|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$99.00
|
|
|
Service Code
|
HCPCS 77332
|
| Min. Negotiated Rate |
$15.34 |
| Max. Negotiated Rate |
$828.16 |
| Rate for Payer: Aetna Commercial |
$50.64
|
| Rate for Payer: Aetna Commercial |
$50.64
|
| Rate for Payer: Aetna Medicare |
$39.30
|
| Rate for Payer: Aetna Medicare |
$39.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.64
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS Complete |
$16.11
|
| Rate for Payer: BCBS MAPPO |
$37.79
|
| Rate for Payer: BCBS MAPPO |
$37.79
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCBS Trust/PPO |
$828.16
|
| Rate for Payer: BCN Commercial |
$118.27
|
| Rate for Payer: BCN Commercial |
$118.27
|
| Rate for Payer: BCN Medicare Advantage |
$37.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.79
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cofinity Commercial |
$50.64
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Cofinity Commercial |
$54.42
|
| Rate for Payer: Cofinity Commercial |
$50.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.68
|
| Rate for Payer: Meridian Medicaid |
$16.11
|
| Rate for Payer: Meridian Medicaid |
$16.11
|
| Rate for Payer: Nomi Health Commercial |
$45.35
|
| Rate for Payer: Nomi Health Commercial |
$45.35
|
| Rate for Payer: PACE SWMI |
$37.79
|
| Rate for Payer: PACE SWMI |
$37.79
|
| Rate for Payer: PHP Commercial |
$52.91
|
| Rate for Payer: PHP Commercial |
$52.91
|
| Rate for Payer: PHP Medicare Advantage |
$37.79
|
| Rate for Payer: PHP Medicare Advantage |
$37.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.57
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Medicare |
$37.79
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health Narrow Network |
$60.57
|
| Rate for Payer: Priority Health SBD |
$36.44
|
| Rate for Payer: Priority Health SBD |
$36.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.79
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: UHC Medicare Advantage |
$37.79
|
| Rate for Payer: UHCCP Medicaid |
$15.34
|
| Rate for Payer: UHCCP Medicaid |
$15.34
|
| Rate for Payer: UMR Bronson Commercial |
$71.30
|
| Rate for Payer: UMR Bronson Commercial |
$45.54
|
|
|
CHG ULTRASONIC GUIDANCE INTRAOPERATIVE
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 76998
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$266.33 |
| Rate for Payer: Aetna Commercial |
$74.11
|
| Rate for Payer: Aetna Medicare |
$147.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.11
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$125.74
|
| Rate for Payer: BCN Commercial |
$266.33
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.83
|
| Rate for Payer: Priority Health Narrow Network |
$70.83
|
| Rate for Payer: Priority Health SBD |
$70.83
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
| Rate for Payer: UMR Bronson Commercial |
$135.70
|
|
|
CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 76981
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$160.65 |
| Rate for Payer: Aetna Commercial |
$128.01
|
| Rate for Payer: Aetna Medicare |
$99.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.56
|
| Rate for Payer: BCBS Complete |
$19.02
|
| Rate for Payer: BCBS MAPPO |
$95.53
|
| Rate for Payer: BCN Commercial |
$152.96
|
| Rate for Payer: BCN Medicare Advantage |
$95.53
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$137.56
|
| Rate for Payer: Cofinity Commercial |
$128.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.31
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Nomi Health Commercial |
$114.64
|
| Rate for Payer: PACE SWMI |
$95.53
|
| Rate for Payer: PHP Commercial |
$133.74
|
| Rate for Payer: PHP Medicare Advantage |
$95.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.65
|
| Rate for Payer: Priority Health Medicare |
$95.53
|
| Rate for Payer: Priority Health Narrow Network |
$160.65
|
| Rate for Payer: Priority Health SBD |
$43.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.53
|
| Rate for Payer: UHC Medicare Advantage |
$95.53
|
| Rate for Payer: UHCCP Medicaid |
$18.11
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 76800
|
| Min. Negotiated Rate |
$40.04 |
| Max. Negotiated Rate |
$337.06 |
| Rate for Payer: Aetna Commercial |
$220.87
|
| Rate for Payer: Aetna Medicare |
$171.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.36
|
| Rate for Payer: BCBS Complete |
$42.04
|
| Rate for Payer: BCBS MAPPO |
$164.83
|
| Rate for Payer: BCBS Trust/PPO |
$337.06
|
| Rate for Payer: BCN Commercial |
$229.68
|
| Rate for Payer: BCN Medicare Advantage |
$164.83
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$237.36
|
| Rate for Payer: Cofinity Commercial |
$220.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$173.07
|
| Rate for Payer: Meridian Medicaid |
$42.04
|
| Rate for Payer: Nomi Health Commercial |
$197.80
|
| Rate for Payer: PACE SWMI |
$164.83
|
| Rate for Payer: PHP Commercial |
$230.76
|
| Rate for Payer: PHP Medicare Advantage |
$164.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$266.38
|
| Rate for Payer: Priority Health Medicare |
$164.83
|
| Rate for Payer: Priority Health Narrow Network |
$266.38
|
| Rate for Payer: Priority Health SBD |
$94.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$164.83
|
| Rate for Payer: UHC Medicare Advantage |
$164.83
|
| Rate for Payer: UHCCP Medicaid |
$40.04
|
| Rate for Payer: UMR Bronson Commercial |
$41.86
|
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 76496
|
| Min. Negotiated Rate |
$63.40 |
| Max. Negotiated Rate |
$165.75 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Aetna Medicare |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.70
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: BCBS Trust/PPO |
$63.40
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: UMR Bronson Commercial |
$117.30
|
|
|
CHG URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM
|
Professional
|
Both
|
$485.00
|
|
|
Service Code
|
HCPCS 78740
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$581.13 |
| Rate for Payer: Aetna Commercial |
$250.46
|
| Rate for Payer: Aetna Medicare |
$194.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.15
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$186.91
|
| Rate for Payer: BCBS Trust/PPO |
$581.13
|
| Rate for Payer: BCN Commercial |
$298.09
|
| Rate for Payer: BCN Medicare Advantage |
$186.91
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cash Price |
$388.00
|
| Rate for Payer: Cofinity Commercial |
$269.15
|
| Rate for Payer: Cofinity Commercial |
$250.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$196.26
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| Rate for Payer: Nomi Health Commercial |
$224.29
|
| Rate for Payer: PACE SWMI |
$186.91
|
| Rate for Payer: PHP Commercial |
$261.67
|
| Rate for Payer: PHP Medicare Advantage |
$186.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$315.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.86
|
| Rate for Payer: Priority Health Medicare |
$186.91
|
| Rate for Payer: Priority Health Narrow Network |
$323.86
|
| Rate for Payer: Priority Health SBD |
$40.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.91
|
| Rate for Payer: UHC Medicare Advantage |
$186.91
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: UMR Bronson Commercial |
$223.10
|
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 74450
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$1,100.98 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: Aetna Medicare |
$56.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.77
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,100.98
|
| Rate for Payer: BCN Commercial |
$238.97
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$102.66
|
| Rate for Payer: Priority Health Narrow Network |
$102.66
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UMR Bronson Commercial |
$51.52
|
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 74455
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$160.14 |
| Rate for Payer: Aetna Commercial |
$121.54
|
| Rate for Payer: Aetna Medicare |
$94.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.61
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCBS MAPPO |
$90.70
|
| Rate for Payer: BCBS Trust/PPO |
$60.70
|
| Rate for Payer: BCN Commercial |
$153.93
|
| Rate for Payer: BCN Medicare Advantage |
$90.70
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$130.61
|
| Rate for Payer: Cofinity Commercial |
$121.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.24
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Nomi Health Commercial |
$108.84
|
| Rate for Payer: PACE SWMI |
$90.70
|
| Rate for Payer: PHP Commercial |
$126.98
|
| Rate for Payer: PHP Medicare Advantage |
$90.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.14
|
| Rate for Payer: Priority Health Medicare |
$90.70
|
| Rate for Payer: Priority Health Narrow Network |
$160.14
|
| Rate for Payer: Priority Health SBD |
$23.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.70
|
| Rate for Payer: UHC Medicare Advantage |
$90.70
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
| Rate for Payer: UMR Bronson Commercial |
$15.18
|
|
|
CHG URINALYSIS MICROSCOPIC ONLY
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 81015
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$2,074.63 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.39
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,074.63
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Cofinity Commercial |
$4.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Nomi Health Commercial |
$3.66
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Commercial |
$4.27
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.00
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$3.00
|
| Rate for Payer: Priority Health SBD |
$3.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.05
|
| Rate for Payer: UHC Medicare Advantage |
$3.05
|
| Rate for Payer: UMR Bronson Commercial |
$3.22
|
|
|
CHG URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81005
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$2,140.67 |
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.12
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$2,140.67
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Nomi Health Commercial |
$2.60
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$3.04
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$2.33
|
| Rate for Payer: Priority Health SBD |
$2.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Medicare Advantage |
$2.17
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG URINARY BLADDER RESIDUAL STUDY
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 78730
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$512.98 |
| Rate for Payer: Aetna Commercial |
$78.87
|
| Rate for Payer: Aetna Medicare |
$61.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.87
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS MAPPO |
$58.86
|
| Rate for Payer: BCBS Trust/PPO |
$512.98
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Medicare Advantage |
$58.86
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$84.76
|
| Rate for Payer: Cofinity Commercial |
$78.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.80
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Nomi Health Commercial |
$70.63
|
| Rate for Payer: PACE SWMI |
$58.86
|
| Rate for Payer: PHP Commercial |
$82.40
|
| Rate for Payer: PHP Medicare Advantage |
$58.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.22
|
| Rate for Payer: Priority Health Medicare |
$58.86
|
| Rate for Payer: Priority Health Narrow Network |
$105.22
|
| Rate for Payer: Priority Health SBD |
$11.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.86
|
| Rate for Payer: UHC Medicare Advantage |
$58.86
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: UMR Bronson Commercial |
$109.48
|
|
|
CHG URINE ALBUMIN SEMIQUANTITATIVE
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82044
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$3,544.36 |
| Rate for Payer: Aetna Commercial |
$8.35
|
| Rate for Payer: Aetna Medicare |
$6.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.97
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$6.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,544.36
|
| Rate for Payer: BCN Commercial |
$4.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.23
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$8.35
|
| Rate for Payer: Cofinity Commercial |
$8.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.54
|
| Rate for Payer: Nomi Health Commercial |
$7.48
|
| Rate for Payer: PACE SWMI |
$6.23
|
| Rate for Payer: PHP Commercial |
$8.72
|
| Rate for Payer: PHP Medicare Advantage |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.32
|
| Rate for Payer: Priority Health Medicare |
$6.23
|
| Rate for Payer: Priority Health Narrow Network |
$6.32
|
| Rate for Payer: Priority Health SBD |
$6.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.23
|
| Rate for Payer: UHC Medicare Advantage |
$6.23
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 81025
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$2,329.80 |
| 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 |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,329.80
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| 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 |
$14.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.65
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$8.65
|
| Rate for Payer: Priority Health SBD |
$8.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.61
|
| Rate for Payer: UHC Medicare Advantage |
$8.61
|
| Rate for Payer: UMR Bronson Commercial |
$10.58
|
|
|
CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY
|
Professional
|
Both
|
$17.00
|
|
|
Service Code
|
HCPCS 81000
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$2,458.18 |
| Rate for Payer: Aetna Commercial |
$5.39
|
| Rate for Payer: Aetna Medicare |
$4.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.79
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,458.18
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cofinity Commercial |
$5.39
|
| Rate for Payer: Cofinity Commercial |
$5.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: Nomi Health Commercial |
$4.82
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Commercial |
$5.63
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.99
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow Network |
$3.99
|
| Rate for Payer: Priority Health SBD |
$3.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.02
|
| Rate for Payer: UHC Medicare Advantage |
$4.02
|
| Rate for Payer: UMR Bronson Commercial |
$7.82
|
|
|
CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 81001
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$3,145.50 |
| Rate for Payer: Aetna Commercial |
$4.25
|
| Rate for Payer: Aetna Medicare |
$3.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.56
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,145.50
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Cofinity Commercial |
$4.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: Nomi Health Commercial |
$3.80
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Commercial |
$4.44
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow Network |
$3.33
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.17
|
| Rate for Payer: UHC Medicare Advantage |
$3.17
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
|
|
CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81003
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$1,827.92 |
| Rate for Payer: Aetna Commercial |
$3.02
|
| Rate for Payer: Aetna Medicare |
$2.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.24
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,827.92
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Cofinity Commercial |
$3.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Nomi Health Commercial |
$2.70
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Commercial |
$3.15
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.33
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow Network |
$2.33
|
| Rate for Payer: Priority Health SBD |
$2.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
| Rate for Payer: UHC Medicare Advantage |
$2.25
|
| Rate for Payer: UMR Bronson Commercial |
$6.44
|
|
|
CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 81002
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$2,102.11 |
| Rate for Payer: Aetna Commercial |
$4.66
|
| Rate for Payer: Aetna Medicare |
$3.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.01
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.11
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$5.01
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Nomi Health Commercial |
$4.18
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Commercial |
$4.87
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.33
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$3.33
|
| Rate for Payer: Priority Health SBD |
$3.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.48
|
| Rate for Payer: UHC Medicare Advantage |
$3.48
|
| Rate for Payer: UMR Bronson Commercial |
$5.52
|
|
|
CHG UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 74400
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$673.05 |
| Rate for Payer: Aetna Commercial |
$159.11
|
| Rate for Payer: Aetna Commercial |
$159.11
|
| Rate for Payer: Aetna Medicare |
$123.49
|
| Rate for Payer: Aetna Medicare |
$123.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.11
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS MAPPO |
$118.74
|
| Rate for Payer: BCBS MAPPO |
$118.74
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCBS Trust/PPO |
$673.05
|
| Rate for Payer: BCN Commercial |
$200.36
|
| Rate for Payer: BCN Commercial |
$200.36
|
| Rate for Payer: BCN Medicare Advantage |
$118.74
|
| Rate for Payer: BCN Medicare Advantage |
$118.74
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$159.11
|
| Rate for Payer: Cofinity Commercial |
$170.99
|
| Rate for Payer: Cofinity Commercial |
$170.99
|
| Rate for Payer: Cofinity Commercial |
$159.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.68
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Nomi Health Commercial |
$142.49
|
| Rate for Payer: Nomi Health Commercial |
$142.49
|
| Rate for Payer: PACE SWMI |
$118.74
|
| Rate for Payer: PACE SWMI |
$118.74
|
| Rate for Payer: PHP Commercial |
$166.24
|
| Rate for Payer: PHP Commercial |
$166.24
|
| Rate for Payer: PHP Medicare Advantage |
$118.74
|
| Rate for Payer: PHP Medicare Advantage |
$118.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.86
|
| Rate for Payer: Priority Health Medicare |
$118.74
|
| Rate for Payer: Priority Health Medicare |
$118.74
|
| Rate for Payer: Priority Health Narrow Network |
$207.86
|
| Rate for Payer: Priority Health Narrow Network |
$207.86
|
| Rate for Payer: Priority Health SBD |
$35.42
|
| Rate for Payer: Priority Health SBD |
$35.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.74
|
| Rate for Payer: UHC Medicare Advantage |
$118.74
|
| Rate for Payer: UHC Medicare Advantage |
$118.74
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
| Rate for Payer: UMR Bronson Commercial |
$64.40
|
| Rate for Payer: UMR Bronson Commercial |
$97.98
|
|
|
CHG UROGRAPHY RETROGRADE WITH/WO KUB
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 74420
|
| Min. Negotiated Rate |
$15.55 |
| Max. Negotiated Rate |
$978.41 |
| Rate for Payer: Aetna Commercial |
$94.75
|
| Rate for Payer: Aetna Medicare |
$73.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.75
|
| Rate for Payer: BCBS Complete |
$16.33
|
| Rate for Payer: BCBS MAPPO |
$70.71
|
| Rate for Payer: BCBS Trust/PPO |
$978.41
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$70.71
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$94.75
|
| Rate for Payer: Cofinity Commercial |
$101.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.25
|
| Rate for Payer: Meridian Medicaid |
$16.33
|
| Rate for Payer: Nomi Health Commercial |
$84.85
|
| Rate for Payer: PACE SWMI |
$70.71
|
| Rate for Payer: PHP Commercial |
$98.99
|
| Rate for Payer: PHP Medicare Advantage |
$70.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.10
|
| Rate for Payer: Priority Health Medicare |
$70.71
|
| Rate for Payer: Priority Health Narrow Network |
$120.10
|
| Rate for Payer: Priority Health SBD |
$36.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.71
|
| Rate for Payer: UHC Medicare Advantage |
$70.71
|
| Rate for Payer: UHCCP Medicaid |
$15.55
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
|
|
CHG US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 76706
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$164.24 |
| Rate for Payer: Aetna Commercial |
$128.93
|
| Rate for Payer: Aetna Medicare |
$100.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.56
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS MAPPO |
$96.22
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: BCN Medicare Advantage |
$96.22
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$138.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.03
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Nomi Health Commercial |
$115.46
|
| Rate for Payer: PACE SWMI |
$96.22
|
| Rate for Payer: PHP Commercial |
$134.71
|
| Rate for Payer: PHP Medicare Advantage |
$96.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.24
|
| Rate for Payer: Priority Health Medicare |
$96.22
|
| Rate for Payer: Priority Health Narrow Network |
$164.24
|
| Rate for Payer: Priority Health SBD |
$39.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$96.22
|
| Rate for Payer: UHC Medicare Advantage |
$96.22
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$213.00
|
|
|
Service Code
|
HCPCS 76700
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$2,008.07 |
| Rate for Payer: Aetna Commercial |
$140.43
|
| Rate for Payer: Aetna Medicare |
$108.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.91
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCBS MAPPO |
$104.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,008.07
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Medicare Advantage |
$104.80
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$140.43
|
| Rate for Payer: Cofinity Commercial |
$150.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.04
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Nomi Health Commercial |
$125.76
|
| Rate for Payer: PACE SWMI |
$104.80
|
| Rate for Payer: PHP Commercial |
$146.72
|
| Rate for Payer: PHP Medicare Advantage |
$104.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.12
|
| Rate for Payer: Priority Health Medicare |
$104.80
|
| Rate for Payer: Priority Health Narrow Network |
$179.12
|
| Rate for Payer: Priority Health SBD |
$57.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.80
|
| Rate for Payer: UHC Medicare Advantage |
$104.80
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
| Rate for Payer: UMR Bronson Commercial |
$97.98
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE LIMITED
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 76705
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$2,317.65 |
| Rate for Payer: Aetna Commercial |
$105.39
|
| Rate for Payer: Aetna Commercial |
$105.39
|
| Rate for Payer: Aetna Medicare |
$81.80
|
| Rate for Payer: Aetna Medicare |
$81.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.26
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCBS Complete |
$18.56
|
| Rate for Payer: BCBS MAPPO |
$78.65
|
| Rate for Payer: BCBS MAPPO |
$78.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,317.65
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Medicare Advantage |
$78.65
|
| Rate for Payer: BCN Medicare Advantage |
$78.65
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$105.39
|
| Rate for Payer: Cofinity Commercial |
$113.26
|
| Rate for Payer: Cofinity Commercial |
$113.26
|
| Rate for Payer: Cofinity Commercial |
$105.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.58
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: Meridian Medicaid |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$94.38
|
| Rate for Payer: Nomi Health Commercial |
$94.38
|
| Rate for Payer: PACE SWMI |
$78.65
|
| Rate for Payer: PACE SWMI |
$78.65
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: PHP Commercial |
$110.11
|
| Rate for Payer: PHP Medicare Advantage |
$78.65
|
| Rate for Payer: PHP Medicare Advantage |
$78.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$133.96
|
| Rate for Payer: Priority Health Medicare |
$78.65
|
| Rate for Payer: Priority Health Medicare |
$78.65
|
| Rate for Payer: Priority Health Narrow Network |
$133.96
|
| Rate for Payer: Priority Health Narrow Network |
$133.96
|
| Rate for Payer: Priority Health SBD |
$42.09
|
| Rate for Payer: Priority Health SBD |
$42.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.65
|
| Rate for Payer: UHC Medicare Advantage |
$78.65
|
| Rate for Payer: UHC Medicare Advantage |
$78.65
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
| Rate for Payer: UHCCP Medicaid |
$17.68
|
| Rate for Payer: UMR Bronson Commercial |
$82.80
|
| Rate for Payer: UMR Bronson Commercial |
$49.68
|
|
|
CHG US, BREAST(S), REAL TIME
|
Professional
|
Both
|
$150.00
|
|
|
Service Code
|
HCPCS 76645
|
| Min. Negotiated Rate |
$60.00 |
| Max. Negotiated Rate |
$97.50 |
| Rate for Payer: Aetna Medicare |
$75.00
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.50
|
| Rate for Payer: UMR Bronson Commercial |
$69.00
|
|
|
CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 76604
|
| Min. Negotiated Rate |
$17.25 |
| Max. Negotiated Rate |
$2,617.20 |
| Rate for Payer: Aetna Commercial |
$71.44
|
| Rate for Payer: Aetna Medicare |
$55.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.77
|
| Rate for Payer: BCBS Complete |
$18.11
|
| Rate for Payer: BCBS MAPPO |
$53.31
|
| Rate for Payer: BCBS Trust/PPO |
$2,617.20
|
| Rate for Payer: BCN Commercial |
$83.07
|
| Rate for Payer: BCN Medicare Advantage |
$53.31
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$76.77
|
| Rate for Payer: Cofinity Commercial |
$71.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.98
|
| Rate for Payer: Meridian Medicaid |
$18.11
|
| Rate for Payer: Nomi Health Commercial |
$63.97
|
| Rate for Payer: PACE SWMI |
$53.31
|
| Rate for Payer: PHP Commercial |
$74.63
|
| Rate for Payer: PHP Medicare Advantage |
$53.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.76
|
| Rate for Payer: Priority Health Medicare |
$53.31
|
| Rate for Payer: Priority Health Narrow Network |
$87.76
|
| Rate for Payer: Priority Health SBD |
$41.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.31
|
| Rate for Payer: UHC Medicare Advantage |
$53.31
|
| Rate for Payer: UHCCP Medicaid |
$17.25
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
|
|
CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL
|
Professional
|
Both
|
$429.00
|
|
|
Service Code
|
HCPCS 76936
|
| Min. Negotiated Rate |
$59.21 |
| Max. Negotiated Rate |
$400.86 |
| Rate for Payer: Aetna Commercial |
$315.24
|
| Rate for Payer: Aetna Medicare |
$244.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$315.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.76
|
| Rate for Payer: BCBS Complete |
$62.17
|
| Rate for Payer: BCBS MAPPO |
$235.25
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$379.21
|
| Rate for Payer: BCN Medicare Advantage |
$235.25
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cash Price |
$343.20
|
| Rate for Payer: Cofinity Commercial |
$315.24
|
| Rate for Payer: Cofinity Commercial |
$338.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.01
|
| Rate for Payer: Meridian Medicaid |
$62.17
|
| Rate for Payer: Nomi Health Commercial |
$282.30
|
| Rate for Payer: PACE SWMI |
$235.25
|
| Rate for Payer: PHP Commercial |
$329.35
|
| Rate for Payer: PHP Medicare Advantage |
$235.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$278.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$400.86
|
| Rate for Payer: Priority Health Medicare |
$235.25
|
| Rate for Payer: Priority Health Narrow Network |
$400.86
|
| Rate for Payer: Priority Health SBD |
$141.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.25
|
| Rate for Payer: UHC Medicare Advantage |
$235.25
|
| Rate for Payer: UHCCP Medicaid |
$59.21
|
| Rate for Payer: UMR Bronson Commercial |
$197.34
|
|
