|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,1 CHANNEL
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 77785
|
| Min. Negotiated Rate |
$123.60 |
| Max. Negotiated Rate |
$200.85 |
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna Medicare |
$228.00
|
| Rate for Payer: BCBS Complete |
$182.40
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: UMR Bronson Commercial |
$142.14
|
| Rate for Payer: UMR Bronson Commercial |
$209.76
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,2-12 CHANNEL
|
Professional
|
Both
|
$682.00
|
|
|
Service Code
|
HCPCS 77786
|
| Min. Negotiated Rate |
$272.80 |
| Max. Negotiated Rate |
$443.30 |
| Rate for Payer: Aetna Medicare |
$341.00
|
| Rate for Payer: Aetna Medicare |
$502.50
|
| Rate for Payer: BCBS Complete |
$402.00
|
| Rate for Payer: BCBS Complete |
$272.80
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.30
|
| Rate for Payer: UMR Bronson Commercial |
$313.72
|
| Rate for Payer: UMR Bronson Commercial |
$462.30
|
|
|
CHG REPAIR,ILIAC ANRYSM/PSEUDO/AV MALF/TRAUMA W/ ENDOPROSTHESIS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 75954
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$143.00 |
| Rate for Payer: Aetna Medicare |
$110.00
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
| Rate for Payer: UMR Bronson Commercial |
$101.20
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
Both
|
$618.00
|
|
|
Service Code
|
HCPCS 77293
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$628.74 |
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Commercial |
$485.84
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna Medicare |
$377.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$485.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$522.10
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCBS MAPPO |
$362.57
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$604.01
|
| Rate for Payer: BCN Commercial |
$604.01
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: BCN Medicare Advantage |
$362.57
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Cofinity Commercial |
$522.10
|
| Rate for Payer: Cofinity Commercial |
$485.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$362.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$380.70
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: Nomi Health Commercial |
$435.08
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PACE SWMI |
$362.57
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Commercial |
$507.60
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: PHP Medicare Advantage |
$362.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$628.74
|
| Rate for Payer: Priority Health Medicare |
$362.57
|
| Rate for Payer: Priority Health Medicare |
$362.57
|
| Rate for Payer: Priority Health Narrow Network |
$628.74
|
| Rate for Payer: Priority Health Narrow Network |
$628.74
|
| Rate for Payer: Priority Health SBD |
$160.65
|
| Rate for Payer: Priority Health SBD |
$160.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$362.57
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
| Rate for Payer: UHC Medicare Advantage |
$362.57
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
| Rate for Payer: UMR Bronson Commercial |
$379.96
|
| Rate for Payer: UMR Bronson Commercial |
$284.28
|
|
|
CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG
|
Professional
|
Both
|
$699.00
|
|
|
Service Code
|
HCPCS 78803
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$1,043.92 |
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Commercial |
$405.51
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna Medicare |
$314.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$435.77
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS MAPPO |
$302.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: BCN Medicare Advantage |
$302.62
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$435.77
|
| Rate for Payer: Cofinity Commercial |
$405.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.75
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: Nomi Health Commercial |
$363.14
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PACE SWMI |
$302.62
|
| Rate for Payer: PHP Commercial |
$423.67
|
| Rate for Payer: PHP Commercial |
$423.67
|
| Rate for Payer: PHP Commercial |
$423.67
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: PHP Medicare Advantage |
$302.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$534.82
|
| Rate for Payer: Priority Health Medicare |
$302.62
|
| Rate for Payer: Priority Health Medicare |
$302.62
|
| Rate for Payer: Priority Health Medicare |
$302.62
|
| Rate for Payer: Priority Health Narrow Network |
$534.82
|
| Rate for Payer: Priority Health Narrow Network |
$534.82
|
| Rate for Payer: Priority Health Narrow Network |
$534.82
|
| Rate for Payer: Priority Health SBD |
$75.97
|
| Rate for Payer: Priority Health SBD |
$75.97
|
| Rate for Payer: Priority Health SBD |
$75.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHC Medicare Advantage |
$302.62
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UMR Bronson Commercial |
$281.52
|
| Rate for Payer: UMR Bronson Commercial |
$40.02
|
| Rate for Payer: UMR Bronson Commercial |
$321.54
|
|
|
CHG RP THERAPY INTRAVENOUS ADMINISTRATION
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 79101
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$1,781.96 |
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Commercial |
$180.63
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: Aetna Medicare |
$140.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.63
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS MAPPO |
$134.80
|
| Rate for Payer: BCBS MAPPO |
$134.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.96
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: BCN Medicare Advantage |
$134.80
|
| Rate for Payer: BCN Medicare Advantage |
$134.80
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cofinity Commercial |
$180.63
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$194.11
|
| Rate for Payer: Cofinity Commercial |
$180.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.54
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Nomi Health Commercial |
$161.76
|
| Rate for Payer: Nomi Health Commercial |
$161.76
|
| Rate for Payer: PACE SWMI |
$134.80
|
| Rate for Payer: PACE SWMI |
$134.80
|
| Rate for Payer: PHP Commercial |
$188.72
|
| Rate for Payer: PHP Commercial |
$188.72
|
| Rate for Payer: PHP Medicare Advantage |
$134.80
|
| Rate for Payer: PHP Medicare Advantage |
$134.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$223.78
|
| Rate for Payer: Priority Health Medicare |
$134.80
|
| Rate for Payer: Priority Health Medicare |
$134.80
|
| Rate for Payer: Priority Health Narrow Network |
$223.78
|
| Rate for Payer: Priority Health Narrow Network |
$223.78
|
| Rate for Payer: Priority Health SBD |
$141.15
|
| Rate for Payer: Priority Health SBD |
$141.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$134.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.80
|
| Rate for Payer: UHC Medicare Advantage |
$134.80
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
| Rate for Payer: UMR Bronson Commercial |
$134.78
|
| Rate for Payer: UMR Bronson Commercial |
$242.42
|
|
|
CHG RP THERAPY ORAL ADMINISTRATION
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 79005
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$1,228.83 |
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Commercial |
$167.49
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.49
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Cofinity Commercial |
$179.99
|
| Rate for Payer: Cofinity Commercial |
$167.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: Nomi Health Commercial |
$149.99
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Commercial |
$174.99
|
| Rate for Payer: PHP Commercial |
$174.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$205.81
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health Medicare |
$124.99
|
| Rate for Payer: Priority Health Narrow Network |
$205.81
|
| Rate for Payer: Priority Health Narrow Network |
$205.81
|
| Rate for Payer: Priority Health SBD |
$126.77
|
| Rate for Payer: Priority Health SBD |
$126.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$124.99
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UMR Bronson Commercial |
$71.30
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
CHG SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 76831
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$764.98 |
| Rate for Payer: Aetna Commercial |
$138.27
|
| Rate for Payer: Aetna Medicare |
$107.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$148.59
|
| Rate for Payer: BCBS Complete |
$22.82
|
| Rate for Payer: BCBS MAPPO |
$103.19
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: BCN Medicare Advantage |
$103.19
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cofinity Commercial |
$148.59
|
| Rate for Payer: Cofinity Commercial |
$138.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.35
|
| Rate for Payer: Meridian Medicaid |
$22.82
|
| Rate for Payer: Nomi Health Commercial |
$123.83
|
| Rate for Payer: PACE SWMI |
$103.19
|
| Rate for Payer: PHP Commercial |
$144.47
|
| Rate for Payer: PHP Medicare Advantage |
$103.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.12
|
| Rate for Payer: Priority Health Medicare |
$103.19
|
| Rate for Payer: Priority Health Narrow Network |
$179.12
|
| Rate for Payer: Priority Health SBD |
$52.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.19
|
| Rate for Payer: UHC Medicare Advantage |
$103.19
|
| Rate for Payer: UHCCP Medicaid |
$21.73
|
| Rate for Payer: UMR Bronson Commercial |
$110.40
|
|
|
CHG SCREENING DIGITAL BREAST TOMOSYNTHESIS BI
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 77063
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$80.07 |
| Rate for Payer: Aetna Commercial |
$64.66
|
| Rate for Payer: Aetna Medicare |
$50.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.48
|
| Rate for Payer: BCBS Complete |
$19.02
|
| Rate for Payer: BCBS MAPPO |
$48.25
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: BCN Medicare Advantage |
$48.25
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$64.66
|
| Rate for Payer: Cofinity Commercial |
$69.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.66
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Nomi Health Commercial |
$57.90
|
| Rate for Payer: PACE SWMI |
$48.25
|
| Rate for Payer: PHP Commercial |
$67.55
|
| Rate for Payer: PHP Medicare Advantage |
$48.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$80.07
|
| Rate for Payer: Priority Health Medicare |
$48.25
|
| Rate for Payer: Priority Health Narrow Network |
$80.07
|
| Rate for Payer: Priority Health SBD |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.25
|
| Rate for Payer: UHC Medicare Advantage |
$48.25
|
| Rate for Payer: UHCCP Medicaid |
$18.11
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 77067
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$197.09 |
| Rate for Payer: Aetna Commercial |
$155.52
|
| Rate for Payer: Aetna Medicare |
$120.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.13
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCBS MAPPO |
$116.06
|
| Rate for Payer: BCN Commercial |
$188.15
|
| Rate for Payer: BCN Medicare Advantage |
$116.06
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$155.52
|
| Rate for Payer: Cofinity Commercial |
$167.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.86
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$139.27
|
| Rate for Payer: PACE SWMI |
$116.06
|
| Rate for Payer: PHP Commercial |
$162.48
|
| Rate for Payer: PHP Medicare Advantage |
$116.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$197.09
|
| Rate for Payer: Priority Health Medicare |
$116.06
|
| Rate for Payer: Priority Health Narrow Network |
$197.09
|
| Rate for Payer: Priority Health SBD |
$54.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.06
|
| Rate for Payer: UHC Medicare Advantage |
$116.06
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
| Rate for Payer: UMR Bronson Commercial |
$36.34
|
|
|
CHG SEDIMENTATION RATE RBC NON-AUTOMATED
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 85651
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$2,682.02 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.15
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,682.02
|
| Rate for Payer: BCN Commercial |
$3.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$5.72
|
| Rate for Payer: Cofinity Commercial |
$6.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Nomi Health Commercial |
$5.12
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$5.98
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.33
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: Priority Health SBD |
$4.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UMR Bronson Commercial |
$6.90
|
|
|
CHG SEMEN ALYS MOTILITY&CNT X W/HUHNER TST
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 89310
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$940.90 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.40
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$940.90
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Nomi Health Commercial |
$10.33
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Commercial |
$12.05
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.40
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$13.40
|
| Rate for Payer: Priority Health SBD |
$13.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
| Rate for Payer: UMR Bronson Commercial |
$9.66
|
|
|
CHG SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 89300
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$3,455.08 |
| Rate for Payer: Aetna Commercial |
$13.19
|
| Rate for Payer: Aetna Medicare |
$10.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.17
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$9.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,455.08
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: BCN Medicare Advantage |
$9.84
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$14.17
|
| Rate for Payer: Cofinity Commercial |
$13.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.33
|
| Rate for Payer: Nomi Health Commercial |
$11.81
|
| Rate for Payer: PACE SWMI |
$9.84
|
| Rate for Payer: PHP Commercial |
$13.78
|
| Rate for Payer: PHP Medicare Advantage |
$9.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.48
|
| Rate for Payer: Priority Health Medicare |
$9.84
|
| Rate for Payer: Priority Health Narrow Network |
$15.48
|
| Rate for Payer: Priority Health SBD |
$15.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.84
|
| Rate for Payer: UHC Medicare Advantage |
$9.84
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
|
|
CHG SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 89321
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$1,251.54 |
| Rate for Payer: Aetna Commercial |
$16.15
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.35
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.54
|
| Rate for Payer: BCN Commercial |
$9.04
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Cofinity Commercial |
$16.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Nomi Health Commercial |
$14.46
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$16.87
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.56
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$18.56
|
| Rate for Payer: Priority Health SBD |
$18.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UMR Bronson Commercial |
$13.34
|
|
|
CHG SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 75809
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$125.74 |
| Rate for Payer: Aetna Commercial |
$98.22
|
| Rate for Payer: Aetna Medicare |
$76.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.55
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$73.30
|
| Rate for Payer: BCBS Trust/PPO |
$122.04
|
| Rate for Payer: BCN Commercial |
$120.70
|
| Rate for Payer: BCN Medicare Advantage |
$73.30
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$98.22
|
| Rate for Payer: Cofinity Commercial |
$105.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.96
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$87.96
|
| Rate for Payer: PACE SWMI |
$73.30
|
| Rate for Payer: PHP Commercial |
$102.62
|
| Rate for Payer: PHP Medicare Advantage |
$73.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.74
|
| Rate for Payer: Priority Health Medicare |
$73.30
|
| Rate for Payer: Priority Health Narrow Network |
$125.74
|
| Rate for Payer: Priority Health SBD |
$34.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.30
|
| Rate for Payer: UHC Medicare Advantage |
$73.30
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UMR Bronson Commercial |
$88.32
|
|
|
CHG SKIN TEST TUBERCULOSIS INTRADERMAL
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS 86580
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$2,063.01 |
| Rate for Payer: Aetna Commercial |
$11.97
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.86
|
| Rate for Payer: BCBS Complete |
$6.40
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.01
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cofinity Commercial |
$11.97
|
| Rate for Payer: Cofinity Commercial |
$12.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Nomi Health Commercial |
$10.72
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$12.50
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.32
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$10.32
|
| Rate for Payer: Priority Health SBD |
$10.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: UMR Bronson Commercial |
$7.36
|
|
|
CHG SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 87209
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$378.81 |
| Rate for Payer: Aetna Commercial |
$24.09
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.89
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$378.81
|
| Rate for Payer: BCN Commercial |
$13.49
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cofinity Commercial |
$25.89
|
| Rate for Payer: Cofinity Commercial |
$24.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Nomi Health Commercial |
$21.58
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$25.17
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.98
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$17.98
|
| Rate for Payer: Priority Health SBD |
$17.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$17.98
|
| Rate for Payer: UMR Bronson Commercial |
$22.54
|
|
|
CHG SMR PRIM SRC WET MOUNT NFCT AGT
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 87210
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$368.23 |
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare |
$6.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.38
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$5.82
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$8.38
|
| Rate for Payer: Cofinity Commercial |
$7.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.11
|
| Rate for Payer: Nomi Health Commercial |
$6.98
|
| Rate for Payer: PACE SWMI |
$5.82
|
| Rate for Payer: PHP Commercial |
$8.15
|
| Rate for Payer: PHP Medicare Advantage |
$5.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.66
|
| Rate for Payer: Priority Health Medicare |
$5.82
|
| Rate for Payer: Priority Health Narrow Network |
$5.66
|
| Rate for Payer: Priority Health SBD |
$5.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.82
|
| Rate for Payer: UHC Medicare Advantage |
$5.82
|
| Rate for Payer: UMR Bronson Commercial |
$8.28
|
|
|
CHG SONO GUIDE PERICARD TAP
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 76930
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
|
|
CHG SONO GUIDE RAD THERAPY FIELDS
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 76950
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$48.75 |
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: Aetna Medicare |
$69.00
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: UMR Bronson Commercial |
$63.48
|
| Rate for Payer: UMR Bronson Commercial |
$34.50
|
|
|
CHG SPEC DOSIM ONLY PRESCRIBED TREATING PHYS
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 77331
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$5,193.72 |
| Rate for Payer: Aetna Commercial |
$81.71
|
| Rate for Payer: Aetna Commercial |
$81.71
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.81
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS Trust/PPO |
$5,193.72
|
| Rate for Payer: BCBS Trust/PPO |
$5,193.72
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$87.81
|
| Rate for Payer: Cofinity Commercial |
$81.71
|
| Rate for Payer: Cofinity Commercial |
$81.71
|
| Rate for Payer: Cofinity Commercial |
$87.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Nomi Health Commercial |
$73.18
|
| Rate for Payer: Nomi Health Commercial |
$73.18
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PHP Commercial |
$85.37
|
| Rate for Payer: PHP Commercial |
$85.37
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.08
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Narrow Network |
$100.08
|
| Rate for Payer: Priority Health Narrow Network |
$100.08
|
| Rate for Payer: Priority Health SBD |
$70.31
|
| Rate for Payer: Priority Health SBD |
$70.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$60.98
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
| Rate for Payer: UMR Bronson Commercial |
$57.50
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
CHG SPECIAL TREATMENT PROCEDURE
|
Professional
|
Both
|
$705.00
|
|
|
Service Code
|
HCPCS 77470
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$519.32 |
| Rate for Payer: Aetna Commercial |
$182.71
|
| Rate for Payer: Aetna Commercial |
$182.71
|
| Rate for Payer: Aetna Medicare |
$141.80
|
| Rate for Payer: Aetna Medicare |
$141.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.71
|
| Rate for Payer: BCBS Complete |
$72.24
|
| Rate for Payer: BCBS Complete |
$72.24
|
| Rate for Payer: BCBS MAPPO |
$136.35
|
| Rate for Payer: BCBS MAPPO |
$136.35
|
| Rate for Payer: BCBS Trust/PPO |
$519.32
|
| Rate for Payer: BCBS Trust/PPO |
$519.32
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Medicare Advantage |
$136.35
|
| Rate for Payer: BCN Medicare Advantage |
$136.35
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cash Price |
$564.00
|
| Rate for Payer: Cofinity Commercial |
$182.71
|
| Rate for Payer: Cofinity Commercial |
$196.34
|
| Rate for Payer: Cofinity Commercial |
$196.34
|
| Rate for Payer: Cofinity Commercial |
$182.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.17
|
| Rate for Payer: Meridian Medicaid |
$72.24
|
| Rate for Payer: Meridian Medicaid |
$72.24
|
| Rate for Payer: Nomi Health Commercial |
$163.62
|
| Rate for Payer: Nomi Health Commercial |
$163.62
|
| Rate for Payer: PACE SWMI |
$136.35
|
| Rate for Payer: PACE SWMI |
$136.35
|
| Rate for Payer: PHP Commercial |
$190.89
|
| Rate for Payer: PHP Commercial |
$190.89
|
| Rate for Payer: PHP Medicare Advantage |
$136.35
|
| Rate for Payer: PHP Medicare Advantage |
$136.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.64
|
| Rate for Payer: Priority Health Medicare |
$136.35
|
| Rate for Payer: Priority Health Medicare |
$136.35
|
| Rate for Payer: Priority Health Narrow Network |
$218.64
|
| Rate for Payer: Priority Health Narrow Network |
$218.64
|
| Rate for Payer: Priority Health SBD |
$163.21
|
| Rate for Payer: Priority Health SBD |
$163.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.35
|
| Rate for Payer: UHC Medicare Advantage |
$136.35
|
| Rate for Payer: UHC Medicare Advantage |
$136.35
|
| Rate for Payer: UHCCP Medicaid |
$68.80
|
| Rate for Payer: UHCCP Medicaid |
$68.80
|
| Rate for Payer: UMR Bronson Commercial |
$244.72
|
| Rate for Payer: UMR Bronson Commercial |
$324.30
|
|
|
CHG SPEC MEDICAL RADJ PHYSICS CONSLTJ
|
Professional
|
Both
|
$216.00
|
|
|
Service Code
|
HCPCS 77370
|
| Min. Negotiated Rate |
$86.40 |
| Max. Negotiated Rate |
$1,979.54 |
| Rate for Payer: Aetna Commercial |
$179.51
|
| Rate for Payer: Aetna Medicare |
$139.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.90
|
| Rate for Payer: BCBS Complete |
$86.40
|
| Rate for Payer: BCBS MAPPO |
$133.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,979.54
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Medicare Advantage |
$133.96
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cash Price |
$172.80
|
| Rate for Payer: Cofinity Commercial |
$179.51
|
| Rate for Payer: Cofinity Commercial |
$192.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.66
|
| Rate for Payer: Nomi Health Commercial |
$160.75
|
| Rate for Payer: PACE SWMI |
$133.96
|
| Rate for Payer: PHP Commercial |
$187.54
|
| Rate for Payer: PHP Medicare Advantage |
$133.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$222.76
|
| Rate for Payer: Priority Health Medicare |
$133.96
|
| Rate for Payer: Priority Health Narrow Network |
$222.76
|
| Rate for Payer: Priority Health SBD |
$222.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$133.96
|
| Rate for Payer: UHC Medicare Advantage |
$133.96
|
| Rate for Payer: UMR Bronson Commercial |
$99.36
|
|
|
CHG SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY
|
Professional
|
Both
|
$282.00
|
|
|
Service Code
|
HCPCS 77321
|
| Min. Negotiated Rate |
$32.16 |
| Max. Negotiated Rate |
$5,378.09 |
| Rate for Payer: Aetna Commercial |
$117.17
|
| Rate for Payer: Aetna Commercial |
$117.17
|
| Rate for Payer: Aetna Medicare |
$90.94
|
| Rate for Payer: Aetna Medicare |
$90.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.17
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS Complete |
$33.77
|
| Rate for Payer: BCBS MAPPO |
$87.44
|
| Rate for Payer: BCBS MAPPO |
$87.44
|
| Rate for Payer: BCBS Trust/PPO |
$5,378.09
|
| Rate for Payer: BCBS Trust/PPO |
$5,378.09
|
| Rate for Payer: BCN Commercial |
$136.83
|
| Rate for Payer: BCN Commercial |
$136.83
|
| Rate for Payer: BCN Medicare Advantage |
$87.44
|
| Rate for Payer: BCN Medicare Advantage |
$87.44
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$162.40
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cash Price |
$225.60
|
| Rate for Payer: Cofinity Commercial |
$117.17
|
| Rate for Payer: Cofinity Commercial |
$125.91
|
| Rate for Payer: Cofinity Commercial |
$117.17
|
| Rate for Payer: Cofinity Commercial |
$125.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.81
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Meridian Medicaid |
$33.77
|
| Rate for Payer: Nomi Health Commercial |
$104.93
|
| Rate for Payer: Nomi Health Commercial |
$104.93
|
| Rate for Payer: PACE SWMI |
$87.44
|
| Rate for Payer: PACE SWMI |
$87.44
|
| Rate for Payer: PHP Commercial |
$122.42
|
| Rate for Payer: PHP Commercial |
$122.42
|
| Rate for Payer: PHP Medicare Advantage |
$87.44
|
| Rate for Payer: PHP Medicare Advantage |
$87.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.25
|
| Rate for Payer: Priority Health Medicare |
$87.44
|
| Rate for Payer: Priority Health Medicare |
$87.44
|
| Rate for Payer: Priority Health Narrow Network |
$145.25
|
| Rate for Payer: Priority Health Narrow Network |
$145.25
|
| Rate for Payer: Priority Health SBD |
$76.48
|
| Rate for Payer: Priority Health SBD |
$76.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.44
|
| Rate for Payer: UHC Medicare Advantage |
$87.44
|
| Rate for Payer: UHC Medicare Advantage |
$87.44
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
| Rate for Payer: UHCCP Medicaid |
$32.16
|
| Rate for Payer: UMR Bronson Commercial |
$129.72
|
| Rate for Payer: UMR Bronson Commercial |
$93.38
|
|
|
CHG STEREOSCOPIC X-RAY GUIDANCE
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 77421
|
| Min. Negotiated Rate |
$82.40 |
| Max. Negotiated Rate |
$133.90 |
| Rate for Payer: Aetna Medicare |
$103.00
|
| Rate for Payer: Aetna Medicare |
$87.00
|
| Rate for Payer: BCBS Complete |
$69.60
|
| Rate for Payer: BCBS Complete |
$82.40
|
| Rate for Payer: Cash Price |
$139.20
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.10
|
| Rate for Payer: UMR Bronson Commercial |
$80.04
|
| Rate for Payer: UMR Bronson Commercial |
$94.76
|
|
