|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 71045
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,646.71 |
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Commercial |
$31.72
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.72
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$31.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: Nomi Health Commercial |
$28.40
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Commercial |
$33.14
|
| Rate for Payer: PHP Commercial |
$33.14
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| 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 |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.52
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Medicare |
$23.67
|
| Rate for Payer: Priority Health Narrow Network |
$39.52
|
| Rate for Payer: Priority Health Narrow Network |
$39.52
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$76.99 |
| Rate for Payer: Aetna Commercial |
$60.81
|
| Rate for Payer: Aetna Medicare |
$47.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.35
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$45.38
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: BCN Medicare Advantage |
$45.38
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$60.81
|
| Rate for Payer: Cofinity Commercial |
$65.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.65
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Nomi Health Commercial |
$54.46
|
| Rate for Payer: PACE SWMI |
$45.38
|
| Rate for Payer: PHP Commercial |
$63.53
|
| Rate for Payer: PHP Medicare Advantage |
$45.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$76.99
|
| Rate for Payer: Priority Health Medicare |
$45.38
|
| Rate for Payer: Priority Health Narrow Network |
$76.99
|
| Rate for Payer: Priority Health SBD |
$23.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.38
|
| Rate for Payer: UHC Medicare Advantage |
$45.38
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 73600
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$1,179.17 |
| 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 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: 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 Trust/PPO |
$1,179.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: BCN Medicare Advantage |
$28.92
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$41.64
|
| Rate for Payer: Cofinity Commercial |
$38.75
|
| 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: 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: 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: 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: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| 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 |
$28.92
|
| Rate for Payer: Priority Health Medicare |
$28.92
|
| Rate for Payer: Priority Health Narrow Network |
$49.79
|
| Rate for Payer: Priority Health Narrow Network |
$49.79
|
| 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 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: UMR Bronson Commercial |
$36.34
|
| Rate for Payer: UMR Bronson Commercial |
$12.88
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 70030
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$5,212.15 |
| Rate for Payer: Aetna Commercial |
$40.01
|
| Rate for Payer: Aetna Medicare |
$31.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.00
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$29.86
|
| Rate for Payer: BCBS Trust/PPO |
$5,212.15
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$29.86
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$40.01
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.35
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$35.83
|
| Rate for Payer: PACE SWMI |
$29.86
|
| Rate for Payer: PHP Commercial |
$41.80
|
| Rate for Payer: PHP Medicare Advantage |
$29.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| 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 Medicare |
$29.86
|
| Rate for Payer: Priority Health Narrow Network |
$50.30
|
| Rate for Payer: Priority Health SBD |
$12.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.86
|
| Rate for Payer: UHC Medicare Advantage |
$29.86
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73551
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$2,038.18 |
| Rate for Payer: Aetna Commercial |
$35.99
|
| Rate for Payer: Aetna Medicare |
$27.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.68
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$26.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,038.18
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Medicare Advantage |
$26.86
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$35.99
|
| Rate for Payer: Cofinity Commercial |
$38.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.20
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Nomi Health Commercial |
$32.23
|
| Rate for Payer: PACE SWMI |
$26.86
|
| Rate for Payer: PHP Commercial |
$37.60
|
| Rate for Payer: PHP Medicare Advantage |
$26.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$45.16
|
| Rate for Payer: Priority Health Medicare |
$26.86
|
| Rate for Payer: Priority Health Narrow Network |
$45.16
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.86
|
| Rate for Payer: UHC Medicare Advantage |
$26.86
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$63.00
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,676.30 |
| Rate for Payer: Aetna Commercial |
$43.17
|
| Rate for Payer: Aetna Commercial |
$43.17
|
| Rate for Payer: Aetna Medicare |
$33.51
|
| Rate for Payer: Aetna Medicare |
$33.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.17
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$32.22
|
| Rate for Payer: BCBS MAPPO |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Medicare Advantage |
$32.22
|
| Rate for Payer: BCN Medicare Advantage |
$32.22
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$43.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.83
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$38.66
|
| Rate for Payer: Nomi Health Commercial |
$38.66
|
| Rate for Payer: PACE SWMI |
$32.22
|
| Rate for Payer: PACE SWMI |
$32.22
|
| Rate for Payer: PHP Commercial |
$45.11
|
| Rate for Payer: PHP Commercial |
$45.11
|
| Rate for Payer: PHP Medicare Advantage |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$32.22
|
| 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 |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.92
|
| Rate for Payer: Priority Health Medicare |
$32.22
|
| Rate for Payer: Priority Health Medicare |
$32.22
|
| Rate for Payer: Priority Health Narrow Network |
$54.92
|
| Rate for Payer: Priority Health Narrow Network |
$54.92
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.22
|
| Rate for Payer: UHC Medicare Advantage |
$32.22
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$9.20
|
| Rate for Payer: UMR Bronson Commercial |
$28.98
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 73620
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$954.11 |
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Commercial |
$34.41
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna Medicare |
$26.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.98
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS MAPPO |
$25.68
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: BCN Medicare Advantage |
$25.68
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Cofinity Commercial |
$34.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.96
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: Nomi Health Commercial |
$30.82
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PACE SWMI |
$25.68
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Commercial |
$35.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: PHP Medicare Advantage |
$25.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| 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 |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.14
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Medicare |
$25.68
|
| Rate for Payer: Priority Health Narrow Network |
$44.14
|
| Rate for Payer: Priority Health Narrow Network |
$44.14
|
| Rate for Payer: Priority Health Narrow Network |
$44.14
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHC Medicare Advantage |
$25.68
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| 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 |
$35.88
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$1,586.48 |
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Commercial |
$41.12
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna Medicare |
$31.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.19
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS MAPPO |
$30.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.48
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: BCN Medicare Advantage |
$30.69
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$44.19
|
| Rate for Payer: Cofinity Commercial |
$41.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.22
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: Nomi Health Commercial |
$36.83
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PACE SWMI |
$30.69
|
| Rate for Payer: PHP Commercial |
$42.97
|
| Rate for Payer: PHP Commercial |
$42.97
|
| Rate for Payer: PHP Commercial |
$42.97
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: PHP Medicare Advantage |
$30.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.87
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Medicare |
$30.69
|
| Rate for Payer: Priority Health Narrow Network |
$52.87
|
| Rate for Payer: Priority Health Narrow Network |
$52.87
|
| Rate for Payer: Priority Health Narrow Network |
$52.87
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$30.69
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
| Rate for Payer: UMR Bronson Commercial |
$39.10
|
| Rate for Payer: UMR Bronson Commercial |
$19.32
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$2,259.01 |
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Commercial |
$49.10
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna Medicare |
$38.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.76
|
| 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) |
$52.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.76
|
| 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 |
$36.64
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS MAPPO |
$36.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.01
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: BCN Medicare Advantage |
$36.64
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$52.76
|
| Rate for Payer: Cofinity Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.47
|
| 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 |
$43.97
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: Nomi Health Commercial |
$43.97
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PACE SWMI |
$36.64
|
| Rate for Payer: PHP Commercial |
$51.30
|
| Rate for Payer: PHP Commercial |
$51.30
|
| Rate for Payer: PHP Commercial |
$51.30
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| Rate for Payer: PHP Medicare Advantage |
$36.64
|
| 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 |
$20.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.13
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: Priority Health Medicare |
$36.64
|
| Rate for Payer: Priority Health Narrow Network |
$63.13
|
| Rate for Payer: Priority Health Narrow Network |
$63.13
|
| Rate for Payer: Priority Health Narrow Network |
$63.13
|
| 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 |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| Rate for Payer: UHC Medicare Advantage |
$36.64
|
| 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 |
$14.72
|
| Rate for Payer: UMR Bronson Commercial |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70100
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,040.22 |
| Rate for Payer: Aetna Commercial |
$46.73
|
| Rate for Payer: Aetna Medicare |
$36.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.21
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$34.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.22
|
| Rate for Payer: BCN Commercial |
$56.68
|
| Rate for Payer: BCN Medicare Advantage |
$34.87
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$46.73
|
| Rate for Payer: Cofinity Commercial |
$50.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.61
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$41.84
|
| Rate for Payer: PACE SWMI |
$34.87
|
| Rate for Payer: PHP Commercial |
$48.82
|
| Rate for Payer: PHP Medicare Advantage |
$34.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.06
|
| Rate for Payer: Priority Health Medicare |
$34.87
|
| Rate for Payer: Priority Health Narrow Network |
$60.06
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.87
|
| Rate for Payer: UHC Medicare Advantage |
$34.87
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 70360
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$38.04
|
| Rate for Payer: Aetna Medicare |
$29.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.88
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$28.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,020.75
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$28.39
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$38.04
|
| Rate for Payer: Cofinity Commercial |
$40.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.81
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$34.07
|
| Rate for Payer: PACE SWMI |
$28.39
|
| Rate for Payer: PHP Commercial |
$39.75
|
| Rate for Payer: PHP Medicare Advantage |
$28.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.25
|
| Rate for Payer: Priority Health Medicare |
$28.39
|
| Rate for Payer: Priority Health Narrow Network |
$48.25
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.39
|
| Rate for Payer: UHC Medicare Advantage |
$28.39
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPLETE
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 77075
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$153.47 |
| Rate for Payer: Aetna Commercial |
$119.97
|
| Rate for Payer: Aetna Medicare |
$93.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.92
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$89.53
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: BCN Medicare Advantage |
$89.53
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$119.97
|
| Rate for Payer: Cofinity Commercial |
$128.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.01
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Nomi Health Commercial |
$107.44
|
| Rate for Payer: PACE SWMI |
$89.53
|
| Rate for Payer: PHP Commercial |
$125.34
|
| Rate for Payer: PHP Medicare Advantage |
$89.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.47
|
| Rate for Payer: Priority Health Medicare |
$89.53
|
| Rate for Payer: Priority Health Narrow Network |
$153.47
|
| Rate for Payer: Priority Health SBD |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.53
|
| Rate for Payer: UHC Medicare Advantage |
$89.53
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 72170
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Commercial |
$34.05
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.05
|
| 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 |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS MAPPO |
$25.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$25.41
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$36.59
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.68
|
| 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 |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$30.49
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PACE SWMI |
$25.41
|
| Rate for Payer: PHP Commercial |
$35.57
|
| Rate for Payer: PHP Commercial |
$35.57
|
| Rate for Payer: PHP Commercial |
$35.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| Rate for Payer: PHP Medicare Advantage |
$25.41
|
| 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 |
$77.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.11
|
| Rate for Payer: Priority Health Medicare |
$25.41
|
| Rate for Payer: Priority Health Medicare |
$25.41
|
| Rate for Payer: Priority Health Medicare |
$25.41
|
| Rate for Payer: Priority Health Narrow Network |
$43.11
|
| Rate for Payer: Priority Health Narrow Network |
$43.11
|
| Rate for Payer: Priority Health Narrow Network |
$43.11
|
| 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 |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| Rate for Payer: UHC Medicare Advantage |
$25.41
|
| 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 |
$20.70
|
| Rate for Payer: UMR Bronson Commercial |
$54.74
|
| Rate for Payer: UMR Bronson Commercial |
$17.94
|
|
|
CHG RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72200
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$2,183.46 |
| Rate for Payer: Aetna Commercial |
$40.76
|
| Rate for Payer: Aetna Medicare |
$31.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.80
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$30.42
|
| Rate for Payer: BCBS Trust/PPO |
$2,183.46
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: BCN Medicare Advantage |
$30.42
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$40.76
|
| Rate for Payer: Cofinity Commercial |
$43.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.94
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Nomi Health Commercial |
$36.50
|
| Rate for Payer: PACE SWMI |
$30.42
|
| Rate for Payer: PHP Commercial |
$42.59
|
| Rate for Payer: PHP Medicare Advantage |
$30.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.33
|
| Rate for Payer: Priority Health Medicare |
$30.42
|
| Rate for Payer: Priority Health Narrow Network |
$51.33
|
| Rate for Payer: Priority Health SBD |
$12.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.42
|
| Rate for Payer: UHC Medicare Advantage |
$30.42
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UMR Bronson Commercial |
$19.78
|
|
|
CHG RADIOLOGIC EXAMINATION SKULL 4< VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70250
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,779.84 |
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Commercial |
$43.56
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Aetna Medicare |
$33.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.81
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS MAPPO |
$32.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.84
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.51
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Cofinity Commercial |
$46.81
|
| Rate for Payer: Cofinity Commercial |
$43.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.14
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: Nomi Health Commercial |
$39.01
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PACE SWMI |
$32.51
|
| Rate for Payer: PHP Commercial |
$45.51
|
| Rate for Payer: PHP Commercial |
$45.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| Rate for Payer: PHP Medicare Advantage |
$32.51
|
| 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 |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55.43
|
| Rate for Payer: Priority Health Medicare |
$32.51
|
| Rate for Payer: Priority Health Medicare |
$32.51
|
| Rate for Payer: Priority Health Narrow Network |
$55.43
|
| Rate for Payer: Priority Health Narrow Network |
$55.43
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: Priority Health SBD |
$13.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHC Medicare Advantage |
$32.51
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$22.08
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
|
|
CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 73590
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$598.56 |
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Commercial |
$38.35
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna Medicare |
$29.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.21
|
| 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 |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$28.62
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: BCN Medicare Advantage |
$28.62
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$41.21
|
| Rate for Payer: Cofinity Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.05
|
| 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 |
$34.34
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: Nomi Health Commercial |
$34.34
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PACE SWMI |
$28.62
|
| Rate for Payer: PHP Commercial |
$40.07
|
| Rate for Payer: PHP Commercial |
$40.07
|
| Rate for Payer: PHP Commercial |
$40.07
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| Rate for Payer: PHP Medicare Advantage |
$28.62
|
| 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 |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.75
|
| Rate for Payer: Priority Health Medicare |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$28.62
|
| Rate for Payer: Priority Health Medicare |
$28.62
|
| Rate for Payer: Priority Health Narrow Network |
$48.75
|
| Rate for Payer: Priority Health Narrow Network |
$48.75
|
| Rate for Payer: Priority Health Narrow Network |
$48.75
|
| 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 |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| Rate for Payer: UHC Medicare Advantage |
$28.62
|
| 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 |
$13.80
|
| Rate for Payer: UMR Bronson Commercial |
$38.64
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
|
|
CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 73564
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$1,700.07 |
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Commercial |
$57.15
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna Medicare |
$44.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.42
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS MAPPO |
$42.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: BCN Medicare Advantage |
$42.65
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$61.42
|
| Rate for Payer: Cofinity Commercial |
$57.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.78
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PACE SWMI |
$42.65
|
| Rate for Payer: PHP Commercial |
$59.71
|
| Rate for Payer: PHP Commercial |
$59.71
|
| Rate for Payer: PHP Commercial |
$59.71
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: PHP Medicare Advantage |
$42.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.89
|
| Rate for Payer: Priority Health Medicare |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$42.65
|
| Rate for Payer: Priority Health Medicare |
$42.65
|
| Rate for Payer: Priority Health Narrow Network |
$72.89
|
| Rate for Payer: Priority Health Narrow Network |
$72.89
|
| Rate for Payer: Priority Health Narrow Network |
$72.89
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHC Medicare Advantage |
$42.65
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UMR Bronson Commercial |
$51.98
|
| Rate for Payer: UMR Bronson Commercial |
$28.06
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
|
|
CHG RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 72190
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$1,716.45 |
| Rate for Payer: Aetna Commercial |
$50.95
|
| Rate for Payer: Aetna Commercial |
$50.95
|
| Rate for Payer: Aetna Medicare |
$39.54
|
| Rate for Payer: Aetna Medicare |
$39.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.95
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$38.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.45
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$38.02
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$54.75
|
| Rate for Payer: Cofinity Commercial |
$50.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.92
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| Rate for Payer: Nomi Health Commercial |
$45.62
|
| Rate for Payer: Nomi Health Commercial |
$45.62
|
| Rate for Payer: PACE SWMI |
$38.02
|
| Rate for Payer: PACE SWMI |
$38.02
|
| Rate for Payer: PHP Commercial |
$53.23
|
| Rate for Payer: PHP Commercial |
$53.23
|
| Rate for Payer: PHP Medicare Advantage |
$38.02
|
| Rate for Payer: PHP Medicare Advantage |
$38.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| 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 |
$38.02
|
| Rate for Payer: Priority Health Medicare |
$38.02
|
| Rate for Payer: Priority Health Narrow Network |
$65.19
|
| Rate for Payer: Priority Health Narrow Network |
$65.19
|
| Rate for Payer: Priority Health SBD |
$18.47
|
| Rate for Payer: Priority Health SBD |
$18.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$38.02
|
| Rate for Payer: UHC Medicare Advantage |
$38.02
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
| Rate for Payer: UMR Bronson Commercial |
$25.30
|
|
|
CHG RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
|
Professional
|
Both
|
$50.00
|
|
|
Service Code
|
HCPCS 72202
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$378.26 |
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Commercial |
$47.70
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: Aetna Medicare |
$37.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.70
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$35.60
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: BCN Medicare Advantage |
$35.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$47.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.38
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Nomi Health Commercial |
$42.72
|
| Rate for Payer: Nomi Health Commercial |
$42.72
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PACE SWMI |
$35.60
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Commercial |
$49.84
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| Rate for Payer: PHP Medicare Advantage |
$35.60
|
| 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 |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health Medicare |
$35.60
|
| Rate for Payer: Priority Health Medicare |
$35.60
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
| Rate for Payer: UHC Medicare Advantage |
$35.60
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UMR Bronson Commercial |
$18.40
|
| Rate for Payer: UMR Bronson Commercial |
$23.00
|
|
|
CHG RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 70260
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$54.22
|
| Rate for Payer: Aetna Medicare |
$42.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.26
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$40.46
|
| Rate for Payer: BCBS Trust/PPO |
$2,020.75
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: BCN Medicare Advantage |
$40.46
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$54.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.48
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Nomi Health Commercial |
$48.55
|
| Rate for Payer: PACE SWMI |
$40.46
|
| Rate for Payer: PHP Commercial |
$56.64
|
| Rate for Payer: PHP Medicare Advantage |
$40.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$68.78
|
| Rate for Payer: Priority Health Medicare |
$40.46
|
| Rate for Payer: Priority Health Narrow Network |
$68.78
|
| Rate for Payer: Priority Health SBD |
$20.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.46
|
| Rate for Payer: UHC Medicare Advantage |
$40.46
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
CHG RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 74250
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$187.34 |
| Rate for Payer: Aetna Commercial |
$145.85
|
| Rate for Payer: Aetna Medicare |
$113.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.73
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$108.84
|
| Rate for Payer: BCN Commercial |
$181.79
|
| Rate for Payer: BCN Medicare Advantage |
$108.84
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Cofinity Commercial |
$156.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$114.28
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Nomi Health Commercial |
$130.61
|
| Rate for Payer: PACE SWMI |
$108.84
|
| Rate for Payer: PHP Commercial |
$152.38
|
| Rate for Payer: PHP Medicare Advantage |
$108.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$187.34
|
| Rate for Payer: Priority Health Medicare |
$108.84
|
| Rate for Payer: Priority Health Narrow Network |
$187.34
|
| Rate for Payer: Priority Health SBD |
$57.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.84
|
| Rate for Payer: UHC Medicare Advantage |
$108.84
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
| Rate for Payer: UMR Bronson Commercial |
$108.56
|
|
|
CHG RADN RX DELIVERY COMPLX 11-19 MEV
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 77414
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$308.75 |
| Rate for Payer: Aetna Medicare |
$237.50
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
| Rate for Payer: UMR Bronson Commercial |
$218.50
|
|
|
CHG RADN RX DELIVERY COMPLX 6-10 MEV
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 77413
|
| Min. Negotiated Rate |
$168.80 |
| Max. Negotiated Rate |
$274.30 |
| Rate for Payer: Aetna Medicare |
$211.00
|
| Rate for Payer: BCBS Complete |
$168.80
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
| Rate for Payer: UMR Bronson Commercial |
$194.12
|
|
|
CHG RADN RX DELIVERY SIMPLE 11-19 MEV
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 77404
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
| Rate for Payer: UMR Bronson Commercial |
$120.06
|
|
|
CHG RADN RX DELIVERY SIMPLE 6-10 MEV
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 77403
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
| Rate for Payer: UMR Bronson Commercial |
$107.64
|
|
