|
CHG INTRAVASC US, RAD SUPERISE/ INTERP, EA ADDN VESSEL
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 75946
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
| Rate for Payer: UMR Bronson Commercial |
$71.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
CHG INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 74340
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$2,030.79 |
| Rate for Payer: Aetna Commercial |
$119.95
|
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.95
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,030.79
|
| Rate for Payer: BCN Commercial |
$178.86
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.97
|
| Rate for Payer: Priority Health Narrow Network |
$153.97
|
| Rate for Payer: Priority Health SBD |
$38.50
|
| Rate for Payer: UHCCP Medicaid |
$16.19
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
CHG JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 77077
|
| Min. Negotiated Rate |
$10.44 |
| Max. Negotiated Rate |
$3,952.74 |
| Rate for Payer: Aetna Commercial |
$56.49
|
| Rate for Payer: Aetna Commercial |
$56.49
|
| Rate for Payer: Aetna Medicare |
$43.85
|
| Rate for Payer: Aetna Medicare |
$43.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.49
|
| Rate for Payer: BCBS Complete |
$10.96
|
| Rate for Payer: BCBS Complete |
$10.96
|
| Rate for Payer: BCBS MAPPO |
$42.16
|
| Rate for Payer: BCBS MAPPO |
$42.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,952.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,952.74
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Medicare Advantage |
$42.16
|
| Rate for Payer: BCN Medicare Advantage |
$42.16
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$56.49
|
| Rate for Payer: Cofinity Commercial |
$60.71
|
| Rate for Payer: Cofinity Commercial |
$60.71
|
| Rate for Payer: Cofinity Commercial |
$56.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.27
|
| Rate for Payer: Meridian Medicaid |
$10.96
|
| Rate for Payer: Meridian Medicaid |
$10.96
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: PACE SWMI |
$42.16
|
| Rate for Payer: PACE SWMI |
$42.16
|
| Rate for Payer: PHP Commercial |
$59.02
|
| Rate for Payer: PHP Commercial |
$59.02
|
| Rate for Payer: PHP Medicare Advantage |
$42.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.38
|
| Rate for Payer: Priority Health Medicare |
$42.16
|
| Rate for Payer: Priority Health Medicare |
$42.16
|
| Rate for Payer: Priority Health Narrow Network |
$72.38
|
| Rate for Payer: Priority Health Narrow Network |
$72.38
|
| Rate for Payer: Priority Health SBD |
$25.15
|
| Rate for Payer: Priority Health SBD |
$25.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.16
|
| Rate for Payer: UHC Medicare Advantage |
$42.16
|
| Rate for Payer: UHC Medicare Advantage |
$42.16
|
| Rate for Payer: UHCCP Medicaid |
$10.44
|
| Rate for Payer: UHCCP Medicaid |
$10.44
|
| Rate for Payer: UMR Bronson Commercial |
$63.48
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
CHG LIPID PANEL
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 80061
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$2,009.65 |
| Rate for Payer: Aetna Commercial |
$17.94
|
| Rate for Payer: Aetna Medicare |
$13.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.28
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,009.65
|
| Rate for Payer: BCN Commercial |
$16.58
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Cofinity Commercial |
$19.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Nomi Health Commercial |
$16.07
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$18.75
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.32
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow Network |
$13.32
|
| Rate for Payer: Priority Health SBD |
$13.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.39
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
|
|
CHG MANUAL APPL STRESS PHYS/QHP JOINT RADIOGRAPHY
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 77071
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$882.79 |
| Rate for Payer: Aetna Commercial |
$66.62
|
| Rate for Payer: Aetna Commercial |
$66.62
|
| Rate for Payer: Aetna Medicare |
$51.71
|
| Rate for Payer: Aetna Medicare |
$51.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.62
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCBS MAPPO |
$49.72
|
| Rate for Payer: BCBS MAPPO |
$49.72
|
| Rate for Payer: BCBS Trust/PPO |
$882.79
|
| Rate for Payer: BCBS Trust/PPO |
$882.79
|
| Rate for Payer: BCN Commercial |
$80.14
|
| Rate for Payer: BCN Commercial |
$80.14
|
| Rate for Payer: BCN Medicare Advantage |
$49.72
|
| Rate for Payer: BCN Medicare Advantage |
$49.72
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Cofinity Commercial |
$71.60
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Cofinity Commercial |
$71.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Nomi Health Commercial |
$59.66
|
| Rate for Payer: Nomi Health Commercial |
$59.66
|
| Rate for Payer: PACE SWMI |
$49.72
|
| Rate for Payer: PACE SWMI |
$49.72
|
| Rate for Payer: PHP Commercial |
$69.61
|
| Rate for Payer: PHP Commercial |
$69.61
|
| Rate for Payer: PHP Medicare Advantage |
$49.72
|
| Rate for Payer: PHP Medicare Advantage |
$49.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.68
|
| Rate for Payer: Priority Health Medicare |
$49.72
|
| Rate for Payer: Priority Health Medicare |
$49.72
|
| Rate for Payer: Priority Health Narrow Network |
$84.68
|
| Rate for Payer: Priority Health Narrow Network |
$84.68
|
| Rate for Payer: Priority Health SBD |
$84.68
|
| Rate for Payer: Priority Health SBD |
$84.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$49.72
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$43.24
|
| Rate for Payer: UMR Bronson Commercial |
$40.94
|
|
|
CHG MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 75902
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$449.58 |
| Rate for Payer: Aetna Commercial |
$103.05
|
| Rate for Payer: Aetna Medicare |
$79.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.74
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$76.90
|
| Rate for Payer: BCBS Trust/PPO |
$449.58
|
| Rate for Payer: BCN Commercial |
$132.92
|
| Rate for Payer: BCN Medicare Advantage |
$76.90
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$103.05
|
| Rate for Payer: Cofinity Commercial |
$110.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.74
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Nomi Health Commercial |
$92.28
|
| Rate for Payer: PACE SWMI |
$76.90
|
| Rate for Payer: PHP Commercial |
$107.66
|
| Rate for Payer: PHP Medicare Advantage |
$76.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.99
|
| Rate for Payer: Priority Health Medicare |
$76.90
|
| Rate for Payer: Priority Health Narrow Network |
$134.99
|
| Rate for Payer: Priority Health SBD |
$27.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$76.90
|
| Rate for Payer: UHC Medicare Advantage |
$76.90
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
CHG MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
HCPCS 75901
|
| Min. Negotiated Rate |
$14.06 |
| Max. Negotiated Rate |
$420.00 |
| Rate for Payer: Aetna Commercial |
$265.44
|
| Rate for Payer: Aetna Medicare |
$206.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.25
|
| Rate for Payer: BCBS Complete |
$14.76
|
| Rate for Payer: BCBS MAPPO |
$198.09
|
| Rate for Payer: BCBS Trust/PPO |
$420.00
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: BCN Medicare Advantage |
$198.09
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cofinity Commercial |
$265.44
|
| Rate for Payer: Cofinity Commercial |
$285.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.99
|
| Rate for Payer: Meridian Medicaid |
$14.76
|
| Rate for Payer: Nomi Health Commercial |
$237.71
|
| Rate for Payer: PACE SWMI |
$198.09
|
| Rate for Payer: PHP Commercial |
$277.33
|
| Rate for Payer: PHP Medicare Advantage |
$198.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$350.04
|
| Rate for Payer: Priority Health Medicare |
$198.09
|
| Rate for Payer: Priority Health Narrow Network |
$350.04
|
| Rate for Payer: Priority Health SBD |
$33.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.09
|
| Rate for Payer: UHC Medicare Advantage |
$198.09
|
| Rate for Payer: UHCCP Medicaid |
$14.06
|
| Rate for Payer: UMR Bronson Commercial |
$155.94
|
|
|
CHG MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN
|
Professional
|
Both
|
$953.00
|
|
|
Service Code
|
HCPCS 77338
|
| Min. Negotiated Rate |
$145.05 |
| Max. Negotiated Rate |
$2,953.73 |
| Rate for Payer: Aetna Commercial |
$582.86
|
| Rate for Payer: Aetna Commercial |
$582.86
|
| Rate for Payer: Aetna Commercial |
$582.86
|
| Rate for Payer: Aetna Medicare |
$452.37
|
| Rate for Payer: Aetna Medicare |
$452.37
|
| Rate for Payer: Aetna Medicare |
$452.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$582.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$626.36
|
| Rate for Payer: BCBS Complete |
$152.30
|
| Rate for Payer: BCBS Complete |
$152.30
|
| Rate for Payer: BCBS Complete |
$152.30
|
| Rate for Payer: BCBS MAPPO |
$434.97
|
| Rate for Payer: BCBS MAPPO |
$434.97
|
| Rate for Payer: BCBS MAPPO |
$434.97
|
| Rate for Payer: BCBS Trust/PPO |
$2,953.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,953.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,953.73
|
| Rate for Payer: BCN Commercial |
$724.75
|
| Rate for Payer: BCN Commercial |
$724.75
|
| Rate for Payer: BCN Commercial |
$724.75
|
| Rate for Payer: BCN Medicare Advantage |
$434.97
|
| Rate for Payer: BCN Medicare Advantage |
$434.97
|
| Rate for Payer: BCN Medicare Advantage |
$434.97
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cash Price |
$776.80
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cash Price |
$762.40
|
| Rate for Payer: Cofinity Commercial |
$582.86
|
| Rate for Payer: Cofinity Commercial |
$582.86
|
| Rate for Payer: Cofinity Commercial |
$626.36
|
| Rate for Payer: Cofinity Commercial |
$626.36
|
| Rate for Payer: Cofinity Commercial |
$626.36
|
| Rate for Payer: Cofinity Commercial |
$582.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$434.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$456.72
|
| Rate for Payer: Meridian Medicaid |
$152.30
|
| Rate for Payer: Meridian Medicaid |
$152.30
|
| Rate for Payer: Meridian Medicaid |
$152.30
|
| Rate for Payer: Nomi Health Commercial |
$521.96
|
| Rate for Payer: Nomi Health Commercial |
$521.96
|
| Rate for Payer: Nomi Health Commercial |
$521.96
|
| Rate for Payer: PACE SWMI |
$434.97
|
| Rate for Payer: PACE SWMI |
$434.97
|
| Rate for Payer: PACE SWMI |
$434.97
|
| Rate for Payer: PHP Commercial |
$608.96
|
| Rate for Payer: PHP Commercial |
$608.96
|
| Rate for Payer: PHP Commercial |
$608.96
|
| Rate for Payer: PHP Medicare Advantage |
$434.97
|
| Rate for Payer: PHP Medicare Advantage |
$434.97
|
| Rate for Payer: PHP Medicare Advantage |
$434.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$631.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$721.64
|
| Rate for Payer: Priority Health Medicare |
$434.97
|
| Rate for Payer: Priority Health Medicare |
$434.97
|
| Rate for Payer: Priority Health Medicare |
$434.97
|
| Rate for Payer: Priority Health Narrow Network |
$721.64
|
| Rate for Payer: Priority Health Narrow Network |
$721.64
|
| Rate for Payer: Priority Health Narrow Network |
$721.64
|
| Rate for Payer: Priority Health SBD |
$344.40
|
| Rate for Payer: Priority Health SBD |
$344.40
|
| Rate for Payer: Priority Health SBD |
$344.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$434.97
|
| Rate for Payer: UHC Medicare Advantage |
$434.97
|
| Rate for Payer: UHC Medicare Advantage |
$434.97
|
| Rate for Payer: UHC Medicare Advantage |
$434.97
|
| Rate for Payer: UHCCP Medicaid |
$145.05
|
| Rate for Payer: UHCCP Medicaid |
$145.05
|
| Rate for Payer: UHCCP Medicaid |
$145.05
|
| Rate for Payer: UMR Bronson Commercial |
$241.50
|
| Rate for Payer: UMR Bronson Commercial |
$446.66
|
| Rate for Payer: UMR Bronson Commercial |
$438.38
|
|
|
CHG MRA ABDOMEN W/WO CONTRAST MATERIAL
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 74185
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$533.28 |
| Rate for Payer: Aetna Commercial |
$413.27
|
| Rate for Payer: Aetna Medicare |
$320.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.11
|
| Rate for Payer: BCBS Complete |
$56.36
|
| Rate for Payer: BCBS MAPPO |
$308.41
|
| Rate for Payer: BCN Commercial |
$515.56
|
| Rate for Payer: BCN Medicare Advantage |
$308.41
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$413.27
|
| Rate for Payer: Cofinity Commercial |
$444.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.83
|
| Rate for Payer: Meridian Medicaid |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$370.09
|
| Rate for Payer: PACE SWMI |
$308.41
|
| Rate for Payer: PHP Commercial |
$431.77
|
| Rate for Payer: PHP Medicare Advantage |
$308.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.28
|
| Rate for Payer: Priority Health Medicare |
$308.41
|
| Rate for Payer: Priority Health Narrow Network |
$533.28
|
| Rate for Payer: Priority Health SBD |
$128.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$308.41
|
| Rate for Payer: UHC Medicare Advantage |
$308.41
|
| Rate for Payer: UHCCP Medicaid |
$53.68
|
| Rate for Payer: UMR Bronson Commercial |
$84.64
|
|
|
CHG MRA HEAD W/O CONTRST MATERIAL
|
Professional
|
Both
|
$239.00
|
|
|
Service Code
|
HCPCS 70544
|
| Min. Negotiated Rate |
$35.78 |
| Max. Negotiated Rate |
$1,742.33 |
| Rate for Payer: Aetna Commercial |
$264.57
|
| Rate for Payer: Aetna Commercial |
$264.57
|
| Rate for Payer: Aetna Medicare |
$205.34
|
| Rate for Payer: Aetna Medicare |
$205.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.57
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS Complete |
$37.57
|
| Rate for Payer: BCBS MAPPO |
$197.44
|
| Rate for Payer: BCBS MAPPO |
$197.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,742.33
|
| Rate for Payer: BCBS Trust/PPO |
$1,742.33
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Medicare Advantage |
$197.44
|
| Rate for Payer: BCN Medicare Advantage |
$197.44
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$191.20
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cash Price |
$548.80
|
| Rate for Payer: Cofinity Commercial |
$284.31
|
| Rate for Payer: Cofinity Commercial |
$284.31
|
| Rate for Payer: Cofinity Commercial |
$264.57
|
| Rate for Payer: Cofinity Commercial |
$264.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$197.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.31
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Meridian Medicaid |
$37.57
|
| Rate for Payer: Nomi Health Commercial |
$236.93
|
| Rate for Payer: Nomi Health Commercial |
$236.93
|
| Rate for Payer: PACE SWMI |
$197.44
|
| Rate for Payer: PACE SWMI |
$197.44
|
| Rate for Payer: PHP Commercial |
$276.42
|
| Rate for Payer: PHP Commercial |
$276.42
|
| Rate for Payer: PHP Medicare Advantage |
$197.44
|
| Rate for Payer: PHP Medicare Advantage |
$197.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$445.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.31
|
| Rate for Payer: Priority Health Medicare |
$197.44
|
| Rate for Payer: Priority Health Medicare |
$197.44
|
| Rate for Payer: Priority Health Narrow Network |
$341.31
|
| Rate for Payer: Priority Health Narrow Network |
$341.31
|
| Rate for Payer: Priority Health SBD |
$86.22
|
| Rate for Payer: Priority Health SBD |
$86.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$197.44
|
| Rate for Payer: UHC Medicare Advantage |
$197.44
|
| Rate for Payer: UHC Medicare Advantage |
$197.44
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
| Rate for Payer: UHCCP Medicaid |
$35.78
|
| Rate for Payer: UMR Bronson Commercial |
$315.56
|
| Rate for Payer: UMR Bronson Commercial |
$109.94
|
|
|
CHG MRA HEAD W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 70546
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$522.50 |
| Rate for Payer: Aetna Commercial |
$403.41
|
| Rate for Payer: Aetna Medicare |
$313.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$403.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$433.51
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$301.05
|
| Rate for Payer: BCN Commercial |
$502.85
|
| Rate for Payer: BCN Medicare Advantage |
$301.05
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$403.41
|
| Rate for Payer: Cofinity Commercial |
$433.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$316.10
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Nomi Health Commercial |
$361.26
|
| Rate for Payer: PACE SWMI |
$301.05
|
| Rate for Payer: PHP Commercial |
$421.47
|
| Rate for Payer: PHP Medicare Advantage |
$301.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.50
|
| Rate for Payer: Priority Health Medicare |
$301.05
|
| Rate for Payer: Priority Health Narrow Network |
$522.50
|
| Rate for Payer: Priority Health SBD |
$106.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.05
|
| Rate for Payer: UHC Medicare Advantage |
$301.05
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
CHG MRA NECK W/O CONTRST MATERIAL
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 70547
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$1,605.50 |
| Rate for Payer: Aetna Commercial |
$265.36
|
| Rate for Payer: Aetna Medicare |
$205.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.16
|
| Rate for Payer: BCBS Complete |
$37.80
|
| Rate for Payer: BCBS MAPPO |
$198.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,605.50
|
| Rate for Payer: BCN Commercial |
$328.88
|
| Rate for Payer: BCN Medicare Advantage |
$198.03
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$265.36
|
| Rate for Payer: Cofinity Commercial |
$285.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$207.93
|
| Rate for Payer: Meridian Medicaid |
$37.80
|
| Rate for Payer: Nomi Health Commercial |
$237.64
|
| Rate for Payer: PACE SWMI |
$198.03
|
| Rate for Payer: PHP Commercial |
$277.24
|
| Rate for Payer: PHP Medicare Advantage |
$198.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$341.82
|
| Rate for Payer: Priority Health Medicare |
$198.03
|
| Rate for Payer: Priority Health Narrow Network |
$341.82
|
| Rate for Payer: Priority Health SBD |
$86.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.03
|
| Rate for Payer: UHC Medicare Advantage |
$198.03
|
| Rate for Payer: UHCCP Medicaid |
$36.00
|
| Rate for Payer: UMR Bronson Commercial |
$108.56
|
|
|
CHG MRA NECK W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 70549
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$2,120.07 |
| Rate for Payer: Aetna Commercial |
$423.71
|
| Rate for Payer: Aetna Medicare |
$328.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.33
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCBS MAPPO |
$316.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,120.07
|
| Rate for Payer: BCN Commercial |
$527.29
|
| Rate for Payer: BCN Medicare Advantage |
$316.20
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$455.33
|
| Rate for Payer: Cofinity Commercial |
$423.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$316.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$332.01
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Nomi Health Commercial |
$379.44
|
| Rate for Payer: PACE SWMI |
$316.20
|
| Rate for Payer: PHP Commercial |
$442.68
|
| Rate for Payer: PHP Medicare Advantage |
$316.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$547.13
|
| Rate for Payer: Priority Health Medicare |
$316.20
|
| Rate for Payer: Priority Health Narrow Network |
$547.13
|
| Rate for Payer: Priority Health SBD |
$129.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$316.20
|
| Rate for Payer: UHC Medicare Advantage |
$316.20
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
| Rate for Payer: UMR Bronson Commercial |
$129.26
|
|
|
CHG MRI ABDOMEN W/O CONTRAST FLWD BY W/CONTRAST
|
Professional
|
Both
|
$226.00
|
|
|
Service Code
|
HCPCS 74183
|
| Min. Negotiated Rate |
$66.24 |
| Max. Negotiated Rate |
$535.33 |
| Rate for Payer: Aetna Commercial |
$416.11
|
| Rate for Payer: Aetna Medicare |
$322.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$416.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.16
|
| Rate for Payer: BCBS Complete |
$69.55
|
| Rate for Payer: BCBS MAPPO |
$310.53
|
| Rate for Payer: BCN Commercial |
$518.49
|
| Rate for Payer: BCN Medicare Advantage |
$310.53
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cash Price |
$180.80
|
| Rate for Payer: Cofinity Commercial |
$416.11
|
| Rate for Payer: Cofinity Commercial |
$447.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$310.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$326.06
|
| Rate for Payer: Meridian Medicaid |
$69.55
|
| Rate for Payer: Nomi Health Commercial |
$372.64
|
| Rate for Payer: PACE SWMI |
$310.53
|
| Rate for Payer: PHP Commercial |
$434.74
|
| Rate for Payer: PHP Medicare Advantage |
$310.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$535.33
|
| Rate for Payer: Priority Health Medicare |
$310.53
|
| Rate for Payer: Priority Health Narrow Network |
$535.33
|
| Rate for Payer: Priority Health SBD |
$158.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$310.53
|
| Rate for Payer: UHC Medicare Advantage |
$310.53
|
| Rate for Payer: UHCCP Medicaid |
$66.24
|
| Rate for Payer: UMR Bronson Commercial |
$103.96
|
|
|
CHG MRI ABDOMEN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$151.00
|
|
|
Service Code
|
HCPCS 74181
|
| Min. Negotiated Rate |
$43.67 |
| Max. Negotiated Rate |
$310.01 |
| Rate for Payer: Aetna Commercial |
$241.60
|
| Rate for Payer: Aetna Medicare |
$187.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$241.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.63
|
| Rate for Payer: BCBS Complete |
$45.85
|
| Rate for Payer: BCBS MAPPO |
$180.30
|
| Rate for Payer: BCN Commercial |
$299.56
|
| Rate for Payer: BCN Medicare Advantage |
$180.30
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cofinity Commercial |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$259.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$180.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$189.32
|
| Rate for Payer: Meridian Medicaid |
$45.85
|
| Rate for Payer: Nomi Health Commercial |
$216.36
|
| Rate for Payer: PACE SWMI |
$180.30
|
| Rate for Payer: PHP Commercial |
$252.42
|
| Rate for Payer: PHP Medicare Advantage |
$180.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$310.01
|
| Rate for Payer: Priority Health Medicare |
$180.30
|
| Rate for Payer: Priority Health Narrow Network |
$310.01
|
| Rate for Payer: Priority Health SBD |
$105.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$180.30
|
| Rate for Payer: UHC Medicare Advantage |
$180.30
|
| Rate for Payer: UHCCP Medicaid |
$43.67
|
| Rate for Payer: UMR Bronson Commercial |
$69.46
|
|
|
CHG MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 73721
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$320.79 |
| Rate for Payer: Aetna Commercial |
$250.65
|
| Rate for Payer: Aetna Medicare |
$194.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.35
|
| Rate for Payer: BCBS Complete |
$42.71
|
| Rate for Payer: BCBS MAPPO |
$187.05
|
| Rate for Payer: BCN Commercial |
$308.36
|
| Rate for Payer: BCN Medicare Advantage |
$187.05
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$269.35
|
| Rate for Payer: Cofinity Commercial |
$250.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.40
|
| Rate for Payer: Meridian Medicaid |
$42.71
|
| Rate for Payer: Nomi Health Commercial |
$224.46
|
| Rate for Payer: PACE SWMI |
$187.05
|
| Rate for Payer: PHP Commercial |
$261.87
|
| Rate for Payer: PHP Medicare Advantage |
$187.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$320.79
|
| Rate for Payer: Priority Health Medicare |
$187.05
|
| Rate for Payer: Priority Health Narrow Network |
$320.79
|
| Rate for Payer: Priority Health SBD |
$98.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.05
|
| Rate for Payer: UHC Medicare Advantage |
$187.05
|
| Rate for Payer: UHCCP Medicaid |
$40.68
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 73723
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$610.78 |
| Rate for Payer: Aetna Commercial |
$470.81
|
| Rate for Payer: Aetna Medicare |
$365.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$470.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.94
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$351.35
|
| Rate for Payer: BCN Commercial |
$592.77
|
| Rate for Payer: BCN Medicare Advantage |
$351.35
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$470.81
|
| Rate for Payer: Cofinity Commercial |
$505.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$351.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.92
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$421.62
|
| Rate for Payer: PACE SWMI |
$351.35
|
| Rate for Payer: PHP Commercial |
$491.89
|
| Rate for Payer: PHP Medicare Advantage |
$351.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$610.78
|
| Rate for Payer: Priority Health Medicare |
$351.35
|
| Rate for Payer: Priority Health Narrow Network |
$610.78
|
| Rate for Payer: Priority Health SBD |
$155.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$351.35
|
| Rate for Payer: UHC Medicare Advantage |
$351.35
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
CHG MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 73222
|
| Min. Negotiated Rate |
$48.78 |
| Max. Negotiated Rate |
$496.32 |
| Rate for Payer: Aetna Commercial |
$380.53
|
| Rate for Payer: Aetna Medicare |
$295.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.93
|
| Rate for Payer: BCBS Complete |
$51.22
|
| Rate for Payer: BCBS MAPPO |
$283.98
|
| Rate for Payer: BCN Commercial |
$480.37
|
| Rate for Payer: BCN Medicare Advantage |
$283.98
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$408.93
|
| Rate for Payer: Cofinity Commercial |
$380.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$283.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$298.18
|
| Rate for Payer: Meridian Medicaid |
$51.22
|
| Rate for Payer: Nomi Health Commercial |
$340.78
|
| Rate for Payer: PACE SWMI |
$283.98
|
| Rate for Payer: PHP Commercial |
$397.57
|
| Rate for Payer: PHP Medicare Advantage |
$283.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$496.32
|
| Rate for Payer: Priority Health Medicare |
$283.98
|
| Rate for Payer: Priority Health Narrow Network |
$496.32
|
| Rate for Payer: Priority Health SBD |
$117.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$283.98
|
| Rate for Payer: UHC Medicare Advantage |
$283.98
|
| Rate for Payer: UHCCP Medicaid |
$48.78
|
| Rate for Payer: UMR Bronson Commercial |
$72.68
|
|
|
CHG MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 73221
|
| Min. Negotiated Rate |
$40.68 |
| Max. Negotiated Rate |
$321.30 |
| Rate for Payer: Aetna Commercial |
$251.05
|
| Rate for Payer: Aetna Medicare |
$194.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$251.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.78
|
| Rate for Payer: BCBS Complete |
$42.71
|
| Rate for Payer: BCBS MAPPO |
$187.35
|
| Rate for Payer: BCN Commercial |
$308.85
|
| Rate for Payer: BCN Medicare Advantage |
$187.35
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$251.05
|
| Rate for Payer: Cofinity Commercial |
$269.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$187.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.72
|
| Rate for Payer: Meridian Medicaid |
$42.71
|
| Rate for Payer: Nomi Health Commercial |
$224.82
|
| Rate for Payer: PACE SWMI |
$187.35
|
| Rate for Payer: PHP Commercial |
$262.29
|
| Rate for Payer: PHP Medicare Advantage |
$187.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$321.30
|
| Rate for Payer: Priority Health Medicare |
$187.35
|
| Rate for Payer: Priority Health Narrow Network |
$321.30
|
| Rate for Payer: Priority Health SBD |
$98.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$187.35
|
| Rate for Payer: UHC Medicare Advantage |
$187.35
|
| Rate for Payer: UHCCP Medicaid |
$40.68
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 73223
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$613.35 |
| Rate for Payer: Aetna Commercial |
$471.99
|
| Rate for Payer: Aetna Medicare |
$366.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$507.21
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$352.23
|
| Rate for Payer: BCN Commercial |
$594.72
|
| Rate for Payer: BCN Medicare Advantage |
$352.23
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$507.21
|
| Rate for Payer: Cofinity Commercial |
$471.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$369.84
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$422.68
|
| Rate for Payer: PACE SWMI |
$352.23
|
| Rate for Payer: PHP Commercial |
$493.12
|
| Rate for Payer: PHP Medicare Advantage |
$352.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$613.35
|
| Rate for Payer: Priority Health Medicare |
$352.23
|
| Rate for Payer: Priority Health Narrow Network |
$613.35
|
| Rate for Payer: Priority Health SBD |
$155.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.23
|
| Rate for Payer: UHC Medicare Advantage |
$352.23
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
|
CHG MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL
|
Professional
|
Both
|
$377.00
|
|
|
Service Code
|
HCPCS 70552
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$1,113.66 |
| Rate for Payer: Aetna Commercial |
$333.49
|
| Rate for Payer: Aetna Medicare |
$258.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$333.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$358.37
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$248.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,113.66
|
| Rate for Payer: BCN Commercial |
$413.42
|
| Rate for Payer: BCN Medicare Advantage |
$248.87
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cash Price |
$301.60
|
| Rate for Payer: Cofinity Commercial |
$333.49
|
| Rate for Payer: Cofinity Commercial |
$358.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.31
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Nomi Health Commercial |
$298.64
|
| Rate for Payer: PACE SWMI |
$248.87
|
| Rate for Payer: PHP Commercial |
$348.42
|
| Rate for Payer: PHP Medicare Advantage |
$248.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.06
|
| Rate for Payer: Priority Health Medicare |
$248.87
|
| Rate for Payer: Priority Health Narrow Network |
$428.06
|
| Rate for Payer: Priority Health SBD |
$128.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$248.87
|
| Rate for Payer: UHC Medicare Advantage |
$248.87
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
| Rate for Payer: UMR Bronson Commercial |
$173.42
|
|
|
CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$325.00
|
|
|
Service Code
|
HCPCS 70551
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$2,070.41 |
| Rate for Payer: Aetna Commercial |
$242.86
|
| Rate for Payer: Aetna Medicare |
$188.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$260.99
|
| Rate for Payer: BCBS Complete |
$46.52
|
| Rate for Payer: BCBS MAPPO |
$181.24
|
| Rate for Payer: BCBS Trust/PPO |
$2,070.41
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: BCN Medicare Advantage |
$181.24
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$242.86
|
| Rate for Payer: Cofinity Commercial |
$260.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.30
|
| Rate for Payer: Meridian Medicaid |
$46.52
|
| Rate for Payer: Nomi Health Commercial |
$217.49
|
| Rate for Payer: PACE SWMI |
$181.24
|
| Rate for Payer: PHP Commercial |
$253.74
|
| Rate for Payer: PHP Medicare Advantage |
$181.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$211.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$310.52
|
| Rate for Payer: Priority Health Medicare |
$181.24
|
| Rate for Payer: Priority Health Narrow Network |
$310.52
|
| Rate for Payer: Priority Health SBD |
$106.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.24
|
| Rate for Payer: UHC Medicare Advantage |
$181.24
|
| Rate for Payer: UHCCP Medicaid |
$44.30
|
| Rate for Payer: UMR Bronson Commercial |
$149.50
|
|
|
CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL
|
Professional
|
Both
|
$348.00
|
|
|
Service Code
|
HCPCS 70553
|
| Min. Negotiated Rate |
$69.01 |
| Max. Negotiated Rate |
$968.37 |
| Rate for Payer: Aetna Commercial |
$394.07
|
| Rate for Payer: Aetna Medicare |
$305.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$394.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$423.48
|
| Rate for Payer: BCBS Complete |
$72.46
|
| Rate for Payer: BCBS MAPPO |
$294.08
|
| Rate for Payer: BCBS Trust/PPO |
$968.37
|
| Rate for Payer: BCN Commercial |
$486.73
|
| Rate for Payer: BCN Medicare Advantage |
$294.08
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cash Price |
$278.40
|
| Rate for Payer: Cofinity Commercial |
$423.48
|
| Rate for Payer: Cofinity Commercial |
$394.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$294.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.78
|
| Rate for Payer: Meridian Medicaid |
$72.46
|
| Rate for Payer: Nomi Health Commercial |
$352.90
|
| Rate for Payer: PACE SWMI |
$294.08
|
| Rate for Payer: PHP Commercial |
$411.71
|
| Rate for Payer: PHP Medicare Advantage |
$294.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$226.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$504.02
|
| Rate for Payer: Priority Health Medicare |
$294.08
|
| Rate for Payer: Priority Health Narrow Network |
$504.02
|
| Rate for Payer: Priority Health SBD |
$164.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$294.08
|
| Rate for Payer: UHC Medicare Advantage |
$294.08
|
| Rate for Payer: UHCCP Medicaid |
$69.01
|
| Rate for Payer: UMR Bronson Commercial |
$160.08
|
|
|
CHG MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 73718
|
| Min. Negotiated Rate |
$40.47 |
| Max. Negotiated Rate |
$353.63 |
| Rate for Payer: Aetna Commercial |
$273.44
|
| Rate for Payer: Aetna Medicare |
$212.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$293.85
|
| Rate for Payer: BCBS Complete |
$42.49
|
| Rate for Payer: BCBS MAPPO |
$204.06
|
| Rate for Payer: BCN Commercial |
$342.07
|
| Rate for Payer: BCN Medicare Advantage |
$204.06
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cofinity Commercial |
$273.44
|
| Rate for Payer: Cofinity Commercial |
$293.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$204.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$214.26
|
| Rate for Payer: Meridian Medicaid |
$42.49
|
| Rate for Payer: Nomi Health Commercial |
$244.87
|
| Rate for Payer: PACE SWMI |
$204.06
|
| Rate for Payer: PHP Commercial |
$285.68
|
| Rate for Payer: PHP Medicare Advantage |
$204.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.63
|
| Rate for Payer: Priority Health Medicare |
$204.06
|
| Rate for Payer: Priority Health Narrow Network |
$353.63
|
| Rate for Payer: Priority Health SBD |
$97.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$204.06
|
| Rate for Payer: UHC Medicare Advantage |
$204.06
|
| Rate for Payer: UHCCP Medicaid |
$40.47
|
| Rate for Payer: UMR Bronson Commercial |
$60.26
|
|
|
CHG MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 73720
|
| Min. Negotiated Rate |
$64.97 |
| Max. Negotiated Rate |
$533.79 |
| Rate for Payer: Aetna Commercial |
$414.73
|
| Rate for Payer: Aetna Medicare |
$321.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$445.68
|
| Rate for Payer: BCBS Complete |
$68.22
|
| Rate for Payer: BCBS MAPPO |
$309.50
|
| Rate for Payer: BCN Commercial |
$517.02
|
| Rate for Payer: BCN Medicare Advantage |
$309.50
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cofinity Commercial |
$414.73
|
| Rate for Payer: Cofinity Commercial |
$445.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$309.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$324.98
|
| Rate for Payer: Meridian Medicaid |
$68.22
|
| Rate for Payer: Nomi Health Commercial |
$371.40
|
| Rate for Payer: PACE SWMI |
$309.50
|
| Rate for Payer: PHP Commercial |
$433.30
|
| Rate for Payer: PHP Medicare Advantage |
$309.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$533.79
|
| Rate for Payer: Priority Health Medicare |
$309.50
|
| Rate for Payer: Priority Health Narrow Network |
$533.79
|
| Rate for Payer: Priority Health SBD |
$154.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$309.50
|
| Rate for Payer: UHC Medicare Advantage |
$309.50
|
| Rate for Payer: UHCCP Medicaid |
$64.97
|
| Rate for Payer: UMR Bronson Commercial |
$96.60
|
|
