|
CHG RADEX HIP UNILATERAL WITH PELVIS 1 VIEW
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 73501
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$471.24 |
| Rate for Payer: UHC Medicare Advantage |
$30.16
|
| 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) |
$43.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.41
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCBS MAPPO |
$30.16
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Commercial |
$48.38
|
| 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 |
$15.20
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| Rate for Payer: Cofinity Commercial |
$43.43
|
| 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: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| 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 Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| 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 HMO/PPO/Tiered Network |
$50.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.81
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: Priority Health Medicare |
$30.16
|
| Rate for Payer: Priority Health Narrow Network |
$50.81
|
| Rate for Payer: Priority Health Narrow Network |
$50.81
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| 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: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UMR Bronson Commercial |
$8.74
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 73502
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$267.32 |
| 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) |
$61.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.54
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCBS MAPPO |
$42.94
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCBS Trust/PPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| 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 |
$17.60
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$57.54
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| 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: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| 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 Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| 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 HMO/PPO/Tiered Network |
$73.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.39
|
| Rate for Payer: Priority Health Medicare |
$42.94
|
| Rate for Payer: Priority Health Medicare |
$42.94
|
| Rate for Payer: Priority Health Narrow Network |
$73.39
|
| Rate for Payer: Priority Health Narrow Network |
$73.39
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| 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: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$10.12
|
| Rate for Payer: UMR Bronson Commercial |
$36.80
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 73503
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$92.39 |
| 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) |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.24
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$54.66
|
| Rate for Payer: BCBS MAPPO |
$54.66
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Commercial |
$86.99
|
| 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 |
$99.20
|
| Rate for Payer: Cash Price |
$22.40
|
| 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: Meridian Medicaid |
$8.95
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| 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 Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| 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 HMO/PPO/Tiered Network |
$92.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.39
|
| Rate for Payer: Priority Health Medicare |
$54.66
|
| Rate for Payer: Priority Health Medicare |
$54.66
|
| Rate for Payer: Priority Health Narrow Network |
$92.39
|
| Rate for Payer: Priority Health Narrow Network |
$92.39
|
| Rate for Payer: Priority Health SBD |
$20.01
|
| Rate for Payer: Priority Health SBD |
$20.01
|
| 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: UHCCP Medicaid |
$8.52
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: UMR Bronson Commercial |
$57.04
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
CHG RADEX HUMERUS MINIMUM 2 VIEWS
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 73060
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$222.41 |
| 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) |
$38.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.75
|
| 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) |
$41.64
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS MAPPO |
$28.92
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCBS Trust/PPO |
$222.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| 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 |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| 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 |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| 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: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| 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 Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| 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 HMO/PPO/Tiered Network |
$49.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.28
|
| 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: Priority Health Narrow Network |
$49.28
|
| Rate for Payer: Priority Health Narrow Network |
$49.28
|
| Rate for Payer: Priority Health Narrow Network |
$49.28
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| 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: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 70160
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$59.17 |
| 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) |
$48.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.51
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCBS MAPPO |
$33.96
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$56.19
|
| Rate for Payer: BCN Commercial |
$56.19
|
| 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 |
$39.20
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$45.51
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| Rate for Payer: Cofinity Commercial |
$48.90
|
| 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: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| 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 Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| 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 HMO/PPO/Tiered Network |
$57.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.99
|
| Rate for Payer: Priority Health Medicare |
$33.96
|
| Rate for Payer: Priority Health Medicare |
$33.96
|
| Rate for Payer: Priority Health Narrow Network |
$57.99
|
| Rate for Payer: Priority Health Narrow Network |
$57.99
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| 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: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
| Rate for Payer: UMR Bronson Commercial |
$25.76
|
|
|
CHG RADEX OPTIC FORAMINA
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 70190
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$79.77 |
| Rate for Payer: Aetna Commercial |
$45.27
|
| Rate for Payer: Aetna Medicare |
$35.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.64
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$33.78
|
| Rate for Payer: BCBS Trust/PPO |
$79.77
|
| Rate for Payer: BCN Commercial |
$55.22
|
| 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 |
$45.27
|
| Rate for Payer: Cofinity Commercial |
$48.64
|
| 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: Meridian Medicaid |
$7.16
|
| 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 Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.99
|
| Rate for Payer: Priority Health Medicare |
$33.78
|
| Rate for Payer: Priority Health Narrow Network |
$57.99
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.78
|
| Rate for Payer: UHC Medicare Advantage |
$33.78
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| 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 |
$8.52 |
| Max. Negotiated Rate |
$120.45 |
| Rate for Payer: Aetna Commercial |
$57.77
|
| Rate for Payer: Aetna Medicare |
$44.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.08
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$43.11
|
| Rate for Payer: BCBS Trust/PPO |
$120.45
|
| Rate for Payer: BCN Commercial |
$70.37
|
| 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 |
$57.77
|
| Rate for Payer: Cofinity Commercial |
$62.08
|
| 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: Meridian Medicaid |
$8.95
|
| 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 Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.90
|
| Rate for Payer: Priority Health Medicare |
$43.11
|
| Rate for Payer: Priority Health Narrow Network |
$73.90
|
| Rate for Payer: Priority Health SBD |
$20.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.11
|
| Rate for Payer: UHC Medicare Advantage |
$43.11
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| 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 |
$8.73 |
| Max. Negotiated Rate |
$3,046.18 |
| Rate for Payer: BCBS Complete |
$9.17
|
| 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) |
$57.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.08
|
| Rate for Payer: BCBS Complete |
$9.17
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCBS MAPPO |
$39.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,046.18
|
| Rate for Payer: BCBS Trust/PPO |
$3,046.18
|
| Rate for Payer: BCN Commercial |
$64.51
|
| Rate for Payer: BCN Commercial |
$64.51
|
| 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 |
$88.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| Rate for Payer: Cofinity Commercial |
$57.04
|
| 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: Meridian Medicaid |
$9.17
|
| Rate for Payer: Meridian Medicaid |
$9.17
|
| 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 Choice Medicaid |
$8.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.73
|
| 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 HMO/PPO/Tiered Network |
$67.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.75
|
| Rate for Payer: Priority Health Medicare |
$39.61
|
| Rate for Payer: Priority Health Medicare |
$39.61
|
| Rate for Payer: Priority Health Narrow Network |
$67.75
|
| Rate for Payer: Priority Health Narrow Network |
$67.75
|
| Rate for Payer: Priority Health SBD |
$21.05
|
| Rate for Payer: Priority Health SBD |
$21.05
|
| 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: UHCCP Medicaid |
$8.73
|
| Rate for Payer: UHCCP Medicaid |
$8.73
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
CHG RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 71111
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$2,693.80 |
| 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) |
$68.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCBS MAPPO |
$47.44
|
| Rate for Payer: BCBS Trust/PPO |
$2,693.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,693.80
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: BCN Commercial |
$77.21
|
| 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 |
$26.40
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$63.57
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| 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: Meridian Medicaid |
$10.29
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| 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 Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| 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 HMO/PPO/Tiered Network |
$81.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$81.09
|
| Rate for Payer: Priority Health Medicare |
$47.44
|
| Rate for Payer: Priority Health Medicare |
$47.44
|
| Rate for Payer: Priority Health Narrow Network |
$81.09
|
| Rate for Payer: Priority Health Narrow Network |
$81.09
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| 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: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
|
|
CHG RADEX RIBS UNILATERAL 2 VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 71100
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$3,087.39 |
| Rate for Payer: Aetna Commercial |
$44.51
|
| Rate for Payer: Aetna Medicare |
$34.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.84
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$33.22
|
| Rate for Payer: BCBS Trust/PPO |
$3,087.39
|
| Rate for Payer: BCN Commercial |
$54.24
|
| 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 |
$44.51
|
| Rate for Payer: Cofinity Commercial |
$47.84
|
| 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: Meridian Medicaid |
$7.16
|
| 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 Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$56.46
|
| Rate for Payer: Priority Health Medicare |
$33.22
|
| Rate for Payer: Priority Health Narrow Network |
$56.46
|
| Rate for Payer: Priority Health SBD |
$15.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.22
|
| Rate for Payer: UHC Medicare Advantage |
$33.22
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
CHG RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 71101
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$2,607.16 |
| 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) |
$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: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCBS MAPPO |
$38.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,607.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,607.16
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Commercial |
$62.06
|
| 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 |
$41.60
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Cofinity Commercial |
$54.84
|
| 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: Meridian Medicaid |
$8.49
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| 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 Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| 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 HMO/PPO/Tiered Network |
$65.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.19
|
| Rate for Payer: Priority Health Medicare |
$38.08
|
| Rate for Payer: Priority Health Medicare |
$38.08
|
| Rate for Payer: Priority Health Narrow Network |
$65.19
|
| Rate for Payer: Priority Health Narrow Network |
$65.19
|
| Rate for Payer: Priority Health SBD |
$19.51
|
| Rate for Payer: Priority Health SBD |
$19.51
|
| 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: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
|
|
CHG RADEX SACRUM & COCCYX MINIMUM 2 VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 72220
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$2,093.12 |
| 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) |
$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: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS MAPPO |
$29.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,093.12
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| 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 |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| 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 |
$42.54
|
| Rate for Payer: Cofinity Commercial |
$42.54
|
| 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: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| 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 Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| 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 HMO/PPO/Tiered Network |
$50.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.30
|
| 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: Priority Health Narrow Network |
$50.30
|
| Rate for Payer: Priority Health Narrow Network |
$50.30
|
| Rate for Payer: Priority Health Narrow Network |
$50.30
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| 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: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UMR Bronson Commercial |
$57.96
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
CHG RADEX SCAPULA COMPLETE
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 73010
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$2,600.29 |
| 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) |
$29.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.32
|
| 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) |
$31.51
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$21.88
|
| Rate for Payer: BCBS MAPPO |
$21.88
|
| Rate for Payer: BCBS MAPPO |
$21.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,600.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,600.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,600.29
|
| Rate for Payer: BCN Commercial |
$34.70
|
| Rate for Payer: BCN Commercial |
$34.70
|
| Rate for Payer: BCN Commercial |
$34.70
|
| 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 |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| 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 |
$31.51
|
| Rate for Payer: Cofinity Commercial |
$31.51
|
| Rate for Payer: Cofinity Commercial |
$29.32
|
| 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: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| 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 Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
| 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 HMO/PPO/Tiered Network |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.96
|
| 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: Priority Health Narrow Network |
$36.96
|
| Rate for Payer: Priority Health Narrow Network |
$36.96
|
| Rate for Payer: Priority Health Narrow Network |
$36.96
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| 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: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$49.22
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
CHG RADEX SHOULDER 1 VIEW
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 73020
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$940.90 |
| 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) |
$28.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.48
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$19.76
|
| Rate for Payer: BCBS MAPPO |
$19.76
|
| Rate for Payer: BCBS Trust/PPO |
$940.90
|
| Rate for Payer: BCBS Trust/PPO |
$940.90
|
| Rate for Payer: BCN Commercial |
$31.76
|
| Rate for Payer: BCN Commercial |
$31.76
|
| 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 |
$21.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$26.48
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| Rate for Payer: Cofinity Commercial |
$28.45
|
| 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: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| 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 Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| 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 HMO/PPO/Tiered Network |
$33.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.37
|
| Rate for Payer: Priority Health Medicare |
$19.76
|
| Rate for Payer: Priority Health Medicare |
$19.76
|
| Rate for Payer: Priority Health Narrow Network |
$33.37
|
| Rate for Payer: Priority Health Narrow Network |
$33.37
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| 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: UHCCP Medicaid |
$4.69
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
|
|
CHG RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 73030
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$2,232.07 |
| 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) |
$41.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.98
|
| 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) |
$45.12
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.07
|
| Rate for Payer: BCBS Trust/PPO |
$2,232.07
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: BCN Commercial |
$50.82
|
| Rate for Payer: BCN Commercial |
$50.82
|
| 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 |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| 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 |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$45.12
|
| Rate for Payer: Cofinity Commercial |
$41.98
|
| 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: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| 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 Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| 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 HMO/PPO/Tiered Network |
$53.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.89
|
| 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: Priority Health Narrow Network |
$53.89
|
| Rate for Payer: Priority Health Narrow Network |
$53.89
|
| Rate for Payer: Priority Health Narrow Network |
$53.89
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| 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: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
CHG RADEX SINUSES PARANASAL <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 70210
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$163.24 |
| 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) |
$42.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.18
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$29.24
|
| Rate for Payer: BCBS MAPPO |
$29.24
|
| Rate for Payer: BCBS Trust/PPO |
$163.24
|
| Rate for Payer: BCBS Trust/PPO |
$163.24
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| 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 |
$14.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$39.18
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| Rate for Payer: Cofinity Commercial |
$42.11
|
| 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: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| 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 Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| 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 HMO/PPO/Tiered Network |
$49.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49.79
|
| Rate for Payer: Priority Health Medicare |
$29.24
|
| Rate for Payer: Priority Health Medicare |
$29.24
|
| Rate for Payer: Priority Health Narrow Network |
$49.79
|
| Rate for Payer: Priority Health Narrow Network |
$49.79
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| 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: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
CHG RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 70220
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$57.99 |
| 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) |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.69
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$34.10
|
| Rate for Payer: BCBS MAPPO |
$34.10
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCBS Trust/PPO |
$57.58
|
| Rate for Payer: BCN Commercial |
$55.22
|
| Rate for Payer: BCN Commercial |
$55.22
|
| 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 |
$40.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$45.69
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| 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: Meridian Medicaid |
$6.93
|
| Rate for Payer: Meridian Medicaid |
$6.93
|
| 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 Choice Medicaid |
$6.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.60
|
| 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 HMO/PPO/Tiered Network |
$57.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.99
|
| Rate for Payer: Priority Health Medicare |
$34.10
|
| Rate for Payer: Priority Health Medicare |
$34.10
|
| Rate for Payer: Priority Health Narrow Network |
$57.99
|
| Rate for Payer: Priority Health Narrow Network |
$57.99
|
| Rate for Payer: Priority Health SBD |
$15.91
|
| Rate for Payer: Priority Health SBD |
$15.91
|
| 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: UHCCP Medicaid |
$6.60
|
| Rate for Payer: UHCCP Medicaid |
$6.60
|
| Rate for Payer: UMR Bronson Commercial |
$23.46
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
|
|
CHG RADEX SPINE 1 VIEW SPECIFY LEVEL
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 72020
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$527.77 |
| Rate for Payer: Aetna Commercial |
$29.67
|
| Rate for Payer: Aetna Commercial |
$29.67
|
| Rate for Payer: Aetna Medicare |
$23.03
|
| Rate for Payer: Aetna Medicare |
$23.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.67
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$22.14
|
| Rate for Payer: BCBS MAPPO |
$22.14
|
| Rate for Payer: BCBS Trust/PPO |
$527.77
|
| Rate for Payer: BCBS Trust/PPO |
$527.77
|
| Rate for Payer: BCN Commercial |
$36.16
|
| Rate for Payer: BCN Commercial |
$36.16
|
| Rate for Payer: BCN Medicare Advantage |
$22.14
|
| Rate for Payer: BCN Medicare Advantage |
$22.14
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Cofinity Commercial |
$31.88
|
| Rate for Payer: Cofinity Commercial |
$31.88
|
| Rate for Payer: Cofinity Commercial |
$29.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.25
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Nomi Health Commercial |
$26.57
|
| Rate for Payer: Nomi Health Commercial |
$26.57
|
| Rate for Payer: PACE SWMI |
$22.14
|
| Rate for Payer: PACE SWMI |
$22.14
|
| Rate for Payer: PHP Commercial |
$31.00
|
| Rate for Payer: PHP Commercial |
$31.00
|
| Rate for Payer: PHP Medicare Advantage |
$22.14
|
| Rate for Payer: PHP Medicare Advantage |
$22.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.47
|
| Rate for Payer: Priority Health Medicare |
$22.14
|
| Rate for Payer: Priority Health Medicare |
$22.14
|
| Rate for Payer: Priority Health Narrow Network |
$37.47
|
| Rate for Payer: Priority Health Narrow Network |
$37.47
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| Rate for Payer: Priority Health SBD |
$11.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.14
|
| Rate for Payer: UHC Medicare Advantage |
$22.14
|
| Rate for Payer: UHC Medicare Advantage |
$22.14
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$12.42
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 72040
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$1,719.09 |
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.65
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,719.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,719.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,719.09
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Commercial |
$58.15
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PHP Commercial |
$50.22
|
| Rate for Payer: PHP Commercial |
$50.22
|
| Rate for Payer: PHP Commercial |
$50.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.07
|
| Rate for Payer: Priority Health Medicare |
$35.87
|
| Rate for Payer: Priority Health Medicare |
$35.87
|
| Rate for Payer: Priority Health Medicare |
$35.87
|
| Rate for Payer: Priority Health Narrow Network |
$61.07
|
| Rate for Payer: Priority Health Narrow Network |
$61.07
|
| Rate for Payer: Priority Health Narrow Network |
$61.07
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
CHG RADEX SPINE CERVICAL 4 OR 5 VIEWS
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 72050
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$1,535.24 |
| Rate for Payer: Aetna Commercial |
$65.23
|
| Rate for Payer: Aetna Commercial |
$65.23
|
| Rate for Payer: Aetna Commercial |
$65.23
|
| Rate for Payer: Aetna Medicare |
$50.63
|
| Rate for Payer: Aetna Medicare |
$50.63
|
| Rate for Payer: Aetna Medicare |
$50.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.10
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS MAPPO |
$48.68
|
| Rate for Payer: BCBS MAPPO |
$48.68
|
| Rate for Payer: BCBS MAPPO |
$48.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,535.24
|
| Rate for Payer: BCN Commercial |
$78.19
|
| Rate for Payer: BCN Commercial |
$78.19
|
| Rate for Payer: BCN Commercial |
$78.19
|
| Rate for Payer: BCN Medicare Advantage |
$48.68
|
| Rate for Payer: BCN Medicare Advantage |
$48.68
|
| Rate for Payer: BCN Medicare Advantage |
$48.68
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$65.23
|
| Rate for Payer: Cofinity Commercial |
$65.23
|
| Rate for Payer: Cofinity Commercial |
$70.10
|
| Rate for Payer: Cofinity Commercial |
$70.10
|
| Rate for Payer: Cofinity Commercial |
$70.10
|
| Rate for Payer: Cofinity Commercial |
$65.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.11
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Nomi Health Commercial |
$58.42
|
| Rate for Payer: Nomi Health Commercial |
$58.42
|
| Rate for Payer: Nomi Health Commercial |
$58.42
|
| Rate for Payer: PACE SWMI |
$48.68
|
| Rate for Payer: PACE SWMI |
$48.68
|
| Rate for Payer: PACE SWMI |
$48.68
|
| Rate for Payer: PHP Commercial |
$68.15
|
| Rate for Payer: PHP Commercial |
$68.15
|
| Rate for Payer: PHP Commercial |
$68.15
|
| Rate for Payer: PHP Medicare Advantage |
$48.68
|
| Rate for Payer: PHP Medicare Advantage |
$48.68
|
| Rate for Payer: PHP Medicare Advantage |
$48.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health Medicare |
$48.68
|
| Rate for Payer: Priority Health Medicare |
$48.68
|
| Rate for Payer: Priority Health Medicare |
$48.68
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health SBD |
$19.51
|
| Rate for Payer: Priority Health SBD |
$19.51
|
| Rate for Payer: Priority Health SBD |
$19.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.68
|
| Rate for Payer: UHC Medicare Advantage |
$48.68
|
| Rate for Payer: UHC Medicare Advantage |
$48.68
|
| Rate for Payer: UHC Medicare Advantage |
$48.68
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
| Rate for Payer: UMR Bronson Commercial |
$23.92
|
|
|
CHG RADEX SPINE CERVICAL 6 OR MORE VIEWS
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 72052
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$1,477.13 |
| Rate for Payer: Aetna Commercial |
$74.95
|
| Rate for Payer: Aetna Commercial |
$74.95
|
| Rate for Payer: Aetna Medicare |
$58.17
|
| Rate for Payer: Aetna Medicare |
$58.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.95
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS Complete |
$9.62
|
| Rate for Payer: BCBS MAPPO |
$55.93
|
| Rate for Payer: BCBS MAPPO |
$55.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,477.13
|
| Rate for Payer: BCN Commercial |
$91.38
|
| Rate for Payer: BCN Commercial |
$91.38
|
| Rate for Payer: BCN Medicare Advantage |
$55.93
|
| Rate for Payer: BCN Medicare Advantage |
$55.93
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$74.95
|
| Rate for Payer: Cofinity Commercial |
$80.54
|
| Rate for Payer: Cofinity Commercial |
$80.54
|
| Rate for Payer: Cofinity Commercial |
$74.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.73
|
| Rate for Payer: Meridian Medicaid |
$9.62
|
| Rate for Payer: Meridian Medicaid |
$9.62
|
| Rate for Payer: Nomi Health Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$67.12
|
| Rate for Payer: PACE SWMI |
$55.93
|
| Rate for Payer: PACE SWMI |
$55.93
|
| Rate for Payer: PHP Commercial |
$78.30
|
| Rate for Payer: PHP Commercial |
$78.30
|
| Rate for Payer: PHP Medicare Advantage |
$55.93
|
| Rate for Payer: PHP Medicare Advantage |
$55.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$96.49
|
| Rate for Payer: Priority Health Medicare |
$55.93
|
| Rate for Payer: Priority Health Medicare |
$55.93
|
| Rate for Payer: Priority Health Narrow Network |
$96.49
|
| Rate for Payer: Priority Health Narrow Network |
$96.49
|
| Rate for Payer: Priority Health SBD |
$22.06
|
| Rate for Payer: Priority Health SBD |
$22.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.93
|
| Rate for Payer: UHC Medicare Advantage |
$55.93
|
| Rate for Payer: UHC Medicare Advantage |
$55.93
|
| Rate for Payer: UHCCP Medicaid |
$9.16
|
| Rate for Payer: UHCCP Medicaid |
$9.16
|
| Rate for Payer: UMR Bronson Commercial |
$40.48
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
|
|
CHG RADEX SPINE LUMBOSACRAL 2/3 VIEWS
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 72100
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$2,071.46 |
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Commercial |
$48.07
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna Medicare |
$37.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.65
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS MAPPO |
$35.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,071.46
|
| Rate for Payer: BCN Commercial |
$58.65
|
| Rate for Payer: BCN Commercial |
$58.65
|
| Rate for Payer: BCN Commercial |
$58.65
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: BCN Medicare Advantage |
$35.87
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$51.65
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.66
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: Nomi Health Commercial |
$43.04
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PACE SWMI |
$35.87
|
| Rate for Payer: PHP Commercial |
$50.22
|
| Rate for Payer: PHP Commercial |
$50.22
|
| Rate for Payer: PHP Commercial |
$50.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: PHP Medicare Advantage |
$35.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$61.60
|
| Rate for Payer: Priority Health Medicare |
$35.87
|
| Rate for Payer: Priority Health Medicare |
$35.87
|
| Rate for Payer: Priority Health Medicare |
$35.87
|
| Rate for Payer: Priority Health Narrow Network |
$61.60
|
| Rate for Payer: Priority Health Narrow Network |
$61.60
|
| Rate for Payer: Priority Health Narrow Network |
$61.60
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHC Medicare Advantage |
$35.87
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$47.84
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
|
|
CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 72110
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$2,111.09 |
| Rate for Payer: Aetna Commercial |
$62.83
|
| Rate for Payer: Aetna Commercial |
$62.83
|
| Rate for Payer: Aetna Commercial |
$62.83
|
| Rate for Payer: Aetna Medicare |
$48.77
|
| Rate for Payer: Aetna Medicare |
$48.77
|
| Rate for Payer: Aetna Medicare |
$48.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.52
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$46.89
|
| Rate for Payer: BCBS MAPPO |
$46.89
|
| Rate for Payer: BCBS MAPPO |
$46.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,111.09
|
| Rate for Payer: BCN Commercial |
$75.26
|
| Rate for Payer: BCN Commercial |
$75.26
|
| Rate for Payer: BCN Commercial |
$75.26
|
| Rate for Payer: BCN Medicare Advantage |
$46.89
|
| Rate for Payer: BCN Medicare Advantage |
$46.89
|
| Rate for Payer: BCN Medicare Advantage |
$46.89
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$120.80
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$67.52
|
| Rate for Payer: Cofinity Commercial |
$67.52
|
| Rate for Payer: Cofinity Commercial |
$67.52
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.23
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Nomi Health Commercial |
$56.27
|
| Rate for Payer: Nomi Health Commercial |
$56.27
|
| Rate for Payer: Nomi Health Commercial |
$56.27
|
| Rate for Payer: PACE SWMI |
$46.89
|
| Rate for Payer: PACE SWMI |
$46.89
|
| Rate for Payer: PACE SWMI |
$46.89
|
| Rate for Payer: PHP Commercial |
$65.65
|
| Rate for Payer: PHP Commercial |
$65.65
|
| Rate for Payer: PHP Commercial |
$65.65
|
| Rate for Payer: PHP Medicare Advantage |
$46.89
|
| Rate for Payer: PHP Medicare Advantage |
$46.89
|
| Rate for Payer: PHP Medicare Advantage |
$46.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.07
|
| Rate for Payer: Priority Health Medicare |
$46.89
|
| Rate for Payer: Priority Health Medicare |
$46.89
|
| Rate for Payer: Priority Health Medicare |
$46.89
|
| Rate for Payer: Priority Health Narrow Network |
$80.07
|
| Rate for Payer: Priority Health Narrow Network |
$80.07
|
| Rate for Payer: Priority Health Narrow Network |
$80.07
|
| Rate for Payer: Priority Health SBD |
$19.00
|
| Rate for Payer: Priority Health SBD |
$19.00
|
| Rate for Payer: Priority Health SBD |
$19.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.89
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
| Rate for Payer: UMR Bronson Commercial |
$69.46
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
CHG RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 72120
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$3,290.25 |
| Rate for Payer: Aetna Commercial |
$49.24
|
| Rate for Payer: Aetna Medicare |
$38.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.92
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$36.75
|
| Rate for Payer: BCBS Trust/PPO |
$3,290.25
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Medicare Advantage |
$36.75
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$49.24
|
| Rate for Payer: Cofinity Commercial |
$52.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.59
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$44.10
|
| Rate for Payer: PACE SWMI |
$36.75
|
| Rate for Payer: PHP Commercial |
$51.45
|
| Rate for Payer: PHP Medicare Advantage |
$36.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.62
|
| Rate for Payer: Priority Health Medicare |
$36.75
|
| Rate for Payer: Priority Health Narrow Network |
$62.62
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.75
|
| Rate for Payer: UHC Medicare Advantage |
$36.75
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
CHG RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 72114
|
| Min. Negotiated Rate |
$9.37 |
| Max. Negotiated Rate |
$2,773.58 |
| Rate for Payer: Aetna Commercial |
$74.16
|
| Rate for Payer: Aetna Commercial |
$74.16
|
| Rate for Payer: Aetna Medicare |
$57.55
|
| Rate for Payer: Aetna Medicare |
$57.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.69
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS Complete |
$9.84
|
| Rate for Payer: BCBS MAPPO |
$55.34
|
| Rate for Payer: BCBS MAPPO |
$55.34
|
| Rate for Payer: BCBS Trust/PPO |
$2,773.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,773.58
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Commercial |
$90.89
|
| Rate for Payer: BCN Medicare Advantage |
$55.34
|
| Rate for Payer: BCN Medicare Advantage |
$55.34
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$74.16
|
| Rate for Payer: Cofinity Commercial |
$79.69
|
| Rate for Payer: Cofinity Commercial |
$79.69
|
| Rate for Payer: Cofinity Commercial |
$74.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.11
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Meridian Medicaid |
$9.84
|
| Rate for Payer: Nomi Health Commercial |
$66.41
|
| Rate for Payer: Nomi Health Commercial |
$66.41
|
| Rate for Payer: PACE SWMI |
$55.34
|
| Rate for Payer: PACE SWMI |
$55.34
|
| Rate for Payer: PHP Commercial |
$77.48
|
| Rate for Payer: PHP Commercial |
$77.48
|
| Rate for Payer: PHP Medicare Advantage |
$55.34
|
| Rate for Payer: PHP Medicare Advantage |
$55.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.44
|
| Rate for Payer: Priority Health Medicare |
$55.34
|
| Rate for Payer: Priority Health Medicare |
$55.34
|
| Rate for Payer: Priority Health Narrow Network |
$94.44
|
| Rate for Payer: Priority Health Narrow Network |
$94.44
|
| Rate for Payer: Priority Health SBD |
$22.06
|
| Rate for Payer: Priority Health SBD |
$22.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$55.34
|
| Rate for Payer: UHC Medicare Advantage |
$55.34
|
| Rate for Payer: UHCCP Medicaid |
$9.37
|
| Rate for Payer: UHCCP Medicaid |
$9.37
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
|
