|
CHG RADEX FINGR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 73140
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$49.58 |
| Rate for Payer: Aetna Commercial |
$46.14
|
| Rate for Payer: Aetna Commercial |
$46.14
|
| Rate for Payer: Aetna Commercial |
$46.14
|
| Rate for Payer: Aetna Medicare |
$35.81
|
| Rate for Payer: Aetna Medicare |
$35.81
|
| Rate for Payer: Aetna Medicare |
$35.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.14
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$34.43
|
| Rate for Payer: BCBS MAPPO |
$34.43
|
| Rate for Payer: BCBS MAPPO |
$34.43
|
| Rate for Payer: BCN Medicare Advantage |
$34.43
|
| Rate for Payer: BCN Medicare Advantage |
$34.43
|
| Rate for Payer: BCN Medicare Advantage |
$34.43
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$49.58
|
| Rate for Payer: Cofinity Commercial |
$46.14
|
| Rate for Payer: Cofinity Commercial |
$46.14
|
| Rate for Payer: Cofinity Commercial |
$49.58
|
| Rate for Payer: Cofinity Commercial |
$46.14
|
| Rate for Payer: Cofinity Commercial |
$49.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.15
|
| Rate for Payer: Nomi Health Commercial |
$41.32
|
| Rate for Payer: Nomi Health Commercial |
$41.32
|
| Rate for Payer: Nomi Health Commercial |
$41.32
|
| Rate for Payer: PACE SWMI |
$34.43
|
| Rate for Payer: PACE SWMI |
$34.43
|
| Rate for Payer: PACE SWMI |
$34.43
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$34.43
|
| Rate for Payer: PHP Medicare Advantage |
$34.43
|
| Rate for Payer: PHP Medicare Advantage |
$34.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health Medicare |
$34.43
|
| Rate for Payer: Priority Health Medicare |
$34.43
|
| Rate for Payer: Priority Health Medicare |
$34.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.43
|
| Rate for Payer: UHC Medicare Advantage |
$34.43
|
| Rate for Payer: UHC Medicare Advantage |
$34.43
|
| Rate for Payer: UHC Medicare Advantage |
$34.43
|
| Rate for Payer: UMR Bronson Commercial |
$10.12
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
|
|
CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 73630
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$44.24 |
| Rate for Payer: Aetna Commercial |
$41.16
|
| Rate for Payer: Aetna Commercial |
$41.16
|
| Rate for Payer: Aetna Commercial |
$41.16
|
| Rate for Payer: Aetna Medicare |
$31.95
|
| Rate for Payer: Aetna Medicare |
$31.95
|
| Rate for Payer: Aetna Medicare |
$31.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.16
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$30.72
|
| Rate for Payer: BCBS MAPPO |
$30.72
|
| Rate for Payer: BCBS MAPPO |
$30.72
|
| Rate for Payer: BCN Medicare Advantage |
$30.72
|
| Rate for Payer: BCN Medicare Advantage |
$30.72
|
| Rate for Payer: BCN Medicare Advantage |
$30.72
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$44.24
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Commercial |
$44.24
|
| Rate for Payer: Cofinity Commercial |
$41.16
|
| Rate for Payer: Cofinity Commercial |
$44.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.26
|
| Rate for Payer: Nomi Health Commercial |
$36.86
|
| Rate for Payer: Nomi Health Commercial |
$36.86
|
| Rate for Payer: Nomi Health Commercial |
$36.86
|
| Rate for Payer: PACE SWMI |
$30.72
|
| Rate for Payer: PACE SWMI |
$30.72
|
| Rate for Payer: PACE SWMI |
$30.72
|
| Rate for Payer: PHP Commercial |
$43.01
|
| Rate for Payer: PHP Commercial |
$43.01
|
| Rate for Payer: PHP Commercial |
$43.01
|
| Rate for Payer: PHP Medicare Advantage |
$30.72
|
| Rate for Payer: PHP Medicare Advantage |
$30.72
|
| Rate for Payer: PHP Medicare Advantage |
$30.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$30.72
|
| Rate for Payer: Priority Health Medicare |
$30.72
|
| Rate for Payer: Priority Health Medicare |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.72
|
| Rate for Payer: UHC Medicare Advantage |
$30.72
|
| Rate for Payer: UHC Medicare Advantage |
$30.72
|
| Rate for Payer: UHC Medicare Advantage |
$30.72
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
| Rate for Payer: UMR Bronson Commercial |
$20.70
|
| Rate for Payer: UMR Bronson Commercial |
$40.02
|
|
|
CHG RADEX FOREARM 2 VIEWS
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 73090
|
| Min. Negotiated Rate |
$11.60 |
| 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 |
$11.60
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS Complete |
$15.60
|
| 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 |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$31.20
|
| 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 |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| 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 |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
| Rate for Payer: UMR Bronson Commercial |
$41.40
|
|
|
CHG RADEX HAND 2 VIEWS
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 73120
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$40.80 |
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Commercial |
$37.96
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.96
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCBS MAPPO |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: BCN Medicare Advantage |
$28.33
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$37.96
|
| Rate for Payer: Cofinity Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.75
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: Nomi Health Commercial |
$34.00
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PACE SWMI |
$28.33
|
| Rate for Payer: PHP Commercial |
$39.66
|
| Rate for Payer: PHP Commercial |
$39.66
|
| Rate for Payer: PHP Commercial |
$39.66
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: PHP Medicare Advantage |
$28.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
| Rate for Payer: UHC Medicare Advantage |
$28.33
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
CHG RADEX HAND MINIMUM 3 VIEWS
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 73130
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna Medicare |
$35.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.10
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Complete |
$38.40
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCBS MAPPO |
$33.66
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: BCN Medicare Advantage |
$33.66
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$76.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Cofinity Commercial |
$45.10
|
| Rate for Payer: Cofinity Commercial |
$48.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.34
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: Nomi Health Commercial |
$40.39
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PACE SWMI |
$33.66
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Commercial |
$47.12
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: PHP Medicare Advantage |
$33.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Medicare |
$33.66
|
| Rate for Payer: Priority Health Medicare |
$33.66
|
| Rate for Payer: Priority Health Medicare |
$33.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.66
|
| Rate for Payer: UHC Medicare Advantage |
$33.66
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 73521
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$53.77 |
| Rate for Payer: Aetna Commercial |
$50.04
|
| Rate for Payer: Aetna Commercial |
$50.04
|
| Rate for Payer: Aetna Medicare |
$38.83
|
| Rate for Payer: Aetna Medicare |
$38.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.77
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$37.34
|
| Rate for Payer: BCBS MAPPO |
$37.34
|
| Rate for Payer: BCN Medicare Advantage |
$37.34
|
| Rate for Payer: BCN Medicare Advantage |
$37.34
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$53.77
|
| Rate for Payer: Cofinity Commercial |
$53.77
|
| Rate for Payer: Cofinity Commercial |
$50.04
|
| Rate for Payer: Cofinity Commercial |
$50.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.21
|
| Rate for Payer: Nomi Health Commercial |
$44.81
|
| Rate for Payer: Nomi Health Commercial |
$44.81
|
| Rate for Payer: PACE SWMI |
$37.34
|
| Rate for Payer: PACE SWMI |
$37.34
|
| Rate for Payer: PHP Commercial |
$52.28
|
| Rate for Payer: PHP Commercial |
$52.28
|
| Rate for Payer: PHP Medicare Advantage |
$37.34
|
| Rate for Payer: PHP Medicare Advantage |
$37.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health Medicare |
$37.34
|
| Rate for Payer: Priority Health Medicare |
$37.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$37.34
|
| Rate for Payer: UHC Medicare Advantage |
$37.34
|
| Rate for Payer: UMR Bronson Commercial |
$35.42
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 73522
|
| Min. Negotiated Rate |
$46.80 |
| Max. Negotiated Rate |
$76.05 |
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Commercial |
$65.31
|
| Rate for Payer: Aetna Medicare |
$50.69
|
| Rate for Payer: Aetna Medicare |
$50.69
|
| Rate for Payer: Aetna Medicare |
$50.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.31
|
| Rate for Payer: BCBS Complete |
$46.80
|
| Rate for Payer: BCBS Complete |
$25.20
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$48.74
|
| Rate for Payer: BCBS MAPPO |
$48.74
|
| Rate for Payer: BCBS MAPPO |
$48.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.74
|
| Rate for Payer: BCN Medicare Advantage |
$48.74
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$70.19
|
| Rate for Payer: Cofinity Commercial |
$65.31
|
| Rate for Payer: Cofinity Commercial |
$65.31
|
| Rate for Payer: Cofinity Commercial |
$70.19
|
| Rate for Payer: Cofinity Commercial |
$65.31
|
| Rate for Payer: Cofinity Commercial |
$70.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$58.49
|
| Rate for Payer: Nomi Health Commercial |
$58.49
|
| Rate for Payer: Nomi Health Commercial |
$58.49
|
| Rate for Payer: PACE SWMI |
$48.74
|
| Rate for Payer: PACE SWMI |
$48.74
|
| Rate for Payer: PACE SWMI |
$48.74
|
| Rate for Payer: PHP Commercial |
$68.24
|
| Rate for Payer: PHP Commercial |
$68.24
|
| Rate for Payer: PHP Commercial |
$68.24
|
| Rate for Payer: PHP Medicare Advantage |
$48.74
|
| Rate for Payer: PHP Medicare Advantage |
$48.74
|
| Rate for Payer: PHP Medicare Advantage |
$48.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.05
|
| Rate for Payer: Priority Health Medicare |
$48.74
|
| Rate for Payer: Priority Health Medicare |
$48.74
|
| Rate for Payer: Priority Health Medicare |
$48.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.74
|
| Rate for Payer: UHC Medicare Advantage |
$48.74
|
| Rate for Payer: UHC Medicare Advantage |
$48.74
|
| Rate for Payer: UHC Medicare Advantage |
$48.74
|
| Rate for Payer: UMR Bronson Commercial |
$53.82
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 73523
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$80.58 |
| Rate for Payer: Aetna Commercial |
$74.99
|
| Rate for Payer: Aetna Commercial |
$74.99
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Aetna Medicare |
$58.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.58
|
| Rate for Payer: BCBS Complete |
$10.40
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS MAPPO |
$55.96
|
| Rate for Payer: BCBS MAPPO |
$55.96
|
| Rate for Payer: BCN Medicare Advantage |
$55.96
|
| Rate for Payer: BCN Medicare Advantage |
$55.96
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$80.58
|
| Rate for Payer: Cofinity Commercial |
$80.58
|
| Rate for Payer: Cofinity Commercial |
$74.99
|
| Rate for Payer: Cofinity Commercial |
$74.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.76
|
| Rate for Payer: Nomi Health Commercial |
$67.15
|
| Rate for Payer: Nomi Health Commercial |
$67.15
|
| Rate for Payer: PACE SWMI |
$55.96
|
| Rate for Payer: PACE SWMI |
$55.96
|
| Rate for Payer: PHP Commercial |
$78.34
|
| Rate for Payer: PHP Commercial |
$78.34
|
| Rate for Payer: PHP Medicare Advantage |
$55.96
|
| Rate for Payer: PHP Medicare Advantage |
$55.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Medicare |
$55.96
|
| Rate for Payer: Priority Health Medicare |
$55.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.96
|
| Rate for Payer: UHC Medicare Advantage |
$55.96
|
| Rate for Payer: UHC Medicare Advantage |
$55.96
|
| Rate for Payer: UMR Bronson Commercial |
$11.96
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 73501
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$43.43 |
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Commercial |
$40.41
|
| Rate for Payer: Aetna Medicare |
$31.37
|
| Rate for Payer: Aetna Medicare |
$31.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.43
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCN Medicare Advantage |
$30.16
|
| Rate for Payer: BCN Medicare Advantage |
$30.16
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.67
|
| Rate for Payer: Nomi Health Commercial |
$36.19
|
| Rate for Payer: Nomi Health Commercial |
$36.19
|
| Rate for Payer: PACE SWMI |
$30.16
|
| Rate for Payer: PACE SWMI |
$30.16
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Commercial |
$42.22
|
| Rate for Payer: PHP Medicare Advantage |
$30.16
|
| Rate for Payer: PHP Medicare Advantage |
$30.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.16
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 73502
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$61.83 |
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Commercial |
$57.54
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: Aetna Medicare |
$44.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.83
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: BCN Medicare Advantage |
$42.94
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.09
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: Nomi Health Commercial |
$51.53
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PACE SWMI |
$42.94
|
| Rate for Payer: PHP Commercial |
$60.12
|
| Rate for Payer: PHP Commercial |
$60.12
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: PHP Medicare Advantage |
$42.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health Medicare |
$42.94
|
| Rate for Payer: Priority Health Medicare |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
| Rate for Payer: UHC Medicare Advantage |
$42.94
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
| Rate for Payer: UMR Bronson Commercial |
$10.12
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 73503
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$78.71 |
| Rate for Payer: Aetna Commercial |
$73.24
|
| Rate for Payer: Aetna Commercial |
$73.24
|
| Rate for Payer: Aetna Medicare |
$56.85
|
| Rate for Payer: Aetna Medicare |
$56.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.71
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: BCBS Complete |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$54.66
|
| Rate for Payer: BCBS MAPPO |
$54.66
|
| Rate for Payer: BCN Medicare Advantage |
$54.66
|
| Rate for Payer: BCN Medicare Advantage |
$54.66
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$99.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$78.71
|
| Rate for Payer: Cofinity Commercial |
$78.71
|
| Rate for Payer: Cofinity Commercial |
$73.24
|
| Rate for Payer: Cofinity Commercial |
$73.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.39
|
| Rate for Payer: Nomi Health Commercial |
$65.59
|
| Rate for Payer: Nomi Health Commercial |
$65.59
|
| Rate for Payer: PACE SWMI |
$54.66
|
| Rate for Payer: PACE SWMI |
$54.66
|
| Rate for Payer: PHP Commercial |
$76.52
|
| Rate for Payer: PHP Commercial |
$76.52
|
| Rate for Payer: PHP Medicare Advantage |
$54.66
|
| Rate for Payer: PHP Medicare Advantage |
$54.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Medicare |
$54.66
|
| Rate for Payer: Priority Health Medicare |
$54.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.66
|
| Rate for Payer: UHC Medicare Advantage |
$54.66
|
| Rate for Payer: UHC Medicare Advantage |
$54.66
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
|
|
CHG RADEX HUMERUS MINIMUM 2 VIEWS
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 73060
|
| Min. Negotiated Rate |
$28.92 |
| Max. Negotiated Rate |
$68.25 |
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Commercial |
$38.75
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna Medicare |
$30.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.37
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: Nomi Health Commercial |
$34.70
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PACE SWMI |
$28.92
|
| Rate for Payer: PHP Commercial |
$40.49
|
| Rate for Payer: PHP Commercial |
$40.49
|
| Rate for Payer: PHP Commercial |
$40.49
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: PHP Medicare Advantage |
$28.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$28.92
|
| Rate for Payer: Priority Health Medicare |
$28.92
|
| Rate for Payer: Priority Health Medicare |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UHC Medicare Advantage |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
CHG RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 70160
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$48.90 |
| Rate for Payer: Aetna Commercial |
$45.51
|
| Rate for Payer: Aetna Commercial |
$45.51
|
| Rate for Payer: Aetna Medicare |
$35.32
|
| Rate for Payer: Aetna Medicare |
$35.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.90
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCN Medicare Advantage |
$33.96
|
| Rate for Payer: BCN Medicare Advantage |
$33.96
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Cofinity Commercial |
$45.51
|
| Rate for Payer: Cofinity Commercial |
$45.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.66
|
| Rate for Payer: Nomi Health Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$40.75
|
| Rate for Payer: PACE SWMI |
$33.96
|
| Rate for Payer: PACE SWMI |
$33.96
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Medicare Advantage |
$33.96
|
| Rate for Payer: PHP Medicare Advantage |
$33.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$33.96
|
| Rate for Payer: Priority Health Medicare |
$33.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.96
|
| Rate for Payer: UHC Medicare Advantage |
$33.96
|
| Rate for Payer: UHC Medicare Advantage |
$33.96
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
CHG RADEX OPTIC FORAMINA
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 70190
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$48.64 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna Medicare |
$35.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.27
|
| Rate for Payer: BCBS Complete |
$25.60
|
| Rate for Payer: BCBS MAPPO |
$33.78
|
| Rate for Payer: BCN Medicare Advantage |
$33.78
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cofinity Commercial |
$48.64
|
| Rate for Payer: Cofinity Commercial |
$45.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.47
|
| Rate for Payer: Nomi Health Commercial |
$40.54
|
| Rate for Payer: PACE SWMI |
$33.78
|
| Rate for Payer: PHP Commercial |
$47.29
|
| Rate for Payer: PHP Medicare Advantage |
$33.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health Medicare |
$33.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.78
|
| Rate for Payer: UHC Medicare Advantage |
$33.78
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
|
|
CHG RADEX ORBITS COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 70200
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna Commercial |
$57.77
|
| Rate for Payer: Aetna Medicare |
$44.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.77
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS MAPPO |
$43.11
|
| Rate for Payer: BCN Medicare Advantage |
$43.11
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$62.08
|
| Rate for Payer: Cofinity Commercial |
$57.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.27
|
| Rate for Payer: Nomi Health Commercial |
$51.73
|
| Rate for Payer: PACE SWMI |
$43.11
|
| Rate for Payer: PHP Commercial |
$60.35
|
| Rate for Payer: PHP Medicare Advantage |
$43.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health Medicare |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.11
|
| Rate for Payer: UHC Medicare Advantage |
$43.11
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
CHG RADEX RIBS BILATERAL 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 71110
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$57.04 |
| Rate for Payer: Aetna Commercial |
$53.08
|
| Rate for Payer: Aetna Commercial |
$53.08
|
| Rate for Payer: Aetna Medicare |
$41.19
|
| Rate for Payer: Aetna Medicare |
$41.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.04
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: BCBS Complete |
$44.00
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCN Medicare Advantage |
$39.61
|
| Rate for Payer: BCN Medicare Advantage |
$39.61
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.59
|
| Rate for Payer: Nomi Health Commercial |
$47.53
|
| Rate for Payer: Nomi Health Commercial |
$47.53
|
| Rate for Payer: PACE SWMI |
$39.61
|
| Rate for Payer: PACE SWMI |
$39.61
|
| Rate for Payer: PHP Commercial |
$55.45
|
| Rate for Payer: PHP Commercial |
$55.45
|
| Rate for Payer: PHP Medicare Advantage |
$39.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Medicare |
$39.61
|
| Rate for Payer: Priority Health Medicare |
$39.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.61
|
| Rate for Payer: UHC Medicare Advantage |
$39.61
|
| Rate for Payer: UHC Medicare Advantage |
$39.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
|
|
CHG RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 71111
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$63.57
|
| Rate for Payer: Aetna Commercial |
$63.57
|
| Rate for Payer: Aetna Medicare |
$49.34
|
| Rate for Payer: Aetna Medicare |
$49.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.31
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCN Medicare Advantage |
$47.44
|
| Rate for Payer: BCN Medicare Advantage |
$47.44
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.81
|
| Rate for Payer: Nomi Health Commercial |
$56.93
|
| Rate for Payer: Nomi Health Commercial |
$56.93
|
| Rate for Payer: PACE SWMI |
$47.44
|
| Rate for Payer: PACE SWMI |
$47.44
|
| Rate for Payer: PHP Commercial |
$66.42
|
| Rate for Payer: PHP Commercial |
$66.42
|
| Rate for Payer: PHP Medicare Advantage |
$47.44
|
| Rate for Payer: PHP Medicare Advantage |
$47.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health Medicare |
$47.44
|
| Rate for Payer: Priority Health Medicare |
$47.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.44
|
| Rate for Payer: UHC Medicare Advantage |
$47.44
|
| Rate for Payer: UHC Medicare Advantage |
$47.44
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG RADEX RIBS UNILATERAL 2 VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 71100
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$47.84 |
| Rate for Payer: Aetna Commercial |
$44.51
|
| Rate for Payer: Aetna Medicare |
$34.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.51
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: BCBS MAPPO |
$33.22
|
| Rate for Payer: BCN Medicare Advantage |
$33.22
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| Rate for Payer: Cofinity Commercial |
$44.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.88
|
| Rate for Payer: Nomi Health Commercial |
$39.86
|
| Rate for Payer: PACE SWMI |
$33.22
|
| Rate for Payer: PHP Commercial |
$46.51
|
| Rate for Payer: PHP Medicare Advantage |
$33.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health Medicare |
$33.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.22
|
| Rate for Payer: UHC Medicare Advantage |
$33.22
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
CHG RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 71101
|
| Min. Negotiated Rate |
$24.40 |
| Max. Negotiated Rate |
$54.84 |
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Commercial |
$51.03
|
| Rate for Payer: Aetna Medicare |
$39.60
|
| Rate for Payer: Aetna Medicare |
$39.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.03
|
| Rate for Payer: BCBS Complete |
$20.80
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCN Medicare Advantage |
$38.08
|
| Rate for Payer: BCN Medicare Advantage |
$38.08
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$54.84
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Cofinity Commercial |
$54.84
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.98
|
| Rate for Payer: Nomi Health Commercial |
$45.70
|
| Rate for Payer: Nomi Health Commercial |
$45.70
|
| Rate for Payer: PACE SWMI |
$38.08
|
| Rate for Payer: PACE SWMI |
$38.08
|
| Rate for Payer: PHP Commercial |
$53.31
|
| Rate for Payer: PHP Commercial |
$53.31
|
| Rate for Payer: PHP Medicare Advantage |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$38.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Medicare |
$38.08
|
| Rate for Payer: Priority Health Medicare |
$38.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.08
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
| Rate for Payer: UHC Medicare Advantage |
$38.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
|
|
CHG RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 72220
|
| Min. Negotiated Rate |
$29.54 |
| Max. Negotiated Rate |
$81.90 |
| 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) |
$42.54
|
| 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) |
$39.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.58
|
| Rate for Payer: BCBS Complete |
$50.40
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS Complete |
$16.00
|
| 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 |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$39.58
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| 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 |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| 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 |
$57.96
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
CHG RADEX SCAPULA COMPLETE
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 73010
|
| Min. Negotiated Rate |
$21.88 |
| Max. Negotiated Rate |
$69.55 |
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Commercial |
$29.32
|
| Rate for Payer: Aetna Medicare |
$22.76
|
| Rate for Payer: Aetna Medicare |
$22.76
|
| Rate for Payer: Aetna Medicare |
$22.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.32
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$21.88
|
| Rate for Payer: BCBS MAPPO |
$21.88
|
| Rate for Payer: BCBS MAPPO |
$21.88
|
| Rate for Payer: BCN Medicare Advantage |
$21.88
|
| Rate for Payer: BCN Medicare Advantage |
$21.88
|
| Rate for Payer: BCN Medicare Advantage |
$21.88
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$31.51
|
| Rate for Payer: Cofinity Commercial |
$29.32
|
| Rate for Payer: Cofinity Commercial |
$29.32
|
| Rate for Payer: Cofinity Commercial |
$31.51
|
| Rate for Payer: Cofinity Commercial |
$29.32
|
| Rate for Payer: Cofinity Commercial |
$31.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.97
|
| Rate for Payer: Nomi Health Commercial |
$26.26
|
| Rate for Payer: Nomi Health Commercial |
$26.26
|
| Rate for Payer: Nomi Health Commercial |
$26.26
|
| Rate for Payer: PACE SWMI |
$21.88
|
| Rate for Payer: PACE SWMI |
$21.88
|
| Rate for Payer: PACE SWMI |
$21.88
|
| Rate for Payer: PHP Commercial |
$30.63
|
| Rate for Payer: PHP Commercial |
$30.63
|
| Rate for Payer: PHP Commercial |
$30.63
|
| Rate for Payer: PHP Medicare Advantage |
$21.88
|
| Rate for Payer: PHP Medicare Advantage |
$21.88
|
| Rate for Payer: PHP Medicare Advantage |
$21.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
| Rate for Payer: Priority Health Medicare |
$21.88
|
| Rate for Payer: Priority Health Medicare |
$21.88
|
| Rate for Payer: Priority Health Medicare |
$21.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.88
|
| Rate for Payer: UHC Medicare Advantage |
$21.88
|
| Rate for Payer: UHC Medicare Advantage |
$21.88
|
| Rate for Payer: UHC Medicare Advantage |
$21.88
|
| Rate for Payer: UMR Bronson Commercial |
$49.22
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
|
|
CHG RADEX SHOULDER 1 VIEW
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 73020
|
| Min. Negotiated Rate |
$19.76 |
| Max. Negotiated Rate |
$52.65 |
| Rate for Payer: Aetna Commercial |
$26.48
|
| Rate for Payer: Aetna Commercial |
$26.48
|
| Rate for Payer: Aetna Medicare |
$20.55
|
| Rate for Payer: Aetna Medicare |
$20.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.45
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Complete |
$10.80
|
| Rate for Payer: BCBS MAPPO |
$19.76
|
| Rate for Payer: BCBS MAPPO |
$19.76
|
| Rate for Payer: BCN Medicare Advantage |
$19.76
|
| Rate for Payer: BCN Medicare Advantage |
$19.76
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| Rate for Payer: Cofinity Commercial |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$26.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.75
|
| Rate for Payer: Nomi Health Commercial |
$23.71
|
| Rate for Payer: Nomi Health Commercial |
$23.71
|
| Rate for Payer: PACE SWMI |
$19.76
|
| Rate for Payer: PACE SWMI |
$19.76
|
| Rate for Payer: PHP Commercial |
$27.66
|
| Rate for Payer: PHP Commercial |
$27.66
|
| Rate for Payer: PHP Medicare Advantage |
$19.76
|
| Rate for Payer: PHP Medicare Advantage |
$19.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Medicare |
$19.76
|
| Rate for Payer: Priority Health Medicare |
$19.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.76
|
| Rate for Payer: UHC Medicare Advantage |
$19.76
|
| Rate for Payer: UHC Medicare Advantage |
$19.76
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
|
|
CHG RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 73030
|
| Min. Negotiated Rate |
$31.33 |
| Max. Negotiated Rate |
$74.10 |
| Rate for Payer: Aetna Commercial |
$41.98
|
| Rate for Payer: Aetna Commercial |
$41.98
|
| Rate for Payer: Aetna Commercial |
$41.98
|
| Rate for Payer: Aetna Medicare |
$32.58
|
| Rate for Payer: Aetna Medicare |
$32.58
|
| Rate for Payer: Aetna Medicare |
$32.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.98
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$41.98
|
| Rate for Payer: Cofinity Commercial |
$41.98
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$41.98
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Nomi Health Commercial |
$37.60
|
| Rate for Payer: Nomi Health Commercial |
$37.60
|
| Rate for Payer: Nomi Health Commercial |
$37.60
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PHP Commercial |
$43.86
|
| Rate for Payer: PHP Commercial |
$43.86
|
| Rate for Payer: PHP Commercial |
$43.86
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.33
|
| Rate for Payer: UHC Medicare Advantage |
$31.33
|
| Rate for Payer: UHC Medicare Advantage |
$31.33
|
| Rate for Payer: UHC Medicare Advantage |
$31.33
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
|
|
CHG RADEX SINUSES PARANASAL <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 70210
|
| Min. Negotiated Rate |
$17.20 |
| Max. Negotiated Rate |
$42.11 |
| Rate for Payer: Aetna Commercial |
$39.18
|
| Rate for Payer: Aetna Commercial |
$39.18
|
| Rate for Payer: Aetna Medicare |
$30.41
|
| Rate for Payer: Aetna Medicare |
$30.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.11
|
| Rate for Payer: BCBS Complete |
$17.20
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$29.24
|
| Rate for Payer: BCBS MAPPO |
$29.24
|
| Rate for Payer: BCN Medicare Advantage |
$29.24
|
| Rate for Payer: BCN Medicare Advantage |
$29.24
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Cofinity Commercial |
$39.18
|
| Rate for Payer: Cofinity Commercial |
$39.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.70
|
| Rate for Payer: Nomi Health Commercial |
$35.09
|
| Rate for Payer: Nomi Health Commercial |
$35.09
|
| Rate for Payer: PACE SWMI |
$29.24
|
| Rate for Payer: PACE SWMI |
$29.24
|
| Rate for Payer: PHP Commercial |
$40.94
|
| Rate for Payer: PHP Commercial |
$40.94
|
| Rate for Payer: PHP Medicare Advantage |
$29.24
|
| Rate for Payer: PHP Medicare Advantage |
$29.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health Medicare |
$29.24
|
| Rate for Payer: Priority Health Medicare |
$29.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.24
|
| Rate for Payer: UHC Medicare Advantage |
$29.24
|
| Rate for Payer: UHC Medicare Advantage |
$29.24
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
|
|
CHG RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 70220
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$49.10 |
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Commercial |
$45.69
|
| Rate for Payer: Aetna Medicare |
$35.46
|
| Rate for Payer: Aetna Medicare |
$35.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: BCBS MAPPO |
$34.10
|
| Rate for Payer: BCBS MAPPO |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$34.10
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$45.69
|
| Rate for Payer: Cofinity Commercial |
$45.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.80
|
| Rate for Payer: Nomi Health Commercial |
$40.92
|
| Rate for Payer: Nomi Health Commercial |
$40.92
|
| Rate for Payer: PACE SWMI |
$34.10
|
| Rate for Payer: PACE SWMI |
$34.10
|
| Rate for Payer: PHP Commercial |
$47.74
|
| Rate for Payer: PHP Commercial |
$47.74
|
| Rate for Payer: PHP Medicare Advantage |
$34.10
|
| Rate for Payer: PHP Medicare Advantage |
$34.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health Medicare |
$34.10
|
| Rate for Payer: Priority Health Medicare |
$34.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.10
|
| Rate for Payer: UHC Medicare Advantage |
$34.10
|
| Rate for Payer: UHC Medicare Advantage |
$34.10
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
|
