare |
$22.00
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
CHG CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 74300
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$79.16 |
| Rate for Payer: Aetna Commercial |
$45.81
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.81
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCN Commercial |
$79.16
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.97
|
| Rate for Payer: Priority Health Narrow Network |
$56.97
|
| Rate for Payer: Priority Health SBD |
$20.01
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
CHG CHOLESTEROL SERUM/WHOLE BLOOD TOTAL
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82465
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$1,764.52 |
| Rate for Payer: Aetna Commercial |
$5.83
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.26
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,764.52
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.26
|
| Rate for Payer: Cofinity Commercial |
$5.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Nomi Health Commercial |
$5.22
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$6.09
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: Priority Health SBD |
$4.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.35
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 71271
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$217.11 |
| Rate for Payer: Aetna Commercial |
$170.41
|
| Rate for Payer: Aetna Medicare |
$132.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.41
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCBS MAPPO |
$127.17
|
| Rate for Payer: BCN Commercial |
$208.66
|
| Rate for Payer: BCN Medicare Advantage |
$127.17
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$183.12
|
| Rate for Payer: Cofinity Commercial |
$170.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.53
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$152.60
|
| Rate for Payer: PACE SWMI |
$127.17
|
| Rate for Payer: PHP Commercial |
$178.04
|
| Rate for Payer: PHP Medicare Advantage |
$127.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$217.11
|
| Rate for Payer: Priority Health Medicare |
$127.17
|
| Rate for Payer: Priority Health Narrow Network |
$217.11
|
| Rate for Payer: Priority Health SBD |
$78.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.17
|
| Rate for Payer: UHC Medicare Advantage |
$127.17
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
| Rate for Payer: UMR Bronson Commercial |
$51.52
|
|
|
CHG CONTINUING MEDICAL PHYSICS CONSLTJ PR WK
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 77336
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$2,156.52 |
| Rate for Payer: Aetna Commercial |
$108.98
|
| Rate for Payer: Aetna Medicare |
$84.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.12
|
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: BCBS MAPPO |
$81.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: BCN Medicare Advantage |
$81.33
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$108.98
|
| Rate for Payer: Cofinity Commercial |
$117.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.40
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: PACE SWMI |
$81.33
|
| Rate for Payer: PHP Commercial |
$113.86
|
| Rate for Payer: PHP Medicare Advantage |
$81.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.04
|
| Rate for Payer: Priority Health Medicare |
$81.33
|
| Rate for Payer: Priority Health Narrow Network |
$137.04
|
| Rate for Payer: Priority Health SBD |
$137.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.33
|
| Rate for Payer: UHC Medicare Advantage |
$81.33
|
| Rate for Payer: UMR Bronson Commercial |
$70.84
|
|
|
CHG CREATININE OTHER SOURCE
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 82570
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$2,406.93 |
| 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 Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.93
|
| Rate for Payer: BCN Commercial |
$3.89
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| 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: Nomi Health Commercial |
$6.22
|
| 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 |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: Priority Health SBD |
$5.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UMR Bronson Commercial |
$5.06
|
|
|
CHG CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 89060
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$2,750.86 |
| Rate for Payer: Aetna Commercial |
$9.82
|
| Rate for Payer: Aetna Medicare |
$7.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.82
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.86
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$10.56
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Nomi Health Commercial |
$8.80
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$10.26
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.16
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$38.16
|
| Rate for Payer: Priority Health SBD |
$26.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.33
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
CHG CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 75635
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$648.75 |
| Rate for Payer: Aetna Commercial |
$505.17
|
| Rate for Payer: Aetna Medicare |
$392.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.87
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS MAPPO |
$376.99
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$622.09
|
| Rate for Payer: BCN Medicare Advantage |
$376.99
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$505.17
|
| Rate for Payer: Cofinity Commercial |
$542.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.84
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Nomi Health Commercial |
$452.39
|
| Rate for Payer: PACE SWMI |
$376.99
|
| Rate for Payer: PHP Commercial |
$527.79
|
| Rate for Payer: PHP Medicare Advantage |
$376.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$648.75
|
| Rate for Payer: Priority Health Medicare |
$376.99
|
| Rate for Payer: Priority Health Narrow Network |
$648.75
|
| Rate for Payer: Priority Health SBD |
$170.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.99
|
| Rate for Payer: UHC Medicare Advantage |
$376.99
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
| Rate for Payer: UMR Bronson Commercial |
$140.76
|
|
