|
CHG CTA ABDOMEN W/CONTRAST&IMG POSTPROCESSING
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 74175
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$482.98 |
| Rate for Payer: Aetna Commercial |
$376.12
|
| Rate for Payer: Aetna Medicare |
$291.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$376.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.19
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCBS MAPPO |
$280.69
|
| Rate for Payer: BCN Commercial |
$467.17
|
| Rate for Payer: BCN Medicare Advantage |
$280.69
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$376.12
|
| Rate for Payer: Cofinity Commercial |
$404.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.72
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Nomi Health Commercial |
$336.83
|
| Rate for Payer: PACE SWMI |
$280.69
|
| Rate for Payer: PHP Commercial |
$392.97
|
| Rate for Payer: PHP Medicare Advantage |
$280.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$482.98
|
| Rate for Payer: Priority Health Medicare |
$280.69
|
| Rate for Payer: Priority Health Narrow Network |
$482.98
|
| Rate for Payer: Priority Health SBD |
$130.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.69
|
| Rate for Payer: UHC Medicare Advantage |
$280.69
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
| Rate for Payer: UMR Bronson Commercial |
$86.02
|
|
|
CHG CTA ABD&PLVS W/CNTRST & IMG POSTPROCESSING
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 74174
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$601.03 |
| Rate for Payer: Aetna Commercial |
$467.28
|
| Rate for Payer: Aetna Medicare |
$362.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$467.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$502.16
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$348.72
|
| Rate for Payer: BCN Commercial |
$579.57
|
| Rate for Payer: BCN Medicare Advantage |
$348.72
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$502.16
|
| Rate for Payer: Cofinity Commercial |
$467.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.16
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Nomi Health Commercial |
$418.46
|
| Rate for Payer: PACE SWMI |
$348.72
|
| Rate for Payer: PHP Commercial |
$488.21
|
| Rate for Payer: PHP Medicare Advantage |
$348.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$601.03
|
| Rate for Payer: Priority Health Medicare |
$348.72
|
| Rate for Payer: Priority Health Narrow Network |
$601.03
|
| Rate for Payer: Priority Health SBD |
$157.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.72
|
| Rate for Payer: UHC Medicare Advantage |
$348.72
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
| Rate for Payer: UMR Bronson Commercial |
$103.50
|
|
|
CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 74177
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$479.39 |
| Rate for Payer: Aetna Commercial |
$371.26
|
| Rate for Payer: Aetna Medicare |
$288.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$371.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$398.97
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCBS MAPPO |
$277.06
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: BCN Medicare Advantage |
$277.06
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Cofinity Commercial |
$398.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$290.91
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Nomi Health Commercial |
$332.47
|
| Rate for Payer: PACE SWMI |
$277.06
|
| Rate for Payer: PHP Commercial |
$387.88
|
| Rate for Payer: PHP Medicare Advantage |
$277.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$479.39
|
| Rate for Payer: Priority Health Medicare |
$277.06
|
| Rate for Payer: Priority Health Narrow Network |
$479.39
|
| Rate for Payer: Priority Health SBD |
$130.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.06
|
| Rate for Payer: UHC Medicare Advantage |
$277.06
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
| Rate for Payer: UMR Bronson Commercial |
$86.48
|
|
|
CHG CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 74176
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$288.97 |
| Rate for Payer: Aetna Commercial |
$228.58
|
| Rate for Payer: Aetna Medicare |
$177.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.64
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: BCBS MAPPO |
$170.58
|
| Rate for Payer: BCN Commercial |
$277.56
|
| Rate for Payer: BCN Medicare Advantage |
$170.58
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$245.64
|
| Rate for Payer: Cofinity Commercial |
$228.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.11
|
| Rate for Payer: Meridian Medicaid |
$54.80
|
| Rate for Payer: Nomi Health Commercial |
$204.70
|
| Rate for Payer: PACE SWMI |
$170.58
|
| Rate for Payer: PHP Commercial |
$238.81
|
| Rate for Payer: PHP Medicare Advantage |
$170.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$288.97
|
| Rate for Payer: Priority Health Medicare |
$170.58
|
| Rate for Payer: Priority Health Narrow Network |
$288.97
|
| Rate for Payer: Priority Health SBD |
$125.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.58
|
| Rate for Payer: UHC Medicare Advantage |
$170.58
|
| Rate for Payer: UHCCP Medicaid |
$52.19
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
|
|
CHG CT ABDOMEN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 74160
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$2,524.22 |
| Rate for Payer: Aetna Commercial |
$283.01
|
| Rate for Payer: Aetna Commercial |
$283.01
|
| Rate for Payer: Aetna Medicare |
$219.65
|
| Rate for Payer: Aetna Medicare |
$219.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.01
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$211.20
|
| Rate for Payer: BCBS MAPPO |
$211.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,524.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,524.22
|
| Rate for Payer: BCN Commercial |
$357.72
|
| Rate for Payer: BCN Commercial |
$357.72
|
| Rate for Payer: BCN Medicare Advantage |
$211.20
|
| Rate for Payer: BCN Medicare Advantage |
$211.20
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$283.01
|
| Rate for Payer: Cofinity Commercial |
$304.13
|
| Rate for Payer: Cofinity Commercial |
$304.13
|
| Rate for Payer: Cofinity Commercial |
$283.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.76
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Nomi Health Commercial |
$253.44
|
| Rate for Payer: Nomi Health Commercial |
$253.44
|
| Rate for Payer: PACE SWMI |
$211.20
|
| Rate for Payer: PACE SWMI |
$211.20
|
| Rate for Payer: PHP Commercial |
$295.68
|
| Rate for Payer: PHP Commercial |
$295.68
|
| Rate for Payer: PHP Medicare Advantage |
$211.20
|
| Rate for Payer: PHP Medicare Advantage |
$211.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$368.51
|
| Rate for Payer: Priority Health Medicare |
$211.20
|
| Rate for Payer: Priority Health Medicare |
$211.20
|
| Rate for Payer: Priority Health Narrow Network |
$368.51
|
| Rate for Payer: Priority Health Narrow Network |
$368.51
|
| Rate for Payer: Priority Health SBD |
$91.87
|
| Rate for Payer: Priority Health SBD |
$91.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.20
|
| Rate for Payer: UHC Medicare Advantage |
$211.20
|
| Rate for Payer: UHC Medicare Advantage |
$211.20
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
| Rate for Payer: UMR Bronson Commercial |
$60.72
|
|
|
CHG CT ABDOMEN W/O CONTRAST FLWD BY CONTRAST MATRL
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 74170
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$414.20 |
| Rate for Payer: Aetna Commercial |
$317.86
|
| Rate for Payer: Aetna Medicare |
$246.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$317.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$341.58
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCBS MAPPO |
$237.21
|
| Rate for Payer: BCN Commercial |
$401.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.21
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$317.86
|
| Rate for Payer: Cofinity Commercial |
$341.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.07
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Nomi Health Commercial |
$284.65
|
| Rate for Payer: PACE SWMI |
$237.21
|
| Rate for Payer: PHP Commercial |
$332.09
|
| Rate for Payer: PHP Medicare Advantage |
$237.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.20
|
| Rate for Payer: Priority Health Medicare |
$237.21
|
| Rate for Payer: Priority Health Narrow Network |
$414.20
|
| Rate for Payer: Priority Health SBD |
$100.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.21
|
| Rate for Payer: UHC Medicare Advantage |
$237.21
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
| Rate for Payer: UMR Bronson Commercial |
$66.24
|
|
|
CHG CT ABDOMEN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 74150
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$215.57 |
| Rate for Payer: Aetna Commercial |
$169.15
|
| Rate for Payer: Aetna Medicare |
$131.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.77
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCBS MAPPO |
$126.23
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: BCN Medicare Advantage |
$126.23
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cofinity Commercial |
$181.77
|
| Rate for Payer: Cofinity Commercial |
$169.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.54
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Nomi Health Commercial |
$151.48
|
| Rate for Payer: PACE SWMI |
$126.23
|
| Rate for Payer: PHP Commercial |
$176.72
|
| Rate for Payer: PHP Medicare Advantage |
$126.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.57
|
| Rate for Payer: Priority Health Medicare |
$126.23
|
| Rate for Payer: Priority Health Narrow Network |
$215.57
|
| Rate for Payer: Priority Health SBD |
$85.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.23
|
| Rate for Payer: UHC Medicare Advantage |
$126.23
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
| Rate for Payer: UMR Bronson Commercial |
$56.12
|
|
|
CHG CT ABD&PLV W/O CNTRST 1/BTH FLWD CNTRST 1/BTH
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 74178
|
| Min. Negotiated Rate |
$60.28 |
| Max. Negotiated Rate |
$537.89 |
| Rate for Payer: Aetna Commercial |
$415.55
|
| Rate for Payer: Aetna Medicare |
$322.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$415.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.56
|
| Rate for Payer: BCBS Complete |
$63.29
|
| Rate for Payer: BCBS MAPPO |
$310.11
|
| Rate for Payer: BCN Commercial |
$520.93
|
| Rate for Payer: BCN Medicare Advantage |
$310.11
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$415.55
|
| Rate for Payer: Cofinity Commercial |
$446.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$325.62
|
| Rate for Payer: Meridian Medicaid |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$372.13
|
| Rate for Payer: PACE SWMI |
$310.11
|
| Rate for Payer: PHP Commercial |
$434.15
|
| Rate for Payer: PHP Medicare Advantage |
$310.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$537.89
|
| Rate for Payer: Priority Health Medicare |
$310.11
|
| Rate for Payer: Priority Health Narrow Network |
$537.89
|
| Rate for Payer: Priority Health SBD |
$144.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.11
|
| Rate for Payer: UHC Medicare Advantage |
$310.11
|
| Rate for Payer: UHCCP Medicaid |
$60.28
|
| Rate for Payer: UMR Bronson Commercial |
$94.76
|
|
|
CHG CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 75574
|
| Min. Negotiated Rate |
$71.78 |
| Max. Negotiated Rate |
$508.13 |
| Rate for Payer: Aetna Commercial |
$399.63
|
| Rate for Payer: Aetna Medicare |
$310.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$399.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$429.45
|
| Rate for Payer: BCBS Complete |
$75.37
|
| Rate for Payer: BCBS MAPPO |
$298.23
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: BCN Medicare Advantage |
$298.23
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$429.45
|
| Rate for Payer: Cofinity Commercial |
$399.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$298.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$313.14
|
| Rate for Payer: Meridian Medicaid |
$75.37
|
| Rate for Payer: Nomi Health Commercial |
$357.88
|
| Rate for Payer: PACE SWMI |
$298.23
|
| Rate for Payer: PHP Commercial |
$417.52
|
| Rate for Payer: PHP Medicare Advantage |
$298.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$508.13
|
| Rate for Payer: Priority Health Medicare |
$298.23
|
| Rate for Payer: Priority Health Narrow Network |
$508.13
|
| Rate for Payer: Priority Health SBD |
$171.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$298.23
|
| Rate for Payer: UHC Medicare Advantage |
$298.23
|
| Rate for Payer: UHCCP Medicaid |
$71.78
|
| Rate for Payer: UMR Bronson Commercial |
$113.16
|
|
|
CHG CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 71275
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$444.48 |
| Rate for Payer: Aetna Commercial |
$347.69
|
| Rate for Payer: Aetna Medicare |
$269.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.64
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCBS MAPPO |
$259.47
|
| Rate for Payer: BCN Commercial |
$427.59
|
| Rate for Payer: BCN Medicare Advantage |
$259.47
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$347.69
|
| Rate for Payer: Cofinity Commercial |
$373.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$259.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$272.44
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Nomi Health Commercial |
$311.36
|
| Rate for Payer: PACE SWMI |
$259.47
|
| Rate for Payer: PHP Commercial |
$363.26
|
| Rate for Payer: PHP Medicare Advantage |
$259.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$444.48
|
| Rate for Payer: Priority Health Medicare |
$259.47
|
| Rate for Payer: Priority Health Narrow Network |
$444.48
|
| Rate for Payer: Priority Health SBD |
$130.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$259.47
|
| Rate for Payer: UHC Medicare Advantage |
$259.47
|
| Rate for Payer: UHCCP Medicaid |
$54.74
|
| Rate for Payer: UMR Bronson Commercial |
$86.48
|
|
|
CHG CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 70496
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$435.76 |
| Rate for Payer: Aetna Commercial |
$340.48
|
| Rate for Payer: Aetna Medicare |
$264.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.89
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$254.09
|
| Rate for Payer: BCN Commercial |
$419.77
|
| Rate for Payer: BCN Medicare Advantage |
$254.09
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$365.89
|
| Rate for Payer: Cofinity Commercial |
$340.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.79
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$304.91
|
| Rate for Payer: PACE SWMI |
$254.09
|
| Rate for Payer: PHP Commercial |
$355.73
|
| Rate for Payer: PHP Medicare Advantage |
$254.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.76
|
| Rate for Payer: Priority Health Medicare |
$254.09
|
| Rate for Payer: Priority Health Narrow Network |
$435.76
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.09
|
| Rate for Payer: UHC Medicare Advantage |
$254.09
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
| Rate for Payer: UMR Bronson Commercial |
$83.26
|
|
|
CHG CT ANGIOGRAPHY LOWER EXTREMITY
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 73706
|
| Min. Negotiated Rate |
$56.66 |
| Max. Negotiated Rate |
$510.18 |
| Rate for Payer: Aetna Commercial |
$397.07
|
| Rate for Payer: Aetna Medicare |
$308.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$426.70
|
| Rate for Payer: BCBS Complete |
$59.49
|
| Rate for Payer: BCBS MAPPO |
$296.32
|
| Rate for Payer: BCN Commercial |
$492.59
|
| Rate for Payer: BCN Medicare Advantage |
$296.32
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$397.07
|
| Rate for Payer: Cofinity Commercial |
$426.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.14
|
| Rate for Payer: Meridian Medicaid |
$59.49
|
| Rate for Payer: Nomi Health Commercial |
$355.58
|
| Rate for Payer: PACE SWMI |
$296.32
|
| Rate for Payer: PHP Commercial |
$414.85
|
| Rate for Payer: PHP Medicare Advantage |
$296.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.18
|
| Rate for Payer: Priority Health Medicare |
$296.32
|
| Rate for Payer: Priority Health Narrow Network |
$510.18
|
| Rate for Payer: Priority Health SBD |
$135.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.32
|
| Rate for Payer: UHC Medicare Advantage |
$296.32
|
| Rate for Payer: UHCCP Medicaid |
$56.66
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 70498
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$435.25 |
| Rate for Payer: Aetna Commercial |
$340.08
|
| Rate for Payer: Aetna Medicare |
$263.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.46
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCBS MAPPO |
$253.79
|
| Rate for Payer: BCN Commercial |
$419.28
|
| Rate for Payer: BCN Medicare Advantage |
$253.79
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cofinity Commercial |
$365.46
|
| Rate for Payer: Cofinity Commercial |
$340.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$253.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.48
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Nomi Health Commercial |
$304.55
|
| Rate for Payer: PACE SWMI |
$253.79
|
| Rate for Payer: PHP Commercial |
$355.31
|
| Rate for Payer: PHP Medicare Advantage |
$253.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$435.25
|
| Rate for Payer: Priority Health Medicare |
$253.79
|
| Rate for Payer: Priority Health Narrow Network |
$435.25
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$253.79
|
| Rate for Payer: UHC Medicare Advantage |
$253.79
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
| Rate for Payer: UMR Bronson Commercial |
$83.26
|
|
|
CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 72191
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$480.92 |
| Rate for Payer: Aetna Commercial |
$374.50
|
| Rate for Payer: Aetna Medicare |
$290.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$374.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$402.45
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$279.48
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: BCN Medicare Advantage |
$279.48
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$374.50
|
| Rate for Payer: Cofinity Commercial |
$402.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$293.45
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$335.38
|
| Rate for Payer: PACE SWMI |
$279.48
|
| Rate for Payer: PHP Commercial |
$391.27
|
| Rate for Payer: PHP Medicare Advantage |
$279.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$480.92
|
| Rate for Payer: Priority Health Medicare |
$279.48
|
| Rate for Payer: Priority Health Narrow Network |
$480.92
|
| Rate for Payer: Priority Health SBD |
$128.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.48
|
| Rate for Payer: UHC Medicare Advantage |
$279.48
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| Rate for Payer: UMR Bronson Commercial |
$85.10
|
|
|
CHG CT ANGIOGRAPHY UPPER EXTREMITY
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 73206
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$469.12 |
| Rate for Payer: Aetna Commercial |
$365.93
|
| Rate for Payer: Aetna Medicare |
$284.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$365.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$393.24
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$273.08
|
| Rate for Payer: BCN Commercial |
$453.00
|
| Rate for Payer: BCN Medicare Advantage |
$273.08
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$393.24
|
| Rate for Payer: Cofinity Commercial |
$365.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$286.73
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$327.70
|
| Rate for Payer: PACE SWMI |
$273.08
|
| Rate for Payer: PHP Commercial |
$382.31
|
| Rate for Payer: PHP Medicare Advantage |
$273.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$469.12
|
| Rate for Payer: Priority Health Medicare |
$273.08
|
| Rate for Payer: Priority Health Narrow Network |
$469.12
|
| Rate for Payer: Priority Health SBD |
$128.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$273.08
|
| Rate for Payer: UHC Medicare Advantage |
$273.08
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| Rate for Payer: UMR Bronson Commercial |
$85.10
|
|
|
CHG CT CERVICAL SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72126
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$266.38 |
| Rate for Payer: Aetna Commercial |
$208.06
|
| Rate for Payer: Aetna Medicare |
$161.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$223.59
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$155.27
|
| Rate for Payer: BCN Commercial |
$256.07
|
| Rate for Payer: BCN Medicare Advantage |
$155.27
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$208.06
|
| Rate for Payer: Cofinity Commercial |
$223.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.03
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$186.32
|
| Rate for Payer: PACE SWMI |
$155.27
|
| Rate for Payer: PHP Commercial |
$217.38
|
| Rate for Payer: PHP Medicare Advantage |
$155.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.38
|
| Rate for Payer: Priority Health Medicare |
$155.27
|
| Rate for Payer: Priority Health Narrow Network |
$266.38
|
| Rate for Payer: Priority Health SBD |
$87.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.27
|
| Rate for Payer: UHC Medicare Advantage |
$155.27
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
CHG CT CERVICAL SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72125
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$205.30 |
| Rate for Payer: Aetna Commercial |
$160.79
|
| Rate for Payer: Aetna Medicare |
$124.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.79
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.99
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$119.99
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$172.79
|
| Rate for Payer: Cofinity Commercial |
$160.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.99
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$143.99
|
| Rate for Payer: PACE SWMI |
$119.99
|
| Rate for Payer: PHP Commercial |
$167.99
|
| Rate for Payer: PHP Medicare Advantage |
$119.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.30
|
| Rate for Payer: Priority Health Medicare |
$119.99
|
| Rate for Payer: Priority Health Narrow Network |
$205.30
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.99
|
| Rate for Payer: UHC Medicare Advantage |
$119.99
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
| Rate for Payer: UMR Bronson Commercial |
$47.38
|
|
|
CHG CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72127
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$312.07 |
| Rate for Payer: Aetna Commercial |
$241.94
|
| Rate for Payer: Aetna Medicare |
$187.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.99
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$180.55
|
| Rate for Payer: BCN Commercial |
$300.05
|
| Rate for Payer: BCN Medicare Advantage |
$180.55
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$241.94
|
| Rate for Payer: Cofinity Commercial |
$259.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.58
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$216.66
|
| Rate for Payer: PACE SWMI |
$180.55
|
| Rate for Payer: PHP Commercial |
$252.77
|
| Rate for Payer: PHP Medicare Advantage |
$180.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.07
|
| Rate for Payer: Priority Health Medicare |
$180.55
|
| Rate for Payer: Priority Health Narrow Network |
$312.07
|
| Rate for Payer: Priority Health SBD |
$91.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.55
|
| Rate for Payer: UHC Medicare Advantage |
$180.55
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 74263
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$1,037.81 |
| Rate for Payer: Aetna Commercial |
$864.31
|
| Rate for Payer: Aetna Medicare |
$670.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$864.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.81
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCBS MAPPO |
$645.01
|
| Rate for Payer: BCN Commercial |
$1,004.72
|
| Rate for Payer: BCN Medicare Advantage |
$645.01
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cofinity Commercial |
$928.81
|
| Rate for Payer: Cofinity Commercial |
$864.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$645.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$677.26
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Nomi Health Commercial |
$774.01
|
| Rate for Payer: PACE SWMI |
$645.01
|
| Rate for Payer: PHP Commercial |
$903.01
|
| Rate for Payer: PHP Medicare Advantage |
$645.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,037.81
|
| Rate for Payer: Priority Health Medicare |
$645.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,037.81
|
| Rate for Payer: Priority Health SBD |
$164.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$645.01
|
| Rate for Payer: UHC Medicare Advantage |
$645.01
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
| Rate for Payer: UMR Bronson Commercial |
$108.10
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 74262
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$737.04 |
| Rate for Payer: Aetna Commercial |
$566.24
|
| Rate for Payer: Aetna Medicare |
$439.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$608.50
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCBS MAPPO |
$422.57
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: BCN Medicare Advantage |
$422.57
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cofinity Commercial |
$566.24
|
| Rate for Payer: Cofinity Commercial |
$608.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$422.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$443.70
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Nomi Health Commercial |
$507.08
|
| Rate for Payer: PACE SWMI |
$422.57
|
| Rate for Payer: PHP Commercial |
$591.60
|
| Rate for Payer: PHP Medicare Advantage |
$422.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$737.04
|
| Rate for Payer: Priority Health Medicare |
$422.57
|
| Rate for Payer: Priority Health Narrow Network |
$737.04
|
| Rate for Payer: Priority Health SBD |
$180.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$422.57
|
| Rate for Payer: UHC Medicare Advantage |
$422.57
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
| Rate for Payer: UMR Bronson Commercial |
$118.68
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
Both
|
$247.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$4,266.02 |
| Rate for Payer: Aetna Commercial |
$504.66
|
| Rate for Payer: Aetna Commercial |
$504.66
|
| Rate for Payer: Aetna Medicare |
$391.67
|
| Rate for Payer: Aetna Medicare |
$391.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$542.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.66
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS MAPPO |
$376.61
|
| Rate for Payer: BCBS MAPPO |
$376.61
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Medicare Advantage |
$376.61
|
| Rate for Payer: BCN Medicare Advantage |
$376.61
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cofinity Commercial |
$542.32
|
| Rate for Payer: Cofinity Commercial |
$542.32
|
| Rate for Payer: Cofinity Commercial |
$504.66
|
| Rate for Payer: Cofinity Commercial |
$504.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.44
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Nomi Health Commercial |
$451.93
|
| Rate for Payer: Nomi Health Commercial |
$451.93
|
| Rate for Payer: PACE SWMI |
$376.61
|
| Rate for Payer: PACE SWMI |
$376.61
|
| Rate for Payer: PHP Commercial |
$527.25
|
| Rate for Payer: PHP Commercial |
$527.25
|
| Rate for Payer: PHP Medicare Advantage |
$376.61
|
| Rate for Payer: PHP Medicare Advantage |
$376.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$654.92
|
| Rate for Payer: Priority Health Medicare |
$376.61
|
| Rate for Payer: Priority Health Medicare |
$376.61
|
| Rate for Payer: Priority Health Narrow Network |
$654.92
|
| Rate for Payer: Priority Health Narrow Network |
$654.92
|
| Rate for Payer: Priority Health SBD |
$172.46
|
| Rate for Payer: Priority Health SBD |
$172.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.61
|
| Rate for Payer: UHC Medicare Advantage |
$376.61
|
| Rate for Payer: UHC Medicare Advantage |
$376.61
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
| Rate for Payer: UMR Bronson Commercial |
$422.28
|
| Rate for Payer: UMR Bronson Commercial |
$113.62
|
|
|
CHG CT GUIDANCE &MONITORING VISC TISS ABLATION
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 77013
|
| Min. Negotiated Rate |
$115.45 |
| Max. Negotiated Rate |
$765.78 |
| Rate for Payer: Aetna Commercial |
$620.14
|
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$620.14
|
| Rate for Payer: BCBS Complete |
$121.22
|
| Rate for Payer: BCN Commercial |
$711.03
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Meridian Medicaid |
$121.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$765.78
|
| Rate for Payer: Priority Health Narrow Network |
$765.78
|
| Rate for Payer: Priority Health SBD |
$275.61
|
| Rate for Payer: UHCCP Medicaid |
$115.45
|
| Rate for Payer: UMR Bronson Commercial |
$182.62
|
|
|
CHG CT GUIDANCE NEEDLE PLACEMENT
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 77012
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$801.43 |
| Rate for Payer: Aetna Commercial |
$156.07
|
| Rate for Payer: Aetna Medicare |
$121.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.72
|
| Rate for Payer: BCBS Complete |
$46.07
|
| Rate for Payer: BCBS MAPPO |
$116.47
|
| Rate for Payer: BCBS Trust/PPO |
$801.43
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: BCN Medicare Advantage |
$116.47
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$167.72
|
| Rate for Payer: Cofinity Commercial |
$156.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.29
|
| Rate for Payer: Meridian Medicaid |
$46.07
|
| Rate for Payer: Nomi Health Commercial |
$139.76
|
| Rate for Payer: PACE SWMI |
$116.47
|
| Rate for Payer: PHP Commercial |
$163.06
|
| Rate for Payer: PHP Medicare Advantage |
$116.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$214.03
|
| Rate for Payer: Priority Health Medicare |
$116.47
|
| Rate for Payer: Priority Health Narrow Network |
$214.03
|
| Rate for Payer: Priority Health SBD |
$105.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.47
|
| Rate for Payer: UHC Medicare Advantage |
$116.47
|
| Rate for Payer: UHCCP Medicaid |
$43.88
|
| Rate for Payer: UMR Bronson Commercial |
$100.28
|
|
|
CHG CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT
|
Professional
|
Both
|
$322.00
|
|
|
Service Code
|
HCPCS 77014
|
| Min. Negotiated Rate |
$28.97 |
| Max. Negotiated Rate |
$1,757.13 |
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Commercial |
$145.20
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: Aetna Medicare |
$112.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.20
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS Complete |
$30.42
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS MAPPO |
$108.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,757.13
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Commercial |
$176.42
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: BCN Medicare Advantage |
$108.36
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$194.40
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cash Price |
$257.60
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Cofinity Commercial |
$156.04
|
| Rate for Payer: Cofinity Commercial |
$145.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.78
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Meridian Medicaid |
$30.42
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: Nomi Health Commercial |
$130.03
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PACE SWMI |
$108.36
|
| Rate for Payer: PHP Commercial |
$151.70
|
| Rate for Payer: PHP Commercial |
$151.70
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: PHP Medicare Advantage |
$108.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$184.26
|
| Rate for Payer: Priority Health Medicare |
$108.36
|
| Rate for Payer: Priority Health Medicare |
$108.36
|
| Rate for Payer: Priority Health Narrow Network |
$184.26
|
| Rate for Payer: Priority Health Narrow Network |
$184.26
|
| Rate for Payer: Priority Health SBD |
$68.26
|
| Rate for Payer: Priority Health SBD |
$68.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.36
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHC Medicare Advantage |
$108.36
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
| Rate for Payer: UHCCP Medicaid |
$28.97
|
| Rate for Payer: UMR Bronson Commercial |
$111.78
|
| Rate for Payer: UMR Bronson Commercial |
$148.12
|
|
|
CHG CT GUIDANCE STEREOTACTIC LOCALIZATION
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 77011
|
| Min. Negotiated Rate |
$38.98 |
| Max. Negotiated Rate |
$340.81 |
| Rate for Payer: Aetna Commercial |
$263.82
|
| Rate for Payer: Aetna Commercial |
$263.82
|
| Rate for Payer: Aetna Medicare |
$204.76
|
| Rate for Payer: Aetna Medicare |
$204.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$283.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$263.82
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS Complete |
$40.93
|
| Rate for Payer: BCBS MAPPO |
$196.88
|
| Rate for Payer: BCBS MAPPO |
$196.88
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCBS Trust/PPO |
$284.23
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Medicare Advantage |
$196.88
|
| Rate for Payer: BCN Medicare Advantage |
$196.88
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Cofinity Commercial |
$283.51
|
| Rate for Payer: Cofinity Commercial |
$283.51
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.72
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Meridian Medicaid |
$40.93
|
| Rate for Payer: Nomi Health Commercial |
$236.26
|
| Rate for Payer: Nomi Health Commercial |
$236.26
|
| Rate for Payer: PACE SWMI |
$196.88
|
| Rate for Payer: PACE SWMI |
$196.88
|
| Rate for Payer: PHP Commercial |
$275.63
|
| Rate for Payer: PHP Commercial |
$275.63
|
| Rate for Payer: PHP Medicare Advantage |
$196.88
|
| Rate for Payer: PHP Medicare Advantage |
$196.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$340.81
|
| Rate for Payer: Priority Health Medicare |
$196.88
|
| Rate for Payer: Priority Health Medicare |
$196.88
|
| Rate for Payer: Priority Health Narrow Network |
$340.81
|
| Rate for Payer: Priority Health Narrow Network |
$340.81
|
| Rate for Payer: Priority Health SBD |
$93.41
|
| Rate for Payer: Priority Health SBD |
$93.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.88
|
| Rate for Payer: UHC Medicare Advantage |
$196.88
|
| Rate for Payer: UHC Medicare Advantage |
$196.88
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
| Rate for Payer: UHCCP Medicaid |
$38.98
|
| Rate for Payer: UMR Bronson Commercial |
$61.64
|
| Rate for Payer: UMR Bronson Commercial |
$214.36
|
|
