|
CHG MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 78491
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$464.10 |
| Rate for Payer: Aetna Medicare |
$357.00
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$464.10
|
| Rate for Payer: UMR Bronson Commercial |
$328.44
|
|
|
CHG NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS
|
Professional
|
Both
|
$1,752.00
|
|
|
Service Code
|
HCPCS 77301
|
| Min. Negotiated Rate |
$700.80 |
| Max. Negotiated Rate |
$2,400.12 |
| Rate for Payer: Aetna Commercial |
$2,233.45
|
| Rate for Payer: Aetna Commercial |
$2,233.45
|
| Rate for Payer: Aetna Commercial |
$2,233.45
|
| Rate for Payer: Aetna Medicare |
$1,733.42
|
| Rate for Payer: Aetna Medicare |
$1,733.42
|
| Rate for Payer: Aetna Medicare |
$1,733.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.45
|
| Rate for Payer: BCBS Complete |
$700.80
|
| Rate for Payer: BCBS Complete |
$1,528.00
|
| Rate for Payer: BCBS Complete |
$1,228.40
|
| Rate for Payer: BCBS MAPPO |
$1,666.75
|
| Rate for Payer: BCBS MAPPO |
$1,666.75
|
| Rate for Payer: BCBS MAPPO |
$1,666.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,666.75
|
| Rate for Payer: Cash Price |
$2,456.80
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cash Price |
$1,401.60
|
| Rate for Payer: Cash Price |
$2,456.80
|
| Rate for Payer: Cash Price |
$3,056.00
|
| Rate for Payer: Cash Price |
$3,056.00
|
| Rate for Payer: Cofinity Commercial |
$2,233.45
|
| Rate for Payer: Cofinity Commercial |
$2,400.12
|
| Rate for Payer: Cofinity Commercial |
$2,400.12
|
| Rate for Payer: Cofinity Commercial |
$2,400.12
|
| Rate for Payer: Cofinity Commercial |
$2,233.45
|
| Rate for Payer: Cofinity Commercial |
$2,233.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,666.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,750.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,750.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,750.09
|
| Rate for Payer: Nomi Health Commercial |
$2,000.10
|
| Rate for Payer: Nomi Health Commercial |
$2,000.10
|
| Rate for Payer: Nomi Health Commercial |
$2,000.10
|
| Rate for Payer: PACE SWMI |
$1,666.75
|
| Rate for Payer: PACE SWMI |
$1,666.75
|
| Rate for Payer: PACE SWMI |
$1,666.75
|
| Rate for Payer: PHP Commercial |
$2,333.45
|
| Rate for Payer: PHP Commercial |
$2,333.45
|
| Rate for Payer: PHP Commercial |
$2,333.45
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.75
|
| Rate for Payer: PHP Medicare Advantage |
$1,666.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,996.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,138.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,483.00
|
| Rate for Payer: Priority Health Medicare |
$1,666.75
|
| Rate for Payer: Priority Health Medicare |
$1,666.75
|
| Rate for Payer: Priority Health Medicare |
$1,666.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,666.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,666.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,666.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,666.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,666.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,666.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,412.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,757.20
|
| Rate for Payer: UMR Bronson Commercial |
$805.92
|
|
|
CHG OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 76519
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$89.05 |
| Rate for Payer: Aetna Commercial |
$82.87
|
| Rate for Payer: Aetna Medicare |
$64.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.87
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$61.84
|
| Rate for Payer: BCN Medicare Advantage |
$61.84
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$89.05
|
| Rate for Payer: Cofinity Commercial |
$82.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.93
|
| Rate for Payer: Nomi Health Commercial |
$74.21
|
| Rate for Payer: PACE SWMI |
$61.84
|
| Rate for Payer: PHP Commercial |
$86.58
|
| Rate for Payer: PHP Medicare Advantage |
$61.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Medicare |
$61.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.84
|
| Rate for Payer: UHC Medicare Advantage |
$61.84
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
CHG OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 76514
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$15.25 |
| Rate for Payer: Aetna Commercial |
$14.19
|
| Rate for Payer: Aetna Medicare |
$11.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$10.59
|
| Rate for Payer: BCN Medicare Advantage |
$10.59
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$15.25
|
| Rate for Payer: Cofinity Commercial |
$14.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.12
|
| Rate for Payer: Nomi Health Commercial |
$12.71
|
| Rate for Payer: PACE SWMI |
$10.59
|
| Rate for Payer: PHP Commercial |
$14.83
|
| Rate for Payer: PHP Medicare Advantage |
$10.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$10.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.59
|
| Rate for Payer: UHC Medicare Advantage |
$10.59
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
CHG PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 86403
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$16.62 |
| Rate for Payer: Aetna Commercial |
$15.46
|
| Rate for Payer: Aetna Medicare |
$12.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.46
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$11.54
|
| Rate for Payer: BCN Medicare Advantage |
$11.54
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$16.62
|
| Rate for Payer: Cofinity Commercial |
$15.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.12
|
| Rate for Payer: Nomi Health Commercial |
$13.85
|
| Rate for Payer: PACE SWMI |
$11.54
|
| Rate for Payer: PHP Commercial |
$16.16
|
| Rate for Payer: PHP Medicare Advantage |
$11.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health Medicare |
$11.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.54
|
| Rate for Payer: UHC Medicare Advantage |
$11.54
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
|
CHG PERCUTANEOUS VERTEBROPLASTY, CT GUIDE
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 72292
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$173.55 |
| Rate for Payer: Aetna Medicare |
$133.50
|
| Rate for Payer: BCBS Complete |
$106.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
| Rate for Payer: UMR Bronson Commercial |
$122.82
|
|
|
CHG PERCUTANEOUS VERTEBROPLASTY, FLUOR GUIDE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 72291
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: UMR Bronson Commercial |
$111.32
|
|
|
CHG PERITONEOGRAM RS&I
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 74190
|
| Min. Negotiated Rate |
$18.40 |
| Max. Negotiated Rate |
$29.90 |
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: UMR Bronson Commercial |
$21.16
|
|
|
CHG PH BODY FLUID NOT ELSEWHERE SPECIFIED
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 83986
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Aetna Commercial |
$4.80
|
| Rate for Payer: Aetna Medicare |
$3.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.16
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$4.80
|
| Rate for Payer: Cofinity Commercial |
$5.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: Nomi Health Commercial |
$4.30
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$5.01
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.58
|
| Rate for Payer: UHC Medicare Advantage |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
|
|
CHG PLACEMNT,PROX/DIST EXT PROS, INFRARENAL
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 75953
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$295.75 |
| Rate for Payer: Aetna Medicare |
$227.50
|
| Rate for Payer: BCBS Complete |
$182.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.75
|
| Rate for Payer: UMR Bronson Commercial |
$209.30
|
|
|
CHG PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 75958
|
| Min. Negotiated Rate |
$151.60 |
| Max. Negotiated Rate |
$246.35 |
| Rate for Payer: Aetna Medicare |
$189.50
|
| Rate for Payer: BCBS Complete |
$151.60
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.35
|
| Rate for Payer: UMR Bronson Commercial |
$174.34
|
|
|
CHG PROTHROMBIN TIME
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 85610
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Commercial |
$5.75
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.18
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.18
|
| Rate for Payer: Cofinity Commercial |
$5.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Nomi Health Commercial |
$5.15
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$6.01
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.29
|
| Rate for Payer: UHC Medicare Advantage |
$4.29
|
| Rate for Payer: UMR Bronson Commercial |
$5.06
|
|
|
CHG RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 73050
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$37.90 |
| Rate for Payer: Aetna Commercial |
$35.27
|
| Rate for Payer: Aetna Commercial |
$35.27
|
| Rate for Payer: Aetna Commercial |
$35.27
|
| Rate for Payer: Aetna Medicare |
$27.37
|
| Rate for Payer: Aetna Medicare |
$27.37
|
| Rate for Payer: Aetna Medicare |
$27.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.27
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS Complete |
$22.00
|
| Rate for Payer: BCBS MAPPO |
$26.32
|
| Rate for Payer: BCBS MAPPO |
$26.32
|
| Rate for Payer: BCBS MAPPO |
$26.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.32
|
| Rate for Payer: BCN Medicare Advantage |
$26.32
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$35.27
|
| Rate for Payer: Cofinity Commercial |
$37.90
|
| Rate for Payer: Cofinity Commercial |
$37.90
|
| Rate for Payer: Cofinity Commercial |
$37.90
|
| Rate for Payer: Cofinity Commercial |
$35.27
|
| Rate for Payer: Cofinity Commercial |
$35.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.64
|
| Rate for Payer: Nomi Health Commercial |
$31.58
|
| Rate for Payer: Nomi Health Commercial |
$31.58
|
| Rate for Payer: Nomi Health Commercial |
$31.58
|
| Rate for Payer: PACE SWMI |
$26.32
|
| Rate for Payer: PACE SWMI |
$26.32
|
| Rate for Payer: PACE SWMI |
$26.32
|
| Rate for Payer: PHP Commercial |
$36.85
|
| Rate for Payer: PHP Commercial |
$36.85
|
| Rate for Payer: PHP Commercial |
$36.85
|
| Rate for Payer: PHP Medicare Advantage |
$26.32
|
| Rate for Payer: PHP Medicare Advantage |
$26.32
|
| Rate for Payer: PHP Medicare Advantage |
$26.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
| Rate for Payer: Priority Health Medicare |
$26.32
|
| Rate for Payer: Priority Health Medicare |
$26.32
|
| Rate for Payer: Priority Health Medicare |
$26.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.32
|
| Rate for Payer: UHC Medicare Advantage |
$26.32
|
| Rate for Payer: UHC Medicare Advantage |
$26.32
|
| Rate for Payer: UHC Medicare Advantage |
$26.32
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
| Rate for Payer: UMR Bronson Commercial |
$32.66
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
CHG RADEX ANKLE COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 73610
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$47.20 |
| Rate for Payer: Aetna Commercial |
$43.93
|
| Rate for Payer: Aetna Commercial |
$43.93
|
| Rate for Payer: Aetna Commercial |
$43.93
|
| Rate for Payer: Aetna Medicare |
$34.09
|
| Rate for Payer: Aetna Medicare |
$34.09
|
| Rate for Payer: Aetna Medicare |
$34.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.93
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$32.78
|
| Rate for Payer: BCBS MAPPO |
$32.78
|
| Rate for Payer: BCBS MAPPO |
$32.78
|
| Rate for Payer: BCN Medicare Advantage |
$32.78
|
| Rate for Payer: BCN Medicare Advantage |
$32.78
|
| Rate for Payer: BCN Medicare Advantage |
$32.78
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$43.93
|
| Rate for Payer: Cofinity Commercial |
$43.93
|
| Rate for Payer: Cofinity Commercial |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$43.93
|
| Rate for Payer: Cofinity Commercial |
$47.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.42
|
| Rate for Payer: Nomi Health Commercial |
$39.34
|
| Rate for Payer: Nomi Health Commercial |
$39.34
|
| Rate for Payer: Nomi Health Commercial |
$39.34
|
| Rate for Payer: PACE SWMI |
$32.78
|
| Rate for Payer: PACE SWMI |
$32.78
|
| Rate for Payer: PACE SWMI |
$32.78
|
| Rate for Payer: PHP Commercial |
$45.89
|
| Rate for Payer: PHP Commercial |
$45.89
|
| Rate for Payer: PHP Commercial |
$45.89
|
| Rate for Payer: PHP Medicare Advantage |
$32.78
|
| Rate for Payer: PHP Medicare Advantage |
$32.78
|
| Rate for Payer: PHP Medicare Advantage |
$32.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$32.78
|
| Rate for Payer: Priority Health Medicare |
$32.78
|
| Rate for Payer: Priority Health Medicare |
$32.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.78
|
| Rate for Payer: UHC Medicare Advantage |
$32.78
|
| Rate for Payer: UHC Medicare Advantage |
$32.78
|
| Rate for Payer: UHC Medicare Advantage |
$32.78
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
| Rate for Payer: UMR Bronson Commercial |
$40.94
|
|
|
CHG RADEX CALCANEUS MINIMUM 2 VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 73650
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$36.98 |
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
CHG RADEX CLAVICLE COMPLETE
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 73000
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$42.49 |
| Rate for Payer: Aetna Commercial |
$39.54
|
| Rate for Payer: Aetna Commercial |
$39.54
|
| Rate for Payer: Aetna Commercial |
$39.54
|
| Rate for Payer: Aetna Medicare |
$30.69
|
| Rate for Payer: Aetna Medicare |
$30.69
|
| Rate for Payer: Aetna Medicare |
$30.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.54
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS MAPPO |
$29.51
|
| Rate for Payer: BCBS MAPPO |
$29.51
|
| Rate for Payer: BCBS MAPPO |
$29.51
|
| Rate for Payer: BCN Medicare Advantage |
$29.51
|
| Rate for Payer: BCN Medicare Advantage |
$29.51
|
| Rate for Payer: BCN Medicare Advantage |
$29.51
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$42.49
|
| Rate for Payer: Cofinity Commercial |
$39.54
|
| Rate for Payer: Cofinity Commercial |
$39.54
|
| Rate for Payer: Cofinity Commercial |
$42.49
|
| Rate for Payer: Cofinity Commercial |
$39.54
|
| Rate for Payer: Cofinity Commercial |
$42.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.99
|
| Rate for Payer: Nomi Health Commercial |
$35.41
|
| Rate for Payer: Nomi Health Commercial |
$35.41
|
| Rate for Payer: Nomi Health Commercial |
$35.41
|
| Rate for Payer: PACE SWMI |
$29.51
|
| Rate for Payer: PACE SWMI |
$29.51
|
| Rate for Payer: PACE SWMI |
$29.51
|
| Rate for Payer: PHP Commercial |
$41.31
|
| Rate for Payer: PHP Commercial |
$41.31
|
| Rate for Payer: PHP Commercial |
$41.31
|
| Rate for Payer: PHP Medicare Advantage |
$29.51
|
| Rate for Payer: PHP Medicare Advantage |
$29.51
|
| Rate for Payer: PHP Medicare Advantage |
$29.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$29.51
|
| Rate for Payer: Priority Health Medicare |
$29.51
|
| Rate for Payer: Priority Health Medicare |
$29.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.51
|
| Rate for Payer: UHC Medicare Advantage |
$29.51
|
| Rate for Payer: UHC Medicare Advantage |
$29.51
|
| Rate for Payer: UHC Medicare Advantage |
$29.51
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
| Rate for Payer: UMR Bronson Commercial |
$43.24
|
|
|
CHG RADEX ELBOW 2 VIEWS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 73070
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$38.25 |
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Commercial |
$35.59
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.59
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$35.20
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$35.59
|
| Rate for Payer: Cofinity Commercial |
$35.59
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Cofinity Commercial |
$35.59
|
| Rate for Payer: Cofinity Commercial |
$38.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: Nomi Health Commercial |
$31.87
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PHP Commercial |
$37.18
|
| Rate for Payer: PHP Commercial |
$37.18
|
| Rate for Payer: PHP Commercial |
$37.18
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Medicare |
$26.56
|
| Rate for Payer: Priority Health Medicare |
$26.56
|
| Rate for Payer: Priority Health Medicare |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$26.56
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: UMR Bronson Commercial |
$40.48
|
|
|
CHG RADEX ELBOW ARTHROGRAPHY RS&I
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 73085
|
| Min. Negotiated Rate |
$34.40 |
| Max. Negotiated Rate |
$127.48 |
| Rate for Payer: Aetna Commercial |
$118.63
|
| Rate for Payer: Aetna Medicare |
$92.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.63
|
| Rate for Payer: BCBS Complete |
$34.40
|
| Rate for Payer: BCBS MAPPO |
$88.53
|
| Rate for Payer: BCN Medicare Advantage |
$88.53
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$127.48
|
| Rate for Payer: Cofinity Commercial |
$118.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.96
|
| Rate for Payer: Nomi Health Commercial |
$106.24
|
| Rate for Payer: PACE SWMI |
$88.53
|
| Rate for Payer: PHP Commercial |
$123.94
|
| Rate for Payer: PHP Medicare Advantage |
$88.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health Medicare |
$88.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.53
|
| Rate for Payer: UHC Medicare Advantage |
$88.53
|
| Rate for Payer: UMR Bronson Commercial |
$39.56
|
|
|
CHG RADEX ELBOW COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 73080
|
| Min. Negotiated Rate |
$19.20 |
| Max. Negotiated Rate |
$42.54 |
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Commercial |
$39.58
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: Aetna Medicare |
$30.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.58
|
| Rate for Payer: BCBS Complete |
$40.40
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS Complete |
$19.20
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: BCN Medicare Advantage |
$29.54
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.02
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: Nomi Health Commercial |
$35.45
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PACE SWMI |
$29.54
|
| Rate for Payer: PHP Commercial |
$41.36
|
| Rate for Payer: PHP Commercial |
$41.36
|
| Rate for Payer: PHP Commercial |
$41.36
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: PHP Medicare Advantage |
$29.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$29.54
|
| Rate for Payer: Priority Health Medicare |
$29.54
|
| Rate for Payer: Priority Health Medicare |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.54
|
| Rate for Payer: UHC Medicare Advantage |
$29.54
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
| Rate for Payer: UMR Bronson Commercial |
$46.46
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 72081
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$59.80 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$40.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.17
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS MAPPO |
$38.93
|
| Rate for Payer: BCN Medicare Advantage |
$38.93
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$56.06
|
| Rate for Payer: Cofinity Commercial |
$52.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.88
|
| Rate for Payer: Nomi Health Commercial |
$46.72
|
| Rate for Payer: PACE SWMI |
$38.93
|
| Rate for Payer: PHP Commercial |
$54.50
|
| Rate for Payer: PHP Medicare Advantage |
$38.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Medicare |
$38.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.93
|
| Rate for Payer: UHC Medicare Advantage |
$38.93
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 72082
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$91.18 |
| Rate for Payer: Aetna Commercial |
$84.85
|
| Rate for Payer: Aetna Medicare |
$65.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.85
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$63.32
|
| Rate for Payer: BCN Medicare Advantage |
$63.32
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$91.18
|
| Rate for Payer: Cofinity Commercial |
$84.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.49
|
| Rate for Payer: Nomi Health Commercial |
$75.98
|
| Rate for Payer: PACE SWMI |
$63.32
|
| Rate for Payer: PHP Commercial |
$88.65
|
| Rate for Payer: PHP Medicare Advantage |
$63.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Medicare |
$63.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.32
|
| Rate for Payer: UHC Medicare Advantage |
$63.32
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 72083
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$103.65 |
| Rate for Payer: Aetna Commercial |
$96.45
|
| Rate for Payer: Aetna Medicare |
$74.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.65
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$71.98
|
| Rate for Payer: BCN Medicare Advantage |
$71.98
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$96.45
|
| Rate for Payer: Cofinity Commercial |
$103.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.58
|
| Rate for Payer: Nomi Health Commercial |
$86.38
|
| Rate for Payer: PACE SWMI |
$71.98
|
| Rate for Payer: PHP Commercial |
$100.77
|
| Rate for Payer: PHP Medicare Advantage |
$71.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Medicare |
$71.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.98
|
| Rate for Payer: UHC Medicare Advantage |
$71.98
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72084
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$127.37 |
| Rate for Payer: Aetna Commercial |
$118.52
|
| Rate for Payer: Aetna Medicare |
$91.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.52
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS MAPPO |
$88.45
|
| Rate for Payer: BCN Medicare Advantage |
$88.45
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$127.37
|
| Rate for Payer: Cofinity Commercial |
$118.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.87
|
| Rate for Payer: Nomi Health Commercial |
$106.14
|
| Rate for Payer: PACE SWMI |
$88.45
|
| Rate for Payer: PHP Commercial |
$123.83
|
| Rate for Payer: PHP Medicare Advantage |
$88.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$88.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.45
|
| Rate for Payer: UHC Medicare Advantage |
$88.45
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
CHG RADEX FACIAL BONES < 3 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70140
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$41.77 |
| Rate for Payer: Aetna Commercial |
$38.87
|
| Rate for Payer: Aetna Medicare |
$30.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.87
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$29.01
|
| Rate for Payer: BCN Medicare Advantage |
$29.01
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$41.77
|
| Rate for Payer: Cofinity Commercial |
$38.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.46
|
| Rate for Payer: Nomi Health Commercial |
$34.81
|
| Rate for Payer: PACE SWMI |
$29.01
|
| Rate for Payer: PHP Commercial |
$40.61
|
| Rate for Payer: PHP Medicare Advantage |
$29.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Medicare |
$29.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.01
|
| Rate for Payer: UHC Medicare Advantage |
$29.01
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
|
|
CHG RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 70150
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$60.72 |
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Commercial |
$56.51
|
| Rate for Payer: Aetna Medicare |
$43.86
|
| Rate for Payer: Aetna Medicare |
$43.86
|
| Rate for Payer: Aetna Medicare |
$43.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.51
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS Complete |
$36.80
|
| Rate for Payer: BCBS MAPPO |
$42.17
|
| Rate for Payer: BCBS MAPPO |
$42.17
|
| Rate for Payer: BCBS MAPPO |
$42.17
|
| Rate for Payer: BCN Medicare Advantage |
$42.17
|
| Rate for Payer: BCN Medicare Advantage |
$42.17
|
| Rate for Payer: BCN Medicare Advantage |
$42.17
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Cofinity Commercial |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Cofinity Commercial |
$56.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.28
|
| Rate for Payer: Nomi Health Commercial |
$50.60
|
| Rate for Payer: Nomi Health Commercial |
$50.60
|
| Rate for Payer: Nomi Health Commercial |
$50.60
|
| Rate for Payer: PACE SWMI |
$42.17
|
| Rate for Payer: PACE SWMI |
$42.17
|
| Rate for Payer: PACE SWMI |
$42.17
|
| Rate for Payer: PHP Commercial |
$59.04
|
| Rate for Payer: PHP Commercial |
$59.04
|
| Rate for Payer: PHP Commercial |
$59.04
|
| Rate for Payer: PHP Medicare Advantage |
$42.17
|
| Rate for Payer: PHP Medicare Advantage |
$42.17
|
| Rate for Payer: PHP Medicare Advantage |
$42.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Medicare |
$42.17
|
| Rate for Payer: Priority Health Medicare |
$42.17
|
| Rate for Payer: Priority Health Medicare |
$42.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.17
|
| Rate for Payer: UHC Medicare Advantage |
$42.17
|
| Rate for Payer: UHC Medicare Advantage |
$42.17
|
| Rate for Payer: UHC Medicare Advantage |
$42.17
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
|
