|
CHG STEREOTACTIC BODY RADIATION MANAGEMENT
|
Professional
|
Both
|
$1,261.00
|
|
|
Service Code
|
HCPCS 77435
|
| Min. Negotiated Rate |
$414.50 |
| Max. Negotiated Rate |
$1,387.84 |
| Rate for Payer: Aetna Commercial |
$824.65
|
| Rate for Payer: Aetna Medicare |
$640.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$824.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$886.19
|
| Rate for Payer: BCBS Complete |
$435.22
|
| Rate for Payer: BCBS MAPPO |
$615.41
|
| Rate for Payer: BCBS Trust/PPO |
$1,387.84
|
| Rate for Payer: BCN Commercial |
$932.88
|
| Rate for Payer: BCN Medicare Advantage |
$615.41
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cash Price |
$1,008.80
|
| Rate for Payer: Cofinity Commercial |
$824.65
|
| Rate for Payer: Cofinity Commercial |
$886.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.18
|
| Rate for Payer: Meridian Medicaid |
$435.22
|
| Rate for Payer: Nomi Health Commercial |
$738.49
|
| Rate for Payer: PACE SWMI |
$615.41
|
| Rate for Payer: PHP Commercial |
$861.57
|
| Rate for Payer: PHP Medicare Advantage |
$615.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$414.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$819.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$983.41
|
| Rate for Payer: Priority Health Medicare |
$615.41
|
| Rate for Payer: Priority Health Narrow Network |
$983.41
|
| Rate for Payer: Priority Health SBD |
$983.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$615.41
|
| Rate for Payer: UHC Medicare Advantage |
$615.41
|
| Rate for Payer: UHCCP Medicaid |
$414.50
|
| Rate for Payer: UMR Bronson Commercial |
$580.06
|
|
|
CHG STEREOTACTIC BODY RADIATION TREATMENT DELIVERY
|
Professional
|
Both
|
$2,706.00
|
|
|
Service Code
|
HCPCS 77373
|
| Min. Negotiated Rate |
$867.16 |
| Max. Negotiated Rate |
$1,987.99 |
| Rate for Payer: Aetna Commercial |
$1,161.99
|
| Rate for Payer: Aetna Medicare |
$901.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,161.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,248.71
|
| Rate for Payer: BCBS Complete |
$1,082.40
|
| Rate for Payer: BCBS MAPPO |
$867.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,987.99
|
| Rate for Payer: BCN Commercial |
$1,469.46
|
| Rate for Payer: BCN Medicare Advantage |
$867.16
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cofinity Commercial |
$1,248.71
|
| Rate for Payer: Cofinity Commercial |
$1,161.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$867.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$910.52
|
| Rate for Payer: Nomi Health Commercial |
$1,040.59
|
| Rate for Payer: PACE SWMI |
$867.16
|
| Rate for Payer: PHP Commercial |
$1,214.02
|
| Rate for Payer: PHP Medicare Advantage |
$867.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,758.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,532.08
|
| Rate for Payer: Priority Health Medicare |
$867.16
|
| Rate for Payer: Priority Health Narrow Network |
$1,532.08
|
| Rate for Payer: Priority Health SBD |
$1,532.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$867.16
|
| Rate for Payer: UHC Medicare Advantage |
$867.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,244.76
|
|
|
CHG STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION
|
Professional
|
Both
|
$872.00
|
|
|
Service Code
|
HCPCS 77432
|
| Min. Negotiated Rate |
$274.34 |
| Max. Negotiated Rate |
$2,005.43 |
| Rate for Payer: Aetna Commercial |
$546.29
|
| Rate for Payer: Aetna Medicare |
$423.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.29
|
| Rate for Payer: BCBS Complete |
$288.06
|
| Rate for Payer: BCBS MAPPO |
$407.68
|
| Rate for Payer: BCBS Trust/PPO |
$2,005.43
|
| Rate for Payer: BCN Commercial |
$617.69
|
| Rate for Payer: BCN Medicare Advantage |
$407.68
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cash Price |
$697.60
|
| Rate for Payer: Cofinity Commercial |
$587.06
|
| Rate for Payer: Cofinity Commercial |
$546.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$428.06
|
| Rate for Payer: Meridian Medicaid |
$288.06
|
| Rate for Payer: Nomi Health Commercial |
$489.22
|
| Rate for Payer: PACE SWMI |
$407.68
|
| Rate for Payer: PHP Commercial |
$570.75
|
| Rate for Payer: PHP Medicare Advantage |
$407.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$274.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$566.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$650.30
|
| Rate for Payer: Priority Health Medicare |
$407.68
|
| Rate for Payer: Priority Health Narrow Network |
$650.30
|
| Rate for Payer: Priority Health SBD |
$572.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$407.68
|
| Rate for Payer: UHC Medicare Advantage |
$407.68
|
| Rate for Payer: UHCCP Medicaid |
$274.34
|
| Rate for Payer: UMR Bronson Commercial |
$401.12
|
|
|
CHG SUPERVISION HANDLING LOADING RADIATION SOURCE
|
Professional
|
Both
|
$81.00
|
|
|
Service Code
|
HCPCS 77790
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$148.98 |
| Rate for Payer: Aetna Commercial |
$22.74
|
| Rate for Payer: Aetna Commercial |
$22.74
|
| Rate for Payer: Aetna Medicare |
$17.65
|
| Rate for Payer: Aetna Medicare |
$17.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.44
|
| Rate for Payer: BCBS Complete |
$32.40
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: BCBS MAPPO |
$16.97
|
| Rate for Payer: BCBS MAPPO |
$16.97
|
| Rate for Payer: BCBS Trust/PPO |
$148.98
|
| Rate for Payer: BCBS Trust/PPO |
$148.98
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$16.97
|
| Rate for Payer: BCN Medicare Advantage |
$16.97
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$24.44
|
| Rate for Payer: Cofinity Commercial |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$24.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.82
|
| Rate for Payer: Nomi Health Commercial |
$20.36
|
| Rate for Payer: Nomi Health Commercial |
$20.36
|
| Rate for Payer: PACE SWMI |
$16.97
|
| Rate for Payer: PACE SWMI |
$16.97
|
| Rate for Payer: PHP Commercial |
$23.76
|
| Rate for Payer: PHP Commercial |
$23.76
|
| Rate for Payer: PHP Medicare Advantage |
$16.97
|
| Rate for Payer: PHP Medicare Advantage |
$16.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.72
|
| Rate for Payer: Priority Health Medicare |
$16.97
|
| Rate for Payer: Priority Health Medicare |
$16.97
|
| Rate for Payer: Priority Health Narrow Network |
$27.72
|
| Rate for Payer: Priority Health Narrow Network |
$27.72
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: Priority Health SBD |
$16.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.97
|
| Rate for Payer: UHC Medicare Advantage |
$16.97
|
| Rate for Payer: UHC Medicare Advantage |
$16.97
|
| Rate for Payer: UMR Bronson Commercial |
$37.26
|
| Rate for Payer: UMR Bronson Commercial |
$86.48
|
|
|
CHG TBS TECHNICAL CALCULATION ONLY
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 77091
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$43.11 |
| Rate for Payer: PACE SWMI |
$24.25
|
| Rate for Payer: Aetna Commercial |
$32.50
|
| Rate for Payer: Aetna Medicare |
$25.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.92
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$24.25
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Medicare Advantage |
$24.25
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.46
|
| Rate for Payer: Nomi Health Commercial |
$29.10
|
| Rate for Payer: PHP Commercial |
$33.95
|
| Rate for Payer: PHP Medicare Advantage |
$24.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.11
|
| Rate for Payer: Priority Health Medicare |
$24.25
|
| Rate for Payer: Priority Health Narrow Network |
$43.11
|
| Rate for Payer: Priority Health SBD |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.25
|
| Rate for Payer: UHC Medicare Advantage |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
|
|
CHG TELETHER ISODOSE PLAN COMPLX
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 77315
|
| Min. Negotiated Rate |
$109.60 |
| Max. Negotiated Rate |
$178.10 |
| Rate for Payer: Aetna Medicare |
$137.00
|
| Rate for Payer: Aetna Medicare |
$72.50
|
| Rate for Payer: BCBS Complete |
$58.00
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: UMR Bronson Commercial |
$126.04
|
| Rate for Payer: UMR Bronson Commercial |
$66.70
|
|
|
CHG TELETHER ISODOSE PLAN SIMPLE
|
Professional
|
Both
|
$97.00
|
|
|
Service Code
|
HCPCS 77305
|
| Min. Negotiated Rate |
$38.80 |
| Max. Negotiated Rate |
$63.05 |
| Rate for Payer: Aetna Medicare |
$48.50
|
| Rate for Payer: Aetna Medicare |
$77.50
|
| Rate for Payer: BCBS Complete |
$62.00
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: UMR Bronson Commercial |
$71.30
|
| Rate for Payer: UMR Bronson Commercial |
$44.62
|
|
|
CHG TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY
|
Professional
|
Both
|
$439.00
|
|
|
Service Code
|
HCPCS 77307
|
| Min. Negotiated Rate |
$98.41 |
| Max. Negotiated Rate |
$1,915.09 |
| Rate for Payer: Aetna Commercial |
$359.03
|
| Rate for Payer: Aetna Commercial |
$359.03
|
| Rate for Payer: Aetna Medicare |
$278.65
|
| Rate for Payer: Aetna Medicare |
$278.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$385.82
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS Complete |
$103.33
|
| Rate for Payer: BCBS MAPPO |
$267.93
|
| Rate for Payer: BCBS MAPPO |
$267.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,915.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,915.09
|
| Rate for Payer: BCN Commercial |
$417.33
|
| Rate for Payer: BCN Commercial |
$417.33
|
| Rate for Payer: BCN Medicare Advantage |
$267.93
|
| Rate for Payer: BCN Medicare Advantage |
$267.93
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cash Price |
$351.20
|
| Rate for Payer: Cash Price |
$670.40
|
| Rate for Payer: Cofinity Commercial |
$385.82
|
| Rate for Payer: Cofinity Commercial |
$359.03
|
| Rate for Payer: Cofinity Commercial |
$359.03
|
| Rate for Payer: Cofinity Commercial |
$385.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.33
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Meridian Medicaid |
$103.33
|
| Rate for Payer: Nomi Health Commercial |
$321.52
|
| Rate for Payer: Nomi Health Commercial |
$321.52
|
| Rate for Payer: PACE SWMI |
$267.93
|
| Rate for Payer: PACE SWMI |
$267.93
|
| Rate for Payer: PHP Commercial |
$375.10
|
| Rate for Payer: PHP Commercial |
$375.10
|
| Rate for Payer: PHP Medicare Advantage |
$267.93
|
| Rate for Payer: PHP Medicare Advantage |
$267.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$544.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$442.43
|
| Rate for Payer: Priority Health Medicare |
$267.93
|
| Rate for Payer: Priority Health Medicare |
$267.93
|
| Rate for Payer: Priority Health Narrow Network |
$442.43
|
| Rate for Payer: Priority Health Narrow Network |
$442.43
|
| Rate for Payer: Priority Health SBD |
$232.50
|
| Rate for Payer: Priority Health SBD |
$232.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$267.93
|
| Rate for Payer: UHC Medicare Advantage |
$267.93
|
| Rate for Payer: UHC Medicare Advantage |
$267.93
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UHCCP Medicaid |
$98.41
|
| Rate for Payer: UMR Bronson Commercial |
$201.94
|
| Rate for Payer: UMR Bronson Commercial |
$385.48
|
|
|
CHG TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION
|
Professional
|
Both
|
$396.00
|
|
|
Service Code
|
HCPCS 77306
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$257.40 |
| Rate for Payer: Aetna Commercial |
$183.89
|
| Rate for Payer: Aetna Commercial |
$183.89
|
| Rate for Payer: Aetna Medicare |
$142.72
|
| Rate for Payer: Aetna Medicare |
$142.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.89
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS MAPPO |
$137.23
|
| Rate for Payer: BCBS MAPPO |
$137.23
|
| Rate for Payer: BCBS Trust/PPO |
$150.66
|
| Rate for Payer: BCBS Trust/PPO |
$150.66
|
| Rate for Payer: BCN Commercial |
$215.51
|
| Rate for Payer: BCN Commercial |
$215.51
|
| Rate for Payer: BCN Medicare Advantage |
$137.23
|
| Rate for Payer: BCN Medicare Advantage |
$137.23
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cash Price |
$316.80
|
| Rate for Payer: Cofinity Commercial |
$183.89
|
| Rate for Payer: Cofinity Commercial |
$197.61
|
| Rate for Payer: Cofinity Commercial |
$197.61
|
| Rate for Payer: Cofinity Commercial |
$183.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.09
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: Nomi Health Commercial |
$164.68
|
| Rate for Payer: Nomi Health Commercial |
$164.68
|
| Rate for Payer: PACE SWMI |
$137.23
|
| Rate for Payer: PACE SWMI |
$137.23
|
| Rate for Payer: PHP Commercial |
$192.12
|
| Rate for Payer: PHP Commercial |
$192.12
|
| Rate for Payer: PHP Medicare Advantage |
$137.23
|
| Rate for Payer: PHP Medicare Advantage |
$137.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.40
|
| Rate for Payer: Priority Health Medicare |
$137.23
|
| Rate for Payer: Priority Health Medicare |
$137.23
|
| Rate for Payer: Priority Health Narrow Network |
$228.40
|
| Rate for Payer: Priority Health Narrow Network |
$228.40
|
| Rate for Payer: Priority Health SBD |
$112.40
|
| Rate for Payer: Priority Health SBD |
$112.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.23
|
| Rate for Payer: UHC Medicare Advantage |
$137.23
|
| Rate for Payer: UHC Medicare Advantage |
$137.23
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
| Rate for Payer: UMR Bronson Commercial |
$107.18
|
| Rate for Payer: UMR Bronson Commercial |
$182.16
|
|
|
CHG THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ
|
Professional
|
Both
|
$277.00
|
|
|
Service Code
|
HCPCS 74283
|
| Min. Negotiated Rate |
$63.90 |
| Max. Negotiated Rate |
$1,701.65 |
| Rate for Payer: Aetna Commercial |
$316.64
|
| Rate for Payer: Aetna Medicare |
$245.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.27
|
| Rate for Payer: BCBS Complete |
$67.10
|
| Rate for Payer: BCBS MAPPO |
$236.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,701.65
|
| Rate for Payer: BCN Commercial |
$376.28
|
| Rate for Payer: BCN Medicare Advantage |
$236.30
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cash Price |
$221.60
|
| Rate for Payer: Cofinity Commercial |
$340.27
|
| Rate for Payer: Cofinity Commercial |
$316.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.12
|
| Rate for Payer: Meridian Medicaid |
$67.10
|
| Rate for Payer: Nomi Health Commercial |
$283.56
|
| Rate for Payer: PACE SWMI |
$236.30
|
| Rate for Payer: PHP Commercial |
$330.82
|
| Rate for Payer: PHP Medicare Advantage |
$236.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$392.14
|
| Rate for Payer: Priority Health Medicare |
$236.30
|
| Rate for Payer: Priority Health Narrow Network |
$392.14
|
| Rate for Payer: Priority Health SBD |
$151.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.30
|
| Rate for Payer: UHC Medicare Advantage |
$236.30
|
| Rate for Payer: UHCCP Medicaid |
$63.90
|
| Rate for Payer: UMR Bronson Commercial |
$127.42
|
|
|
CHG THERAPEUTIC RADIOLOGY PORT IMAGE(S)
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 77417
|
| Min. Negotiated Rate |
$13.60 |
| Max. Negotiated Rate |
$3,385.87 |
| Rate for Payer: Aetna Commercial |
$19.58
|
| Rate for Payer: Aetna Medicare |
$15.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.04
|
| Rate for Payer: BCBS Complete |
$13.60
|
| Rate for Payer: BCBS MAPPO |
$14.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,385.87
|
| Rate for Payer: BCN Commercial |
$20.04
|
| Rate for Payer: BCN Medicare Advantage |
$14.61
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$21.04
|
| Rate for Payer: Cofinity Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.34
|
| Rate for Payer: Nomi Health Commercial |
$17.53
|
| Rate for Payer: PACE SWMI |
$14.61
|
| Rate for Payer: PHP Commercial |
$20.45
|
| Rate for Payer: PHP Medicare Advantage |
$14.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.10
|
| Rate for Payer: Priority Health Medicare |
$14.61
|
| Rate for Payer: Priority Health Narrow Network |
$23.10
|
| Rate for Payer: Priority Health SBD |
$23.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.61
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
| Rate for Payer: UMR Bronson Commercial |
$15.64
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 77263
|
| Min. Negotiated Rate |
$108.63 |
| Max. Negotiated Rate |
$1,737.05 |
| Rate for Payer: Aetna Commercial |
$216.22
|
| Rate for Payer: Aetna Medicare |
$167.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.36
|
| Rate for Payer: BCBS Complete |
$114.06
|
| Rate for Payer: BCBS MAPPO |
$161.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,737.05
|
| Rate for Payer: BCN Commercial |
$245.32
|
| Rate for Payer: BCN Medicare Advantage |
$161.36
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$216.22
|
| Rate for Payer: Cofinity Commercial |
$232.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$161.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$169.43
|
| Rate for Payer: Meridian Medicaid |
$114.06
|
| Rate for Payer: Nomi Health Commercial |
$193.63
|
| Rate for Payer: PACE SWMI |
$161.36
|
| Rate for Payer: PHP Commercial |
$225.90
|
| Rate for Payer: PHP Medicare Advantage |
$161.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$108.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.14
|
| Rate for Payer: Priority Health Medicare |
$161.36
|
| Rate for Payer: Priority Health Narrow Network |
$257.14
|
| Rate for Payer: Priority Health SBD |
$257.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$161.36
|
| Rate for Payer: UHC Medicare Advantage |
$161.36
|
| Rate for Payer: UHCCP Medicaid |
$108.63
|
| Rate for Payer: UMR Bronson Commercial |
$138.92
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE
|
Professional
|
Both
|
$202.00
|
|
|
Service Code
|
HCPCS 77262
|
| Min. Negotiated Rate |
$69.86 |
| Max. Negotiated Rate |
$381.96 |
| Rate for Payer: Aetna Commercial |
$138.70
|
| Rate for Payer: Aetna Medicare |
$107.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.05
|
| Rate for Payer: BCBS Complete |
$73.35
|
| Rate for Payer: BCBS MAPPO |
$103.51
|
| Rate for Payer: BCBS Trust/PPO |
$381.96
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: BCN Medicare Advantage |
$103.51
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cofinity Commercial |
$138.70
|
| Rate for Payer: Cofinity Commercial |
$149.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.69
|
| Rate for Payer: Meridian Medicaid |
$73.35
|
| Rate for Payer: Nomi Health Commercial |
$124.21
|
| Rate for Payer: PACE SWMI |
$103.51
|
| Rate for Payer: PHP Commercial |
$144.91
|
| Rate for Payer: PHP Medicare Advantage |
$103.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$165.79
|
| Rate for Payer: Priority Health Medicare |
$103.51
|
| Rate for Payer: Priority Health Narrow Network |
$165.79
|
| Rate for Payer: Priority Health SBD |
$165.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.51
|
| Rate for Payer: UHC Medicare Advantage |
$103.51
|
| Rate for Payer: UHCCP Medicaid |
$69.86
|
| Rate for Payer: UMR Bronson Commercial |
$92.92
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 77261
|
| Min. Negotiated Rate |
$45.16 |
| Max. Negotiated Rate |
$984.75 |
| Rate for Payer: Aetna Commercial |
$89.40
|
| Rate for Payer: Aetna Medicare |
$69.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.08
|
| Rate for Payer: BCBS Complete |
$47.42
|
| Rate for Payer: BCBS MAPPO |
$66.72
|
| Rate for Payer: BCBS Trust/PPO |
$984.75
|
| Rate for Payer: BCN Commercial |
$102.62
|
| Rate for Payer: BCN Medicare Advantage |
$66.72
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$89.40
|
| Rate for Payer: Cofinity Commercial |
$96.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.06
|
| Rate for Payer: Meridian Medicaid |
$47.42
|
| Rate for Payer: Nomi Health Commercial |
$80.06
|
| Rate for Payer: PACE SWMI |
$66.72
|
| Rate for Payer: PHP Commercial |
$93.41
|
| Rate for Payer: PHP Medicare Advantage |
$66.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.30
|
| Rate for Payer: Priority Health Medicare |
$66.72
|
| Rate for Payer: Priority Health Narrow Network |
$108.30
|
| Rate for Payer: Priority Health SBD |
$237.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$66.72
|
| Rate for Payer: UHC Medicare Advantage |
$66.72
|
| Rate for Payer: UHCCP Medicaid |
$45.16
|
| Rate for Payer: UMR Bronson Commercial |
$62.10
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX
|
Professional
|
Both
|
$803.00
|
|
|
Service Code
|
HCPCS 77290
|
| Min. Negotiated Rate |
$52.82 |
| Max. Negotiated Rate |
$689.31 |
| Rate for Payer: Aetna Commercial |
$529.06
|
| Rate for Payer: Aetna Commercial |
$529.06
|
| Rate for Payer: Aetna Medicare |
$410.61
|
| Rate for Payer: Aetna Medicare |
$410.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.54
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: BCBS MAPPO |
$394.82
|
| Rate for Payer: BCBS MAPPO |
$394.82
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCBS Trust/PPO |
$222.94
|
| Rate for Payer: BCN Commercial |
$661.67
|
| Rate for Payer: BCN Commercial |
$661.67
|
| Rate for Payer: BCN Medicare Advantage |
$394.82
|
| Rate for Payer: BCN Medicare Advantage |
$394.82
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$642.40
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cash Price |
$771.20
|
| Rate for Payer: Cofinity Commercial |
$529.06
|
| Rate for Payer: Cofinity Commercial |
$568.54
|
| Rate for Payer: Cofinity Commercial |
$568.54
|
| Rate for Payer: Cofinity Commercial |
$529.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$394.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$414.56
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Meridian Medicaid |
$55.46
|
| Rate for Payer: Nomi Health Commercial |
$473.78
|
| Rate for Payer: Nomi Health Commercial |
$473.78
|
| Rate for Payer: PACE SWMI |
$394.82
|
| Rate for Payer: PACE SWMI |
$394.82
|
| Rate for Payer: PHP Commercial |
$552.75
|
| Rate for Payer: PHP Commercial |
$552.75
|
| Rate for Payer: PHP Medicare Advantage |
$394.82
|
| Rate for Payer: PHP Medicare Advantage |
$394.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$521.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$626.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$689.31
|
| Rate for Payer: Priority Health Medicare |
$394.82
|
| Rate for Payer: Priority Health Medicare |
$394.82
|
| Rate for Payer: Priority Health Narrow Network |
$689.31
|
| Rate for Payer: Priority Health Narrow Network |
$689.31
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: Priority Health SBD |
$125.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$394.82
|
| Rate for Payer: UHC Medicare Advantage |
$394.82
|
| Rate for Payer: UHC Medicare Advantage |
$394.82
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
| Rate for Payer: UHCCP Medicaid |
$52.82
|
| Rate for Payer: UMR Bronson Commercial |
$443.44
|
| Rate for Payer: UMR Bronson Commercial |
$369.38
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 77285
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$679.04 |
| Rate for Payer: Aetna Commercial |
$531.48
|
| Rate for Payer: Aetna Medicare |
$412.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$571.15
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCBS MAPPO |
$396.63
|
| Rate for Payer: BCBS Trust/PPO |
$212.38
|
| Rate for Payer: BCN Commercial |
$645.54
|
| Rate for Payer: BCN Medicare Advantage |
$396.63
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$531.48
|
| Rate for Payer: Cofinity Commercial |
$571.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$396.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$416.46
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Nomi Health Commercial |
$475.96
|
| Rate for Payer: PACE SWMI |
$396.63
|
| Rate for Payer: PHP Commercial |
$555.28
|
| Rate for Payer: PHP Medicare Advantage |
$396.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$679.04
|
| Rate for Payer: Priority Health Medicare |
$396.63
|
| Rate for Payer: Priority Health Narrow Network |
$679.04
|
| Rate for Payer: Priority Health SBD |
$86.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$396.63
|
| Rate for Payer: UHC Medicare Advantage |
$396.63
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$52.44
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE
|
Professional
|
Both
|
$444.00
|
|
|
Service Code
|
HCPCS 77280
|
| Min. Negotiated Rate |
$24.07 |
| Max. Negotiated Rate |
$1,443.32 |
| Rate for Payer: Aetna Commercial |
$320.74
|
| Rate for Payer: Aetna Commercial |
$320.74
|
| Rate for Payer: Aetna Medicare |
$248.93
|
| Rate for Payer: Aetna Medicare |
$248.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$320.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.68
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS Complete |
$25.27
|
| Rate for Payer: BCBS MAPPO |
$239.36
|
| Rate for Payer: BCBS MAPPO |
$239.36
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,443.32
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Medicare Advantage |
$239.36
|
| Rate for Payer: BCN Medicare Advantage |
$239.36
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$355.20
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cofinity Commercial |
$320.74
|
| Rate for Payer: Cofinity Commercial |
$344.68
|
| Rate for Payer: Cofinity Commercial |
$344.68
|
| Rate for Payer: Cofinity Commercial |
$320.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$239.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$251.33
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Meridian Medicaid |
$25.27
|
| Rate for Payer: Nomi Health Commercial |
$287.23
|
| Rate for Payer: Nomi Health Commercial |
$287.23
|
| Rate for Payer: PACE SWMI |
$239.36
|
| Rate for Payer: PACE SWMI |
$239.36
|
| Rate for Payer: PHP Commercial |
$335.10
|
| Rate for Payer: PHP Commercial |
$335.10
|
| Rate for Payer: PHP Medicare Advantage |
$239.36
|
| Rate for Payer: PHP Medicare Advantage |
$239.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$288.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$334.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$414.71
|
| Rate for Payer: Priority Health Medicare |
$239.36
|
| Rate for Payer: Priority Health Medicare |
$239.36
|
| Rate for Payer: Priority Health Narrow Network |
$414.71
|
| Rate for Payer: Priority Health Narrow Network |
$414.71
|
| Rate for Payer: Priority Health SBD |
$57.48
|
| Rate for Payer: Priority Health SBD |
$57.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$239.36
|
| Rate for Payer: UHC Medicare Advantage |
$239.36
|
| Rate for Payer: UHC Medicare Advantage |
$239.36
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
| Rate for Payer: UHCCP Medicaid |
$24.07
|
| Rate for Payer: UMR Bronson Commercial |
$236.90
|
| Rate for Payer: UMR Bronson Commercial |
$204.24
|
|
|
CHG TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX
|
Professional
|
Both
|
$299.00
|
|
|
Service Code
|
HCPCS 88233
|
| Min. Negotiated Rate |
$105.55 |
| Max. Negotiated Rate |
$218.18 |
| Rate for Payer: Aetna Commercial |
$188.58
|
| Rate for Payer: Aetna Medicare |
$146.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.65
|
| Rate for Payer: BCBS Complete |
$119.60
|
| Rate for Payer: BCBS MAPPO |
$140.73
|
| Rate for Payer: BCBS Trust/PPO |
$183.85
|
| Rate for Payer: BCN Commercial |
$105.55
|
| Rate for Payer: BCN Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cash Price |
$239.20
|
| Rate for Payer: Cofinity Commercial |
$188.58
|
| Rate for Payer: Cofinity Commercial |
$202.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.77
|
| Rate for Payer: Nomi Health Commercial |
$168.88
|
| Rate for Payer: PACE SWMI |
$140.73
|
| Rate for Payer: PHP Commercial |
$197.02
|
| Rate for Payer: PHP Medicare Advantage |
$140.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$218.18
|
| Rate for Payer: Priority Health Medicare |
$140.73
|
| Rate for Payer: Priority Health Narrow Network |
$218.18
|
| Rate for Payer: Priority Health SBD |
$218.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.73
|
| Rate for Payer: UHC Medicare Advantage |
$140.73
|
| Rate for Payer: UMR Bronson Commercial |
$137.54
|
|
|
CHG TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT
|
Professional
|
Both
|
$22.00
|
|
|
Service Code
|
HCPCS 87220
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$4,124.97 |
| 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 |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4,124.97
|
| Rate for Payer: BCN Commercial |
$3.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$6.15
|
| Rate for Payer: Cofinity Commercial |
$5.72
|
| 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 |
$14.30
|
| 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 |
$10.12
|
|
|
CHG TRANSCATHETER EMBOLIZATION ANY METH RS&I
|
Professional
|
Both
|
$359.00
|
|
|
Service Code
|
HCPCS 75894
|
| Min. Negotiated Rate |
$45.58 |
| Max. Negotiated Rate |
$1,546.97 |
| Rate for Payer: Priority Health Narrow Network |
$1,546.97
|
| Rate for Payer: Aetna Commercial |
$1,126.65
|
| Rate for Payer: Aetna Medicare |
$179.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,126.65
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$393.58
|
| Rate for Payer: BCN Commercial |
$1,451.37
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Meridian Medicaid |
$47.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,546.97
|
| Rate for Payer: Priority Health SBD |
$108.30
|
| Rate for Payer: UHCCP Medicaid |
$45.58
|
| Rate for Payer: UMR Bronson Commercial |
$165.14
|
|
|
CHG TRANSCATHETER INFUSION OTHER THAN THROMBOLYSIS
|
Professional
|
Both
|
$284.00
|
|
|
Service Code
|
HCPCS 75896
|
| Min. Negotiated Rate |
$113.60 |
| Max. Negotiated Rate |
$184.60 |
| Rate for Payer: Aetna Medicare |
$142.00
|
| Rate for Payer: BCBS Complete |
$113.60
|
| Rate for Payer: Cash Price |
$227.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.60
|
| Rate for Payer: UMR Bronson Commercial |
$130.64
|
|
|
CHG TRANSFERASE ALANINE AMINO ALT SGPT
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 84460
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$1,976.37 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: Aetna Medicare |
$5.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.10
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,976.37
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.63
|
| Rate for Payer: Cofinity Commercial |
$7.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: Nomi Health Commercial |
$6.36
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$7.42
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: Priority Health SBD |
$5.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.30
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG TRANSFERASE ASPARTATE AMINO AST SGOT
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 84450
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$2,972.74 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.46
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$2,972.74
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Nomi Health Commercial |
$6.22
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$7.25
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: Priority Health SBD |
$5.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
Both
|
$291.00
|
|
|
Service Code
|
HCPCS 77334
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$596.98 |
| Rate for Payer: Aetna Commercial |
$155.05
|
| Rate for Payer: Aetna Commercial |
$155.05
|
| Rate for Payer: Aetna Medicare |
$120.34
|
| Rate for Payer: Aetna Medicare |
$120.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$166.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.05
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS Complete |
$40.71
|
| Rate for Payer: BCBS MAPPO |
$115.71
|
| Rate for Payer: BCBS MAPPO |
$115.71
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCBS Trust/PPO |
$596.98
|
| Rate for Payer: BCN Commercial |
$217.82
|
| Rate for Payer: BCN Commercial |
$217.82
|
| Rate for Payer: BCN Medicare Advantage |
$115.71
|
| Rate for Payer: BCN Medicare Advantage |
$115.71
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cash Price |
$232.80
|
| Rate for Payer: Cofinity Commercial |
$155.05
|
| Rate for Payer: Cofinity Commercial |
$166.62
|
| Rate for Payer: Cofinity Commercial |
$155.05
|
| Rate for Payer: Cofinity Commercial |
$166.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.50
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Meridian Medicaid |
$40.71
|
| Rate for Payer: Nomi Health Commercial |
$138.85
|
| Rate for Payer: Nomi Health Commercial |
$138.85
|
| Rate for Payer: PACE SWMI |
$115.71
|
| Rate for Payer: PACE SWMI |
$115.71
|
| Rate for Payer: PHP Commercial |
$161.99
|
| Rate for Payer: PHP Commercial |
$161.99
|
| Rate for Payer: PHP Medicare Advantage |
$115.71
|
| Rate for Payer: PHP Medicare Advantage |
$115.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$193.49
|
| Rate for Payer: Priority Health Medicare |
$115.71
|
| Rate for Payer: Priority Health Medicare |
$115.71
|
| Rate for Payer: Priority Health Narrow Network |
$193.49
|
| Rate for Payer: Priority Health Narrow Network |
$193.49
|
| Rate for Payer: Priority Health SBD |
$92.39
|
| Rate for Payer: Priority Health SBD |
$92.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.71
|
| Rate for Payer: UHC Medicare Advantage |
$115.71
|
| Rate for Payer: UHC Medicare Advantage |
$115.71
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
| Rate for Payer: UHCCP Medicaid |
$38.77
|
| Rate for Payer: UMR Bronson Commercial |
$133.86
|
| Rate for Payer: UMR Bronson Commercial |
$84.18
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 77333
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$828.16 |
| Rate for Payer: Aetna Commercial |
$165.64
|
| Rate for Payer: Aetna Commercial |
$165.64
|
| Rate for Payer: Aetna Medicare |
$128.55
|
| Rate for Payer: Aetna Medicare |
$128.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.64
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCBS MAPPO |
$123.61
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCN Commercial |
$75.81
|
| Rate for Payer: BCN Commercial |
$75.81
|
| Rate for Payer: BCN Medicare Advantage |
$123.61
|
| Rate for Payer: BCN Medicare Advantage |
$123.61
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$165.64
|
| Rate for Payer: Cofinity Commercial |
$178.00
|
| Rate for Payer: Cofinity Commercial |
$178.00
|
| Rate for Payer: Cofinity Commercial |
$165.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$123.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.79
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Nomi Health Commercial |
$148.33
|
| Rate for Payer: Nomi Health Commercial |
$148.33
|
| Rate for Payer: PACE SWMI |
$123.61
|
| Rate for Payer: PACE SWMI |
$123.61
|
| Rate for Payer: PHP Commercial |
$173.05
|
| Rate for Payer: PHP Commercial |
$173.05
|
| Rate for Payer: PHP Medicare Advantage |
$123.61
|
| Rate for Payer: PHP Medicare Advantage |
$123.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$210.95
|
| Rate for Payer: Priority Health Medicare |
$123.61
|
| Rate for Payer: Priority Health Medicare |
$123.61
|
| Rate for Payer: Priority Health Narrow Network |
$210.95
|
| Rate for Payer: Priority Health Narrow Network |
$210.95
|
| Rate for Payer: Priority Health SBD |
$60.06
|
| Rate for Payer: Priority Health SBD |
$60.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.61
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
| Rate for Payer: UHC Medicare Advantage |
$123.61
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
| Rate for Payer: UMR Bronson Commercial |
$74.06
|
| Rate for Payer: UMR Bronson Commercial |
$42.32
|
|
