|
CHG CT HEAD/BRAIN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 70460
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$234.04 |
| Rate for Payer: Aetna Commercial |
$183.63
|
| Rate for Payer: Aetna Medicare |
$142.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.34
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$137.04
|
| Rate for Payer: BCN Commercial |
$224.30
|
| Rate for Payer: BCN Medicare Advantage |
$137.04
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$183.63
|
| Rate for Payer: Cofinity Commercial |
$197.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.89
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$164.45
|
| Rate for Payer: PACE SWMI |
$137.04
|
| Rate for Payer: PHP Commercial |
$191.86
|
| Rate for Payer: PHP Medicare Advantage |
$137.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.04
|
| Rate for Payer: Priority Health Medicare |
$137.04
|
| Rate for Payer: Priority Health Narrow Network |
$234.04
|
| Rate for Payer: Priority Health SBD |
$81.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.04
|
| Rate for Payer: UHC Medicare Advantage |
$137.04
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 70450
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$167.33 |
| Rate for Payer: Aetna Commercial |
$132.18
|
| Rate for Payer: Aetna Medicare |
$102.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.04
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$98.64
|
| Rate for Payer: BCN Commercial |
$160.77
|
| Rate for Payer: BCN Medicare Advantage |
$98.64
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$142.04
|
| Rate for Payer: Cofinity Commercial |
$132.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.57
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Nomi Health Commercial |
$118.37
|
| Rate for Payer: PACE SWMI |
$98.64
|
| Rate for Payer: PHP Commercial |
$138.10
|
| Rate for Payer: PHP Medicare Advantage |
$98.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.33
|
| Rate for Payer: Priority Health Medicare |
$98.64
|
| Rate for Payer: Priority Health Narrow Network |
$167.33
|
| Rate for Payer: Priority Health SBD |
$61.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.64
|
| Rate for Payer: UHC Medicare Advantage |
$98.64
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
| Rate for Payer: UMR Bronson Commercial |
$40.48
|
|
|
CHG CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 70470
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$274.09 |
| Rate for Payer: Aetna Commercial |
$214.29
|
| Rate for Payer: Aetna Medicare |
$166.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$230.28
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS MAPPO |
$159.92
|
| Rate for Payer: BCN Commercial |
$263.88
|
| Rate for Payer: BCN Medicare Advantage |
$159.92
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$214.29
|
| Rate for Payer: Cofinity Commercial |
$230.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.92
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Nomi Health Commercial |
$191.90
|
| Rate for Payer: PACE SWMI |
$159.92
|
| Rate for Payer: PHP Commercial |
$223.89
|
| Rate for Payer: PHP Medicare Advantage |
$159.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$274.09
|
| Rate for Payer: Priority Health Medicare |
$159.92
|
| Rate for Payer: Priority Health Narrow Network |
$274.09
|
| Rate for Payer: Priority Health SBD |
$91.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.92
|
| Rate for Payer: UHC Medicare Advantage |
$159.92
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
| Rate for Payer: UMR Bronson Commercial |
$60.72
|
|
|
CHG CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH
|
Professional
|
Both
|
$179.00
|
|
|
Service Code
|
HCPCS 75572
|
| Min. Negotiated Rate |
$51.97 |
| Max. Negotiated Rate |
$359.28 |
| Rate for Payer: Aetna Commercial |
$281.92
|
| Rate for Payer: Aetna Medicare |
$218.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$281.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$302.96
|
| Rate for Payer: BCBS Complete |
$54.57
|
| Rate for Payer: BCBS MAPPO |
$210.39
|
| Rate for Payer: BCN Commercial |
$343.54
|
| Rate for Payer: BCN Medicare Advantage |
$210.39
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$302.96
|
| Rate for Payer: Cofinity Commercial |
$281.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.91
|
| Rate for Payer: Meridian Medicaid |
$54.57
|
| Rate for Payer: Nomi Health Commercial |
$252.47
|
| Rate for Payer: PACE SWMI |
$210.39
|
| Rate for Payer: PHP Commercial |
$294.55
|
| Rate for Payer: PHP Medicare Advantage |
$210.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$116.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$359.28
|
| Rate for Payer: Priority Health Medicare |
$210.39
|
| Rate for Payer: Priority Health Narrow Network |
$359.28
|
| Rate for Payer: Priority Health SBD |
$124.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$210.39
|
| Rate for Payer: UHC Medicare Advantage |
$210.39
|
| Rate for Payer: UHCCP Medicaid |
$51.97
|
| Rate for Payer: UMR Bronson Commercial |
$82.34
|
|
|
CHG CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 75571
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$157.57 |
| Rate for Payer: Aetna Commercial |
$123.63
|
| Rate for Payer: Aetna Medicare |
$95.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.85
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$92.26
|
| Rate for Payer: BCN Commercial |
$151.00
|
| Rate for Payer: BCN Medicare Advantage |
$92.26
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$123.63
|
| Rate for Payer: Cofinity Commercial |
$132.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.87
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Nomi Health Commercial |
$110.71
|
| Rate for Payer: PACE SWMI |
$92.26
|
| Rate for Payer: PHP Commercial |
$129.16
|
| Rate for Payer: PHP Medicare Advantage |
$92.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.57
|
| Rate for Payer: Priority Health Medicare |
$92.26
|
| Rate for Payer: Priority Health Narrow Network |
$157.57
|
| Rate for Payer: Priority Health SBD |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$92.26
|
| Rate for Payer: UHC Medicare Advantage |
$92.26
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
CHG CT LIMITED/LOCALIZED FOLLOW UP STUDY
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 76380
|
| Min. Negotiated Rate |
$28.54 |
| Max. Negotiated Rate |
$954.11 |
| Rate for Payer: Aetna Commercial |
$161.62
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$161.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$173.68
|
| Rate for Payer: BCBS Complete |
$29.97
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$161.62
|
| Rate for Payer: Cofinity Commercial |
$173.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: Meridian Medicaid |
$29.97
|
| Rate for Payer: Nomi Health Commercial |
$144.73
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PHP Commercial |
$168.85
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$206.34
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Narrow Network |
$206.34
|
| Rate for Payer: Priority Health SBD |
$68.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Medicare Advantage |
$120.61
|
| Rate for Payer: UHCCP Medicaid |
$28.54
|
| Rate for Payer: UMR Bronson Commercial |
$70.38
|
|
|
CHG CT LOWER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 73701
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$263.29 |
| Rate for Payer: Aetna Commercial |
$205.46
|
| Rate for Payer: Aetna Medicare |
$159.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.80
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$153.33
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: BCN Medicare Advantage |
$153.33
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$205.46
|
| Rate for Payer: Cofinity Commercial |
$220.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.00
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$184.00
|
| Rate for Payer: PACE SWMI |
$153.33
|
| Rate for Payer: PHP Commercial |
$214.66
|
| Rate for Payer: PHP Medicare Advantage |
$153.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$263.29
|
| Rate for Payer: Priority Health Medicare |
$153.33
|
| Rate for Payer: Priority Health Narrow Network |
$263.29
|
| Rate for Payer: Priority Health SBD |
$83.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.33
|
| Rate for Payer: UHC Medicare Advantage |
$153.33
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$54.74
|
|
|
CHG CT LOWER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 73700
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$204.27 |
| Rate for Payer: Aetna Commercial |
$160.40
|
| Rate for Payer: Aetna Medicare |
$124.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.37
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.70
|
| Rate for Payer: BCN Commercial |
$195.96
|
| Rate for Payer: BCN Medicare Advantage |
$119.70
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$172.37
|
| Rate for Payer: Cofinity Commercial |
$160.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.68
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$143.64
|
| Rate for Payer: PACE SWMI |
$119.70
|
| Rate for Payer: PHP Commercial |
$167.58
|
| Rate for Payer: PHP Medicare Advantage |
$119.70
|
| 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 |
$204.27
|
| Rate for Payer: Priority Health Medicare |
$119.70
|
| Rate for Payer: Priority Health Narrow Network |
$204.27
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.70
|
| Rate for Payer: UHC Medicare Advantage |
$119.70
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
| Rate for Payer: UMR Bronson Commercial |
$47.38
|
|
|
CHG CT LOWER EXTREMITY W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 73702
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$308.47 |
| Rate for Payer: Aetna Commercial |
$240.05
|
| Rate for Payer: Aetna Medicare |
$186.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.96
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$179.14
|
| Rate for Payer: BCN Commercial |
$296.63
|
| Rate for Payer: BCN Medicare Advantage |
$179.14
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$240.05
|
| Rate for Payer: Cofinity Commercial |
$257.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$179.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$188.10
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Nomi Health Commercial |
$214.97
|
| Rate for Payer: PACE SWMI |
$179.14
|
| Rate for Payer: PHP Commercial |
$250.80
|
| Rate for Payer: PHP Medicare Advantage |
$179.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$308.47
|
| Rate for Payer: Priority Health Medicare |
$179.14
|
| Rate for Payer: Priority Health Narrow Network |
$308.47
|
| Rate for Payer: Priority Health SBD |
$87.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$179.14
|
| Rate for Payer: UHC Medicare Advantage |
$179.14
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
CHG CT LUMBAR SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72132
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$266.90 |
| Rate for Payer: Aetna Commercial |
$208.85
|
| Rate for Payer: Aetna Medicare |
$162.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.44
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$155.86
|
| Rate for Payer: BCN Commercial |
$256.56
|
| Rate for Payer: BCN Medicare Advantage |
$155.86
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$224.44
|
| Rate for Payer: Cofinity Commercial |
$208.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.65
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$187.03
|
| Rate for Payer: PACE SWMI |
$155.86
|
| Rate for Payer: PHP Commercial |
$218.20
|
| Rate for Payer: PHP Medicare Advantage |
$155.86
|
| 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 |
$266.90
|
| Rate for Payer: Priority Health Medicare |
$155.86
|
| Rate for Payer: Priority Health Narrow Network |
$266.90
|
| Rate for Payer: Priority Health SBD |
$87.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.86
|
| Rate for Payer: UHC Medicare Advantage |
$155.86
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
CHG CT LUMBAR SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72131
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$203.76 |
| Rate for Payer: Aetna Commercial |
$160.01
|
| Rate for Payer: Aetna Medicare |
$124.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.95
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$119.41
|
| Rate for Payer: BCN Commercial |
$195.47
|
| Rate for Payer: BCN Medicare Advantage |
$119.41
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Cofinity Commercial |
$171.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.38
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$143.29
|
| Rate for Payer: PACE SWMI |
$119.41
|
| Rate for Payer: PHP Commercial |
$167.17
|
| Rate for Payer: PHP Medicare Advantage |
$119.41
|
| 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 |
$203.76
|
| Rate for Payer: Priority Health Medicare |
$119.41
|
| Rate for Payer: Priority Health Narrow Network |
$203.76
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$119.41
|
| Rate for Payer: UHC Medicare Advantage |
$119.41
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
| Rate for Payer: UMR Bronson Commercial |
$47.38
|
|
|
CHG CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72133
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$312.57 |
| Rate for Payer: Aetna Commercial |
$242.34
|
| Rate for Payer: Aetna Medicare |
$188.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.42
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$180.85
|
| Rate for Payer: BCN Commercial |
$301.02
|
| Rate for Payer: BCN Medicare Advantage |
$180.85
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$260.42
|
| Rate for Payer: Cofinity Commercial |
$242.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.89
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$217.02
|
| Rate for Payer: PACE SWMI |
$180.85
|
| Rate for Payer: PHP Commercial |
$253.19
|
| Rate for Payer: PHP Medicare Advantage |
$180.85
|
| 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 |
$312.57
|
| Rate for Payer: Priority Health Medicare |
$180.85
|
| Rate for Payer: Priority Health Narrow Network |
$312.57
|
| Rate for Payer: Priority Health SBD |
$91.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.85
|
| Rate for Payer: UHC Medicare Advantage |
$180.85
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG CT MAXILLOFACIAL W/CONTRAST MATERIAL
|
Professional
|
Both
|
$116.00
|
|
|
Service Code
|
HCPCS 70487
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$240.21 |
| Rate for Payer: Aetna Commercial |
$187.98
|
| Rate for Payer: Aetna Medicare |
$145.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$187.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.00
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$140.28
|
| Rate for Payer: BCN Commercial |
$230.66
|
| Rate for Payer: BCN Medicare Advantage |
$140.28
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$187.98
|
| Rate for Payer: Cofinity Commercial |
$202.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.29
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$168.34
|
| Rate for Payer: PACE SWMI |
$140.28
|
| Rate for Payer: PHP Commercial |
$196.39
|
| Rate for Payer: PHP Medicare Advantage |
$140.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.21
|
| Rate for Payer: Priority Health Medicare |
$140.28
|
| Rate for Payer: Priority Health Narrow Network |
$240.21
|
| Rate for Payer: Priority Health SBD |
$81.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.28
|
| Rate for Payer: UHC Medicare Advantage |
$140.28
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
| Rate for Payer: UMR Bronson Commercial |
$53.36
|
|
|
CHG CT MAXILLOFACIAL W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$88.00
|
|
|
Service Code
|
HCPCS 70486
|
| Min. Negotiated Rate |
$25.77 |
| Max. Negotiated Rate |
$202.22 |
| Rate for Payer: Aetna Commercial |
$157.84
|
| Rate for Payer: Aetna Medicare |
$122.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.62
|
| Rate for Payer: BCBS Complete |
$27.06
|
| Rate for Payer: BCBS MAPPO |
$117.79
|
| Rate for Payer: BCN Commercial |
$194.49
|
| Rate for Payer: BCN Medicare Advantage |
$117.79
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$169.62
|
| Rate for Payer: Cofinity Commercial |
$157.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.68
|
| Rate for Payer: Meridian Medicaid |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$141.35
|
| Rate for Payer: PACE SWMI |
$117.79
|
| Rate for Payer: PHP Commercial |
$164.91
|
| Rate for Payer: PHP Medicare Advantage |
$117.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$202.22
|
| Rate for Payer: Priority Health Medicare |
$117.79
|
| Rate for Payer: Priority Health Narrow Network |
$202.22
|
| Rate for Payer: Priority Health SBD |
$61.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.79
|
| Rate for Payer: UHC Medicare Advantage |
$117.79
|
| Rate for Payer: UHCCP Medicaid |
$25.77
|
| Rate for Payer: UMR Bronson Commercial |
$40.48
|
|
|
CHG CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 70488
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$291.02 |
| Rate for Payer: Aetna Commercial |
$226.93
|
| Rate for Payer: Aetna Medicare |
$176.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$226.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.86
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$169.35
|
| Rate for Payer: BCN Commercial |
$280.99
|
| Rate for Payer: BCN Medicare Advantage |
$169.35
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$226.93
|
| Rate for Payer: Cofinity Commercial |
$243.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$177.82
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$203.22
|
| Rate for Payer: PACE SWMI |
$169.35
|
| Rate for Payer: PHP Commercial |
$237.09
|
| Rate for Payer: PHP Medicare Advantage |
$169.35
|
| 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 |
$291.02
|
| Rate for Payer: Priority Health Medicare |
$169.35
|
| Rate for Payer: Priority Health Narrow Network |
$291.02
|
| Rate for Payer: Priority Health SBD |
$91.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.35
|
| Rate for Payer: UHC Medicare Advantage |
$169.35
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 70481
|
| Min. Negotiated Rate |
$33.87 |
| Max. Negotiated Rate |
$285.37 |
| Rate for Payer: Aetna Commercial |
$221.93
|
| Rate for Payer: Aetna Medicare |
$172.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$238.49
|
| Rate for Payer: BCBS Complete |
$35.56
|
| Rate for Payer: BCBS MAPPO |
$165.62
|
| Rate for Payer: BCN Commercial |
$274.63
|
| Rate for Payer: BCN Medicare Advantage |
$165.62
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$238.49
|
| Rate for Payer: Cofinity Commercial |
$221.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.90
|
| Rate for Payer: Meridian Medicaid |
$35.56
|
| Rate for Payer: Nomi Health Commercial |
$198.74
|
| Rate for Payer: PACE SWMI |
$165.62
|
| Rate for Payer: PHP Commercial |
$231.87
|
| Rate for Payer: PHP Medicare Advantage |
$165.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$285.37
|
| Rate for Payer: Priority Health Medicare |
$165.62
|
| Rate for Payer: Priority Health Narrow Network |
$285.37
|
| Rate for Payer: Priority Health SBD |
$81.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$165.62
|
| Rate for Payer: UHC Medicare Advantage |
$165.62
|
| Rate for Payer: UHCCP Medicaid |
$33.87
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 70480
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$250.99 |
| Rate for Payer: Aetna Commercial |
$196.97
|
| Rate for Payer: Aetna Medicare |
$152.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$211.67
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$146.99
|
| Rate for Payer: BCN Commercial |
$240.43
|
| Rate for Payer: BCN Medicare Advantage |
$146.99
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$196.97
|
| Rate for Payer: Cofinity Commercial |
$211.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.34
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$176.39
|
| Rate for Payer: PACE SWMI |
$146.99
|
| Rate for Payer: PHP Commercial |
$205.79
|
| Rate for Payer: PHP Medicare Advantage |
$146.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$250.99
|
| Rate for Payer: Priority Health Medicare |
$146.99
|
| Rate for Payer: Priority Health Narrow Network |
$250.99
|
| Rate for Payer: Priority Health SBD |
$92.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$146.99
|
| Rate for Payer: UHC Medicare Advantage |
$146.99
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
| Rate for Payer: UMR Bronson Commercial |
$61.18
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 70482
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$333.11 |
| Rate for Payer: Aetna Commercial |
$258.12
|
| Rate for Payer: Aetna Medicare |
$200.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$258.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.39
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCBS MAPPO |
$192.63
|
| Rate for Payer: BCN Commercial |
$320.57
|
| Rate for Payer: BCN Medicare Advantage |
$192.63
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$277.39
|
| Rate for Payer: Cofinity Commercial |
$258.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$202.26
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Nomi Health Commercial |
$231.16
|
| Rate for Payer: PACE SWMI |
$192.63
|
| Rate for Payer: PHP Commercial |
$269.68
|
| Rate for Payer: PHP Medicare Advantage |
$192.63
|
| 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 |
$333.11
|
| Rate for Payer: Priority Health Medicare |
$192.63
|
| Rate for Payer: Priority Health Narrow Network |
$333.11
|
| Rate for Payer: Priority Health SBD |
$91.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.63
|
| Rate for Payer: UHC Medicare Advantage |
$192.63
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG CT PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 72193
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$361.85 |
| Rate for Payer: Aetna Commercial |
$277.73
|
| Rate for Payer: Aetna Medicare |
$215.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$277.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$298.45
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$207.26
|
| Rate for Payer: BCN Commercial |
$351.36
|
| Rate for Payer: BCN Medicare Advantage |
$207.26
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$277.73
|
| Rate for Payer: Cofinity Commercial |
$298.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$207.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$217.62
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$248.71
|
| Rate for Payer: PACE SWMI |
$207.26
|
| Rate for Payer: PHP Commercial |
$290.16
|
| Rate for Payer: PHP Medicare Advantage |
$207.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$361.85
|
| Rate for Payer: Priority Health Medicare |
$207.26
|
| Rate for Payer: Priority Health Narrow Network |
$361.85
|
| Rate for Payer: Priority Health SBD |
$83.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$207.26
|
| Rate for Payer: UHC Medicare Advantage |
$207.26
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$54.74
|
|
|
CHG CT PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 72192
|
| Min. Negotiated Rate |
$32.59 |
| Max. Negotiated Rate |
$209.93 |
| Rate for Payer: Aetna Commercial |
$164.81
|
| Rate for Payer: Aetna Medicare |
$127.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.11
|
| Rate for Payer: BCBS Complete |
$34.22
|
| Rate for Payer: BCBS MAPPO |
$122.99
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: BCN Medicare Advantage |
$122.99
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$177.11
|
| Rate for Payer: Cofinity Commercial |
$164.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.14
|
| Rate for Payer: Meridian Medicaid |
$34.22
|
| Rate for Payer: Nomi Health Commercial |
$147.59
|
| Rate for Payer: PACE SWMI |
$122.99
|
| Rate for Payer: PHP Commercial |
$172.19
|
| Rate for Payer: PHP Medicare Advantage |
$122.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.93
|
| Rate for Payer: Priority Health Medicare |
$122.99
|
| Rate for Payer: Priority Health Narrow Network |
$209.93
|
| Rate for Payer: Priority Health SBD |
$78.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.99
|
| Rate for Payer: UHC Medicare Advantage |
$122.99
|
| Rate for Payer: UHCCP Medicaid |
$32.59
|
| Rate for Payer: UMR Bronson Commercial |
$51.52
|
|
|
CHG CT PELVIS W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72194
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$399.32 |
| Rate for Payer: Aetna Commercial |
$306.39
|
| Rate for Payer: Aetna Medicare |
$237.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$306.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.26
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCBS MAPPO |
$228.65
|
| Rate for Payer: BCN Commercial |
$387.52
|
| Rate for Payer: BCN Medicare Advantage |
$228.65
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$306.39
|
| Rate for Payer: Cofinity Commercial |
$329.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$228.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$240.08
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Nomi Health Commercial |
$274.38
|
| Rate for Payer: PACE SWMI |
$228.65
|
| Rate for Payer: PHP Commercial |
$320.11
|
| Rate for Payer: PHP Medicare Advantage |
$228.65
|
| 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 |
$399.32
|
| Rate for Payer: Priority Health Medicare |
$228.65
|
| Rate for Payer: Priority Health Narrow Network |
$399.32
|
| Rate for Payer: Priority Health SBD |
$87.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$228.65
|
| Rate for Payer: UHC Medicare Advantage |
$228.65
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
|
|
CHG CT SOFT TISSUE NECK W/CONTRAST MATERIAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 70491
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$291.02 |
| Rate for Payer: Aetna Commercial |
$227.36
|
| Rate for Payer: Aetna Medicare |
$176.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$244.32
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCBS MAPPO |
$169.67
|
| Rate for Payer: BCN Commercial |
$280.50
|
| Rate for Payer: BCN Medicare Advantage |
$169.67
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$244.32
|
| Rate for Payer: Cofinity Commercial |
$227.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.15
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Nomi Health Commercial |
$203.60
|
| Rate for Payer: PACE SWMI |
$169.67
|
| Rate for Payer: PHP Commercial |
$237.54
|
| Rate for Payer: PHP Medicare Advantage |
$169.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$291.02
|
| Rate for Payer: Priority Health Medicare |
$169.67
|
| Rate for Payer: Priority Health Narrow Network |
$291.02
|
| Rate for Payer: Priority Health SBD |
$99.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.67
|
| Rate for Payer: UHC Medicare Advantage |
$169.67
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
CHG CT SOFT TISSUE NECK W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 70490
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$236.62 |
| Rate for Payer: Aetna Commercial |
$186.19
|
| Rate for Payer: Aetna Medicare |
$144.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.09
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCBS MAPPO |
$138.95
|
| Rate for Payer: BCN Commercial |
$227.73
|
| Rate for Payer: BCN Medicare Advantage |
$138.95
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$186.19
|
| Rate for Payer: Cofinity Commercial |
$200.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.90
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Nomi Health Commercial |
$166.74
|
| Rate for Payer: PACE SWMI |
$138.95
|
| Rate for Payer: PHP Commercial |
$194.53
|
| Rate for Payer: PHP Medicare Advantage |
$138.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$236.62
|
| Rate for Payer: Priority Health Medicare |
$138.95
|
| Rate for Payer: Priority Health Narrow Network |
$236.62
|
| Rate for Payer: Priority Health SBD |
$92.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.95
|
| Rate for Payer: UHC Medicare Advantage |
$138.95
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
| Rate for Payer: UMR Bronson Commercial |
$61.18
|
|
|
CHG CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 70492
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$349.02 |
| Rate for Payer: Aetna Commercial |
$272.62
|
| Rate for Payer: Aetna Medicare |
$211.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$272.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.97
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$203.45
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: BCN Medicare Advantage |
$203.45
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cofinity Commercial |
$292.97
|
| Rate for Payer: Cofinity Commercial |
$272.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.62
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Nomi Health Commercial |
$244.14
|
| Rate for Payer: PACE SWMI |
$203.45
|
| Rate for Payer: PHP Commercial |
$284.83
|
| Rate for Payer: PHP Medicare Advantage |
$203.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$349.02
|
| Rate for Payer: Priority Health Medicare |
$203.45
|
| Rate for Payer: Priority Health Narrow Network |
$349.02
|
| Rate for Payer: Priority Health SBD |
$116.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$203.45
|
| Rate for Payer: UHC Medicare Advantage |
$203.45
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: UMR Bronson Commercial |
$76.36
|
|
|
CHG CT THORACIC SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 72129
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$268.43 |
| Rate for Payer: Aetna Commercial |
$210.15
|
| Rate for Payer: Aetna Medicare |
$163.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$210.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.84
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCBS MAPPO |
$156.83
|
| Rate for Payer: BCN Commercial |
$258.02
|
| Rate for Payer: BCN Medicare Advantage |
$156.83
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$210.15
|
| Rate for Payer: Cofinity Commercial |
$225.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$156.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.67
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Nomi Health Commercial |
$188.20
|
| Rate for Payer: PACE SWMI |
$156.83
|
| Rate for Payer: PHP Commercial |
$219.56
|
| Rate for Payer: PHP Medicare Advantage |
$156.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$268.43
|
| Rate for Payer: Priority Health Medicare |
$156.83
|
| Rate for Payer: Priority Health Narrow Network |
$268.43
|
| Rate for Payer: Priority Health SBD |
$88.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$156.83
|
| Rate for Payer: UHC Medicare Advantage |
$156.83
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
| Rate for Payer: UMR Bronson Commercial |
$57.96
|
|
