|
CHG US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 76817
|
| Min. Negotiated Rate |
$83.53 |
| Max. Negotiated Rate |
$185.25 |
| Rate for Payer: Aetna Commercial |
$111.93
|
| Rate for Payer: Aetna Medicare |
$86.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.93
|
| Rate for Payer: BCBS Complete |
$114.00
|
| Rate for Payer: BCBS MAPPO |
$83.53
|
| Rate for Payer: BCN Medicare Advantage |
$83.53
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$120.28
|
| Rate for Payer: Cofinity Commercial |
$111.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$87.71
|
| Rate for Payer: Nomi Health Commercial |
$100.24
|
| Rate for Payer: PACE SWMI |
$83.53
|
| Rate for Payer: PHP Commercial |
$116.94
|
| Rate for Payer: PHP Medicare Advantage |
$83.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health Medicare |
$83.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.53
|
| Rate for Payer: UHC Medicare Advantage |
$83.53
|
| Rate for Payer: UMR Bronson Commercial |
$131.10
|
|
|
CHG US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION
|
Professional
|
Both
|
$378.00
|
|
|
Service Code
|
HCPCS 76811
|
| Min. Negotiated Rate |
$151.20 |
| Max. Negotiated Rate |
$245.70 |
| Rate for Payer: Aetna Commercial |
$218.19
|
| Rate for Payer: Aetna Medicare |
$169.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.19
|
| Rate for Payer: BCBS Complete |
$151.20
|
| Rate for Payer: BCBS MAPPO |
$162.83
|
| Rate for Payer: BCN Medicare Advantage |
$162.83
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| Rate for Payer: Cofinity Commercial |
$234.48
|
| Rate for Payer: Cofinity Commercial |
$218.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.97
|
| Rate for Payer: Nomi Health Commercial |
$195.40
|
| Rate for Payer: PACE SWMI |
$162.83
|
| Rate for Payer: PHP Commercial |
$227.96
|
| Rate for Payer: PHP Medicare Advantage |
$162.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
| Rate for Payer: Priority Health Medicare |
$162.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.83
|
| Rate for Payer: UHC Medicare Advantage |
$162.83
|
| Rate for Payer: UMR Bronson Commercial |
$173.88
|
|
|
CHG US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE
|
Professional
|
Both
|
$72.00
|
|
|
Service Code
|
HCPCS 76770
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$140.86 |
| Rate for Payer: Aetna Commercial |
$131.08
|
| Rate for Payer: Aetna Medicare |
$101.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.08
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: BCBS MAPPO |
$97.82
|
| Rate for Payer: BCN Medicare Advantage |
$97.82
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$140.86
|
| Rate for Payer: Cofinity Commercial |
$131.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.71
|
| Rate for Payer: Nomi Health Commercial |
$117.38
|
| Rate for Payer: PACE SWMI |
$97.82
|
| Rate for Payer: PHP Commercial |
$136.95
|
| Rate for Payer: PHP Medicare Advantage |
$97.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health Medicare |
$97.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.82
|
| Rate for Payer: UHC Medicare Advantage |
$97.82
|
| Rate for Payer: UMR Bronson Commercial |
$33.12
|
|
|
CHG US RETROPERITONEAL REAL TIME W/IMAGE LIMITED
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 76775
|
| Min. Negotiated Rate |
$55.64 |
| Max. Negotiated Rate |
$126.10 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna Medicare |
$57.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.56
|
| Rate for Payer: BCBS Complete |
$77.60
|
| Rate for Payer: BCBS MAPPO |
$55.64
|
| Rate for Payer: BCN Medicare Advantage |
$55.64
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$80.12
|
| Rate for Payer: Cofinity Commercial |
$74.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.42
|
| Rate for Payer: Nomi Health Commercial |
$66.77
|
| Rate for Payer: PACE SWMI |
$55.64
|
| Rate for Payer: PHP Commercial |
$77.90
|
| Rate for Payer: PHP Medicare Advantage |
$55.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health Medicare |
$55.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.64
|
| Rate for Payer: UHC Medicare Advantage |
$55.64
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
CHG US SCROTUM & CONTENTS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 76870
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$130.13 |
| Rate for Payer: Aetna Commercial |
$121.10
|
| Rate for Payer: Aetna Medicare |
$93.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.10
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$90.37
|
| Rate for Payer: BCN Medicare Advantage |
$90.37
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$130.13
|
| Rate for Payer: Cofinity Commercial |
$121.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.89
|
| Rate for Payer: Nomi Health Commercial |
$108.44
|
| Rate for Payer: PACE SWMI |
$90.37
|
| Rate for Payer: PHP Commercial |
$126.52
|
| Rate for Payer: PHP Medicare Advantage |
$90.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$90.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.37
|
| Rate for Payer: UHC Medicare Advantage |
$90.37
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
CHG US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM
|
Professional
|
Both
|
$227.00
|
|
|
Service Code
|
HCPCS 76536
|
| Min. Negotiated Rate |
$90.80 |
| Max. Negotiated Rate |
$147.55 |
| Rate for Payer: Aetna Commercial |
$132.24
|
| Rate for Payer: Aetna Commercial |
$132.24
|
| Rate for Payer: Aetna Medicare |
$102.64
|
| Rate for Payer: Aetna Medicare |
$102.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.11
|
| Rate for Payer: BCBS Complete |
$90.80
|
| Rate for Payer: BCBS Complete |
$40.80
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCN Medicare Advantage |
$98.69
|
| Rate for Payer: BCN Medicare Advantage |
$98.69
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Commercial |
$132.24
|
| Rate for Payer: Cofinity Commercial |
$132.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.62
|
| Rate for Payer: Nomi Health Commercial |
$118.43
|
| Rate for Payer: Nomi Health Commercial |
$118.43
|
| Rate for Payer: PACE SWMI |
$98.69
|
| Rate for Payer: PACE SWMI |
$98.69
|
| Rate for Payer: PHP Commercial |
$138.17
|
| Rate for Payer: PHP Commercial |
$138.17
|
| Rate for Payer: PHP Medicare Advantage |
$98.69
|
| Rate for Payer: PHP Medicare Advantage |
$98.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$147.55
|
| Rate for Payer: Priority Health Medicare |
$98.69
|
| Rate for Payer: Priority Health Medicare |
$98.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.69
|
| Rate for Payer: UHC Medicare Advantage |
$98.69
|
| Rate for Payer: UHC Medicare Advantage |
$98.69
|
| Rate for Payer: UMR Bronson Commercial |
$104.42
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
|
|
CHG US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 76873
|
| Min. Negotiated Rate |
$104.00 |
| Max. Negotiated Rate |
$229.64 |
| Rate for Payer: Aetna Commercial |
$213.69
|
| Rate for Payer: Aetna Medicare |
$165.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.69
|
| Rate for Payer: BCBS Complete |
$104.00
|
| Rate for Payer: BCBS MAPPO |
$159.47
|
| Rate for Payer: BCN Medicare Advantage |
$159.47
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$229.64
|
| Rate for Payer: Cofinity Commercial |
$213.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$159.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$167.44
|
| Rate for Payer: Nomi Health Commercial |
$191.36
|
| Rate for Payer: PACE SWMI |
$159.47
|
| Rate for Payer: PHP Commercial |
$223.26
|
| Rate for Payer: PHP Medicare Advantage |
$159.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health Medicare |
$159.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.47
|
| Rate for Payer: UHC Medicare Advantage |
$159.47
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
CHG US TRANSRECTAL
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 76872
|
| Min. Negotiated Rate |
$28.40 |
| Max. Negotiated Rate |
$253.28 |
| Rate for Payer: Aetna Commercial |
$235.69
|
| Rate for Payer: Aetna Commercial |
$235.69
|
| Rate for Payer: Aetna Medicare |
$182.93
|
| Rate for Payer: Aetna Medicare |
$182.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$235.69
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS Complete |
$28.40
|
| Rate for Payer: BCBS MAPPO |
$175.89
|
| Rate for Payer: BCBS MAPPO |
$175.89
|
| Rate for Payer: BCN Medicare Advantage |
$175.89
|
| Rate for Payer: BCN Medicare Advantage |
$175.89
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$253.28
|
| Rate for Payer: Cofinity Commercial |
$235.69
|
| Rate for Payer: Cofinity Commercial |
$253.28
|
| Rate for Payer: Cofinity Commercial |
$235.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.68
|
| Rate for Payer: Nomi Health Commercial |
$211.07
|
| Rate for Payer: Nomi Health Commercial |
$211.07
|
| Rate for Payer: PACE SWMI |
$175.89
|
| Rate for Payer: PACE SWMI |
$175.89
|
| Rate for Payer: PHP Commercial |
$246.25
|
| Rate for Payer: PHP Commercial |
$246.25
|
| Rate for Payer: PHP Medicare Advantage |
$175.89
|
| Rate for Payer: PHP Medicare Advantage |
$175.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
| Rate for Payer: Priority Health Medicare |
$175.89
|
| Rate for Payer: Priority Health Medicare |
$175.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$175.89
|
| Rate for Payer: UHC Medicare Advantage |
$175.89
|
| Rate for Payer: UHC Medicare Advantage |
$175.89
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
| Rate for Payer: UMR Bronson Commercial |
$32.66
|
|
|
CHG US TRANSVAGINAL
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 76830
|
| Min. Negotiated Rate |
$106.43 |
| Max. Negotiated Rate |
$201.50 |
| Rate for Payer: Aetna Commercial |
$142.62
|
| Rate for Payer: Aetna Medicare |
$110.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.62
|
| Rate for Payer: BCBS Complete |
$124.00
|
| Rate for Payer: BCBS MAPPO |
$106.43
|
| Rate for Payer: BCN Medicare Advantage |
$106.43
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cofinity Commercial |
$153.26
|
| Rate for Payer: Cofinity Commercial |
$142.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.75
|
| Rate for Payer: Nomi Health Commercial |
$127.72
|
| Rate for Payer: PACE SWMI |
$106.43
|
| Rate for Payer: PHP Commercial |
$149.00
|
| Rate for Payer: PHP Medicare Advantage |
$106.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health Medicare |
$106.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.43
|
| Rate for Payer: UHC Medicare Advantage |
$106.43
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
|
|
CHG US VASC ACCESS SITS VSL PATENCY NDL ENTRY
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 76937
|
| Min. Negotiated Rate |
$24.80 |
| Max. Negotiated Rate |
$50.41 |
| Rate for Payer: Aetna Commercial |
$46.91
|
| Rate for Payer: Aetna Commercial |
$46.91
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Aetna Medicare |
$36.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: BCBS Complete |
$22.80
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: BCBS MAPPO |
$35.01
|
| Rate for Payer: BCBS MAPPO |
$35.01
|
| Rate for Payer: BCN Medicare Advantage |
$35.01
|
| Rate for Payer: BCN Medicare Advantage |
$35.01
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$50.41
|
| Rate for Payer: Cofinity Commercial |
$46.91
|
| Rate for Payer: Cofinity Commercial |
$50.41
|
| Rate for Payer: Cofinity Commercial |
$46.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.76
|
| Rate for Payer: Nomi Health Commercial |
$42.01
|
| Rate for Payer: Nomi Health Commercial |
$42.01
|
| Rate for Payer: PACE SWMI |
$35.01
|
| Rate for Payer: PACE SWMI |
$35.01
|
| Rate for Payer: PHP Commercial |
$49.01
|
| Rate for Payer: PHP Commercial |
$49.01
|
| Rate for Payer: PHP Medicare Advantage |
$35.01
|
| Rate for Payer: PHP Medicare Advantage |
$35.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health Medicare |
$35.01
|
| Rate for Payer: Priority Health Medicare |
$35.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$35.01
|
| Rate for Payer: UHC Medicare Advantage |
$35.01
|
| Rate for Payer: UMR Bronson Commercial |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$28.52
|
|
|
CHG VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 75840
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$189.80 |
| Rate for Payer: Aetna Commercial |
$156.82
|
| Rate for Payer: Aetna Medicare |
$121.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.82
|
| Rate for Payer: BCBS Complete |
$116.80
|
| Rate for Payer: BCBS MAPPO |
$117.03
|
| Rate for Payer: BCN Medicare Advantage |
$117.03
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$168.52
|
| Rate for Payer: Cofinity Commercial |
$156.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.88
|
| Rate for Payer: Nomi Health Commercial |
$140.44
|
| Rate for Payer: PACE SWMI |
$117.03
|
| Rate for Payer: PHP Commercial |
$163.84
|
| Rate for Payer: PHP Medicare Advantage |
$117.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health Medicare |
$117.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.03
|
| Rate for Payer: UHC Medicare Advantage |
$117.03
|
| Rate for Payer: UMR Bronson Commercial |
$134.32
|
|
|
CHG VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$108.00
|
|
|
Service Code
|
HCPCS 75825
|
| Min. Negotiated Rate |
$43.20 |
| Max. Negotiated Rate |
$151.80 |
| Rate for Payer: Aetna Commercial |
$141.26
|
| Rate for Payer: Aetna Medicare |
$109.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.26
|
| Rate for Payer: BCBS Complete |
$43.20
|
| Rate for Payer: BCBS MAPPO |
$105.42
|
| Rate for Payer: BCN Medicare Advantage |
$105.42
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cofinity Commercial |
$151.80
|
| Rate for Payer: Cofinity Commercial |
$141.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$110.69
|
| Rate for Payer: Nomi Health Commercial |
$126.50
|
| Rate for Payer: PACE SWMI |
$105.42
|
| Rate for Payer: PHP Commercial |
$147.59
|
| Rate for Payer: PHP Medicare Advantage |
$105.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.20
|
| Rate for Payer: Priority Health Medicare |
$105.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$105.42
|
| Rate for Payer: UHC Medicare Advantage |
$105.42
|
| Rate for Payer: UMR Bronson Commercial |
$49.68
|
|
|
CHG VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 75827
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$155.79 |
| Rate for Payer: Aetna Commercial |
$144.97
|
| Rate for Payer: Aetna Medicare |
$112.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.97
|
| Rate for Payer: BCBS Complete |
$42.00
|
| Rate for Payer: BCBS MAPPO |
$108.19
|
| Rate for Payer: BCN Medicare Advantage |
$108.19
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$155.79
|
| Rate for Payer: Cofinity Commercial |
$144.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$108.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.60
|
| Rate for Payer: Nomi Health Commercial |
$129.83
|
| Rate for Payer: PACE SWMI |
$108.19
|
| Rate for Payer: PHP Commercial |
$151.47
|
| Rate for Payer: PHP Medicare Advantage |
$108.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$108.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$108.19
|
| Rate for Payer: UHC Medicare Advantage |
$108.19
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
|
|
CHG VENOGRAPHY EXTREMITY BILATERAL RS&I
|
Professional
|
Both
|
$274.00
|
|
|
Service Code
|
HCPCS 75822
|
| Min. Negotiated Rate |
$109.60 |
| Max. Negotiated Rate |
$178.10 |
| Rate for Payer: Aetna Commercial |
$164.46
|
| Rate for Payer: Aetna Commercial |
$164.46
|
| Rate for Payer: Aetna Medicare |
$127.64
|
| Rate for Payer: Aetna Medicare |
$127.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$176.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$164.46
|
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS Complete |
$109.60
|
| Rate for Payer: BCBS MAPPO |
$122.73
|
| Rate for Payer: BCBS MAPPO |
$122.73
|
| Rate for Payer: BCN Medicare Advantage |
$122.73
|
| Rate for Payer: BCN Medicare Advantage |
$122.73
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$219.20
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Cofinity Commercial |
$176.73
|
| Rate for Payer: Cofinity Commercial |
$164.46
|
| Rate for Payer: Cofinity Commercial |
$176.73
|
| Rate for Payer: Cofinity Commercial |
$164.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.87
|
| Rate for Payer: Nomi Health Commercial |
$147.28
|
| Rate for Payer: Nomi Health Commercial |
$147.28
|
| Rate for Payer: PACE SWMI |
$122.73
|
| Rate for Payer: PACE SWMI |
$122.73
|
| Rate for Payer: PHP Commercial |
$171.82
|
| Rate for Payer: PHP Commercial |
$171.82
|
| Rate for Payer: PHP Medicare Advantage |
$122.73
|
| Rate for Payer: PHP Medicare Advantage |
$122.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$122.73
|
| Rate for Payer: Priority Health Medicare |
$122.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.73
|
| Rate for Payer: UHC Medicare Advantage |
$122.73
|
| Rate for Payer: UHC Medicare Advantage |
$122.73
|
| Rate for Payer: UMR Bronson Commercial |
$65.32
|
| Rate for Payer: UMR Bronson Commercial |
$126.04
|
|
|
CHG VENOGRAPHY EXTREMITY UNILATERAL RS&I
|
Professional
|
Both
|
$231.00
|
|
|
Service Code
|
HCPCS 75820
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$150.15 |
| Rate for Payer: Aetna Commercial |
$130.53
|
| Rate for Payer: Aetna Commercial |
$130.53
|
| Rate for Payer: Aetna Medicare |
$101.31
|
| Rate for Payer: Aetna Medicare |
$101.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.27
|
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: BCBS Complete |
$43.20
|
| Rate for Payer: BCBS MAPPO |
$97.41
|
| Rate for Payer: BCBS MAPPO |
$97.41
|
| Rate for Payer: BCN Medicare Advantage |
$97.41
|
| Rate for Payer: BCN Medicare Advantage |
$97.41
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$86.40
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$140.27
|
| Rate for Payer: Cofinity Commercial |
$140.27
|
| Rate for Payer: Cofinity Commercial |
$130.53
|
| Rate for Payer: Cofinity Commercial |
$130.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.28
|
| Rate for Payer: Nomi Health Commercial |
$116.89
|
| Rate for Payer: Nomi Health Commercial |
$116.89
|
| Rate for Payer: PACE SWMI |
$97.41
|
| Rate for Payer: PACE SWMI |
$97.41
|
| Rate for Payer: PHP Commercial |
$136.37
|
| Rate for Payer: PHP Commercial |
$136.37
|
| Rate for Payer: PHP Medicare Advantage |
$97.41
|
| Rate for Payer: PHP Medicare Advantage |
$97.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.15
|
| Rate for Payer: Priority Health Medicare |
$97.41
|
| Rate for Payer: Priority Health Medicare |
$97.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.41
|
| Rate for Payer: UHC Medicare Advantage |
$97.41
|
| Rate for Payer: UHC Medicare Advantage |
$97.41
|
| Rate for Payer: UMR Bronson Commercial |
$106.26
|
| Rate for Payer: UMR Bronson Commercial |
$49.68
|
|
|
CHG VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$139.00
|
|
|
Service Code
|
HCPCS 75833
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$196.17 |
| Rate for Payer: Aetna Commercial |
$182.55
|
| Rate for Payer: Aetna Medicare |
$141.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.55
|
| Rate for Payer: BCBS Complete |
$55.60
|
| Rate for Payer: BCBS MAPPO |
$136.23
|
| Rate for Payer: BCN Medicare Advantage |
$136.23
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cash Price |
$111.20
|
| Rate for Payer: Cofinity Commercial |
$196.17
|
| Rate for Payer: Cofinity Commercial |
$182.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.04
|
| Rate for Payer: Nomi Health Commercial |
$163.48
|
| Rate for Payer: PACE SWMI |
$136.23
|
| Rate for Payer: PHP Commercial |
$190.72
|
| Rate for Payer: PHP Medicare Advantage |
$136.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.35
|
| Rate for Payer: Priority Health Medicare |
$136.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$136.23
|
| Rate for Payer: UHC Medicare Advantage |
$136.23
|
| Rate for Payer: UMR Bronson Commercial |
$63.94
|
|
|
CHG VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 75831
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$177.45 |
| Rate for Payer: Aetna Commercial |
$147.29
|
| Rate for Payer: Aetna Commercial |
$147.29
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Aetna Medicare |
$114.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.29
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS Complete |
$109.20
|
| Rate for Payer: BCBS MAPPO |
$109.92
|
| Rate for Payer: BCBS MAPPO |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$109.92
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cofinity Commercial |
$158.28
|
| Rate for Payer: Cofinity Commercial |
$147.29
|
| Rate for Payer: Cofinity Commercial |
$158.28
|
| Rate for Payer: Cofinity Commercial |
$147.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.42
|
| Rate for Payer: Nomi Health Commercial |
$131.90
|
| Rate for Payer: Nomi Health Commercial |
$131.90
|
| Rate for Payer: PACE SWMI |
$109.92
|
| Rate for Payer: PACE SWMI |
$109.92
|
| Rate for Payer: PHP Commercial |
$153.89
|
| Rate for Payer: PHP Commercial |
$153.89
|
| Rate for Payer: PHP Medicare Advantage |
$109.92
|
| Rate for Payer: PHP Medicare Advantage |
$109.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.45
|
| Rate for Payer: Priority Health Medicare |
$109.92
|
| Rate for Payer: Priority Health Medicare |
$109.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$109.92
|
| Rate for Payer: UHC Medicare Advantage |
$109.92
|
| Rate for Payer: UHC Medicare Advantage |
$109.92
|
| Rate for Payer: UMR Bronson Commercial |
$51.06
|
| Rate for Payer: UMR Bronson Commercial |
$125.58
|
|
|
CHG VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I
|
Professional
|
Both
|
$366.00
|
|
|
Service Code
|
HCPCS 75860
|
| Min. Negotiated Rate |
$115.98 |
| Max. Negotiated Rate |
$237.90 |
| Rate for Payer: Aetna Commercial |
$155.41
|
| Rate for Payer: Aetna Commercial |
$155.41
|
| Rate for Payer: Aetna Medicare |
$120.62
|
| Rate for Payer: Aetna Medicare |
$120.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.01
|
| Rate for Payer: BCBS Complete |
$146.40
|
| Rate for Payer: BCBS Complete |
$112.40
|
| Rate for Payer: BCBS MAPPO |
$115.98
|
| Rate for Payer: BCBS MAPPO |
$115.98
|
| Rate for Payer: BCN Medicare Advantage |
$115.98
|
| Rate for Payer: BCN Medicare Advantage |
$115.98
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$292.80
|
| Rate for Payer: Cofinity Commercial |
$167.01
|
| Rate for Payer: Cofinity Commercial |
$167.01
|
| Rate for Payer: Cofinity Commercial |
$155.41
|
| Rate for Payer: Cofinity Commercial |
$155.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$115.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$121.78
|
| Rate for Payer: Nomi Health Commercial |
$139.18
|
| Rate for Payer: Nomi Health Commercial |
$139.18
|
| Rate for Payer: PACE SWMI |
$115.98
|
| Rate for Payer: PACE SWMI |
$115.98
|
| Rate for Payer: PHP Commercial |
$162.37
|
| Rate for Payer: PHP Commercial |
$162.37
|
| Rate for Payer: PHP Medicare Advantage |
$115.98
|
| Rate for Payer: PHP Medicare Advantage |
$115.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.90
|
| Rate for Payer: Priority Health Medicare |
$115.98
|
| Rate for Payer: Priority Health Medicare |
$115.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$115.98
|
| Rate for Payer: UHC Medicare Advantage |
$115.98
|
| Rate for Payer: UHC Medicare Advantage |
$115.98
|
| Rate for Payer: UMR Bronson Commercial |
$168.36
|
| Rate for Payer: UMR Bronson Commercial |
$129.26
|
|
|
CHG VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&
|
Professional
|
Both
|
$334.00
|
|
|
Service Code
|
HCPCS 75893
|
| Min. Negotiated Rate |
$95.18 |
| Max. Negotiated Rate |
$217.10 |
| Rate for Payer: Aetna Commercial |
$127.54
|
| Rate for Payer: Aetna Medicare |
$98.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.54
|
| Rate for Payer: BCBS Complete |
$133.60
|
| Rate for Payer: BCBS MAPPO |
$95.18
|
| Rate for Payer: BCN Medicare Advantage |
$95.18
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cash Price |
$267.20
|
| Rate for Payer: Cofinity Commercial |
$137.06
|
| Rate for Payer: Cofinity Commercial |
$127.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.94
|
| Rate for Payer: Nomi Health Commercial |
$114.22
|
| Rate for Payer: PACE SWMI |
$95.18
|
| Rate for Payer: PHP Commercial |
$133.25
|
| Rate for Payer: PHP Medicare Advantage |
$95.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$217.10
|
| Rate for Payer: Priority Health Medicare |
$95.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.18
|
| Rate for Payer: UHC Medicare Advantage |
$95.18
|
| Rate for Payer: UMR Bronson Commercial |
$153.64
|
|
|
CHG VENOUS THROMBOSIS IMAGING VENOGRAM UNILATERAL
|
Professional
|
Both
|
$82.00
|
|
|
Service Code
|
HCPCS 78457
|
| Min. Negotiated Rate |
$32.80 |
| Max. Negotiated Rate |
$203.86 |
| Rate for Payer: Aetna Commercial |
$189.70
|
| Rate for Payer: Aetna Commercial |
$189.70
|
| Rate for Payer: Aetna Medicare |
$147.23
|
| Rate for Payer: Aetna Medicare |
$147.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$203.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.70
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS Complete |
$32.80
|
| Rate for Payer: BCBS MAPPO |
$141.57
|
| Rate for Payer: BCBS MAPPO |
$141.57
|
| Rate for Payer: BCN Medicare Advantage |
$141.57
|
| Rate for Payer: BCN Medicare Advantage |
$141.57
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$203.86
|
| Rate for Payer: Cofinity Commercial |
$189.70
|
| Rate for Payer: Cofinity Commercial |
$203.86
|
| Rate for Payer: Cofinity Commercial |
$189.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.65
|
| Rate for Payer: Nomi Health Commercial |
$169.88
|
| Rate for Payer: Nomi Health Commercial |
$169.88
|
| Rate for Payer: PACE SWMI |
$141.57
|
| Rate for Payer: PACE SWMI |
$141.57
|
| Rate for Payer: PHP Commercial |
$198.20
|
| Rate for Payer: PHP Commercial |
$198.20
|
| Rate for Payer: PHP Medicare Advantage |
$141.57
|
| Rate for Payer: PHP Medicare Advantage |
$141.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Medicare |
$141.57
|
| Rate for Payer: Priority Health Medicare |
$141.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$141.57
|
| Rate for Payer: UHC Medicare Advantage |
$141.57
|
| Rate for Payer: UHC Medicare Advantage |
$141.57
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
|
|
CHG X-RAY ABDOMEN 1 VW
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 74000
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$23.40 |
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: BCBS Complete |
$12.40
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: UMR Bronson Commercial |
$14.26
|
| Rate for Payer: UMR Bronson Commercial |
$16.56
|
|
|
CHG X-RAY ABDOMEN 2 VW
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 74020
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$34.45 |
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: BCBS Complete |
$21.20
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: UMR Bronson Commercial |
$24.38
|
|
|
CHG X-RAY FEMUR 2 VW
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 73550
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$24.70 |
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
| Rate for Payer: UMR Bronson Commercial |
$13.80
|
| Rate for Payer: UMR Bronson Commercial |
$43.24
|
|
|
CHG X-RAY HIPS 4 VW + PELVIS
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 73520
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$30.55 |
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
| Rate for Payer: UMR Bronson Commercial |
$21.62
|
|
|
CHG X-RAY HIP UNI 2+ VW
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 73510
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$65.00 |
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: Aetna Medicare |
$27.00
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Complete |
$21.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$43.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
| Rate for Payer: UMR Bronson Commercial |
$46.00
|
| Rate for Payer: UMR Bronson Commercial |
$24.84
|
|
