|
CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$310.00
|
|
|
Service Code
|
HCPCS 76881
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$763.39 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Medicare |
$52.17
|
| Rate for Payer: Aetna Medicare |
$52.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.23
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$50.16
|
| Rate for Payer: BCBS MAPPO |
$50.16
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$50.16
|
| Rate for Payer: BCN Medicare Advantage |
$50.16
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$248.00
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cofinity Commercial |
$67.21
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Cofinity Commercial |
$72.23
|
| Rate for Payer: Cofinity Commercial |
$67.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.67
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: Nomi Health Commercial |
$60.19
|
| Rate for Payer: Nomi Health Commercial |
$60.19
|
| Rate for Payer: PACE SWMI |
$50.16
|
| Rate for Payer: PACE SWMI |
$50.16
|
| Rate for Payer: PHP Commercial |
$70.22
|
| Rate for Payer: PHP Commercial |
$70.22
|
| Rate for Payer: PHP Medicare Advantage |
$50.16
|
| Rate for Payer: PHP Medicare Advantage |
$50.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$201.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.63
|
| Rate for Payer: Priority Health Medicare |
$50.16
|
| Rate for Payer: Priority Health Medicare |
$50.16
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health Narrow Network |
$82.63
|
| Rate for Payer: Priority Health SBD |
$65.70
|
| Rate for Payer: Priority Health SBD |
$65.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.16
|
| Rate for Payer: UHC Medicare Advantage |
$50.16
|
| Rate for Payer: UHC Medicare Advantage |
$50.16
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
| Rate for Payer: UMR Bronson Commercial |
$39.56
|
| Rate for Payer: UMR Bronson Commercial |
$142.60
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION
|
Professional
|
Both
|
$292.00
|
|
|
Service Code
|
HCPCS 76813
|
| Min. Negotiated Rate |
$35.36 |
| Max. Negotiated Rate |
$675.17 |
| Rate for Payer: Aetna Commercial |
$139.27
|
| Rate for Payer: Aetna Medicare |
$108.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.66
|
| Rate for Payer: BCBS Complete |
$37.13
|
| Rate for Payer: BCBS MAPPO |
$103.93
|
| Rate for Payer: BCBS Trust/PPO |
$675.17
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: BCN Medicare Advantage |
$103.93
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cash Price |
$233.60
|
| Rate for Payer: Cofinity Commercial |
$139.27
|
| Rate for Payer: Cofinity Commercial |
$149.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.13
|
| Rate for Payer: Meridian Medicaid |
$37.13
|
| Rate for Payer: Nomi Health Commercial |
$124.72
|
| Rate for Payer: PACE SWMI |
$103.93
|
| Rate for Payer: PHP Commercial |
$145.50
|
| Rate for Payer: PHP Medicare Advantage |
$103.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$178.10
|
| Rate for Payer: Priority Health Medicare |
$103.93
|
| Rate for Payer: Priority Health Narrow Network |
$178.10
|
| Rate for Payer: Priority Health SBD |
$85.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.93
|
| Rate for Payer: UHC Medicare Advantage |
$103.93
|
| Rate for Payer: UHCCP Medicaid |
$35.36
|
| Rate for Payer: UMR Bronson Commercial |
$134.32
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION
|
Professional
|
Both
|
$195.00
|
|
|
Service Code
|
HCPCS 76814
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$696.30 |
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$70.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.82
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS MAPPO |
$67.93
|
| Rate for Payer: BCBS Trust/PPO |
$696.30
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$67.93
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cash Price |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$91.03
|
| Rate for Payer: Cofinity Commercial |
$97.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.33
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Nomi Health Commercial |
$81.52
|
| Rate for Payer: PACE SWMI |
$67.93
|
| Rate for Payer: PHP Commercial |
$95.10
|
| Rate for Payer: PHP Medicare Advantage |
$67.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.46
|
| Rate for Payer: Priority Health Medicare |
$67.93
|
| Rate for Payer: Priority Health Narrow Network |
$114.46
|
| Rate for Payer: Priority Health SBD |
$71.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.93
|
| Rate for Payer: UHC Medicare Advantage |
$67.93
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
| Rate for Payer: UMR Bronson Commercial |
$89.70
|
|
|
CHG US GUIDANCE AMNIOCENTESIS IMG S&I
|
Professional
|
Both
|
$320.00
|
|
|
Service Code
|
HCPCS 76946
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$208.00 |
| Rate for Payer: Aetna Commercial |
$41.18
|
| Rate for Payer: Aetna Medicare |
$31.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.25
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$30.73
|
| Rate for Payer: BCBS Trust/PPO |
$194.41
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$30.73
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cash Price |
$256.00
|
| Rate for Payer: Cofinity Commercial |
$41.18
|
| Rate for Payer: Cofinity Commercial |
$44.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.27
|
| Rate for Payer: Meridian Medicaid |
$12.08
|
| Rate for Payer: Nomi Health Commercial |
$36.88
|
| Rate for Payer: PACE SWMI |
$30.73
|
| Rate for Payer: PHP Commercial |
$43.02
|
| Rate for Payer: PHP Medicare Advantage |
$30.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.33
|
| Rate for Payer: Priority Health Medicare |
$30.73
|
| Rate for Payer: Priority Health Narrow Network |
$51.33
|
| Rate for Payer: Priority Health SBD |
$27.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.73
|
| Rate for Payer: UHC Medicare Advantage |
$30.73
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$147.20
|
|
|
CHG US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 76965
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$173.55 |
| Rate for Payer: PHP Medicare Advantage |
$88.56
|
| Rate for Payer: Aetna Commercial |
$118.67
|
| Rate for Payer: Aetna Commercial |
$118.67
|
| Rate for Payer: Aetna Medicare |
$92.10
|
| Rate for Payer: Aetna Medicare |
$92.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.53
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS Complete |
$45.18
|
| Rate for Payer: BCBS MAPPO |
$88.56
|
| Rate for Payer: BCBS MAPPO |
$88.56
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Medicare Advantage |
$88.56
|
| Rate for Payer: BCN Medicare Advantage |
$88.56
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cofinity Commercial |
$118.67
|
| Rate for Payer: Cofinity Commercial |
$127.53
|
| Rate for Payer: Cofinity Commercial |
$127.53
|
| Rate for Payer: Cofinity Commercial |
$118.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.99
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Meridian Medicaid |
$45.18
|
| Rate for Payer: Nomi Health Commercial |
$106.27
|
| Rate for Payer: Nomi Health Commercial |
$106.27
|
| Rate for Payer: PACE SWMI |
$88.56
|
| Rate for Payer: PACE SWMI |
$88.56
|
| Rate for Payer: PHP Commercial |
$123.98
|
| Rate for Payer: PHP Commercial |
$123.98
|
| Rate for Payer: PHP Medicare Advantage |
$88.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.25
|
| Rate for Payer: Priority Health Medicare |
$88.56
|
| Rate for Payer: Priority Health Medicare |
$88.56
|
| Rate for Payer: Priority Health Narrow Network |
$145.25
|
| Rate for Payer: Priority Health Narrow Network |
$145.25
|
| Rate for Payer: Priority Health SBD |
$102.66
|
| Rate for Payer: Priority Health SBD |
$102.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.56
|
| Rate for Payer: UHC Medicare Advantage |
$88.56
|
| Rate for Payer: UHC Medicare Advantage |
$88.56
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
| Rate for Payer: UHCCP Medicaid |
$43.03
|
| Rate for Payer: UMR Bronson Commercial |
$174.34
|
| Rate for Payer: UMR Bronson Commercial |
$122.82
|
|
|
CHG US GUIDANCE NEEDLE PLACEMENT IMG S&I
|
Professional
|
Both
|
$466.00
|
|
|
Service Code
|
HCPCS 76942
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$302.90 |
| Rate for Payer: Aetna Commercial |
$72.94
|
| Rate for Payer: Aetna Commercial |
$72.94
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.94
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS MAPPO |
$54.43
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: BCN Medicare Advantage |
$54.43
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cash Price |
$372.80
|
| Rate for Payer: Cofinity Commercial |
$72.94
|
| Rate for Payer: Cofinity Commercial |
$78.38
|
| Rate for Payer: Cofinity Commercial |
$78.38
|
| Rate for Payer: Cofinity Commercial |
$72.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.15
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Meridian Medicaid |
$20.13
|
| Rate for Payer: Nomi Health Commercial |
$65.32
|
| Rate for Payer: Nomi Health Commercial |
$65.32
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PACE SWMI |
$54.43
|
| Rate for Payer: PHP Commercial |
$76.20
|
| Rate for Payer: PHP Commercial |
$76.20
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: PHP Medicare Advantage |
$54.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.31
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Medicare |
$54.43
|
| Rate for Payer: Priority Health Narrow Network |
$89.31
|
| Rate for Payer: Priority Health Narrow Network |
$89.31
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.43
|
| Rate for Payer: UHC Medicare Advantage |
$54.43
|
| Rate for Payer: UHC Medicare Advantage |
$54.43
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| Rate for Payer: UMR Bronson Commercial |
$51.98
|
| Rate for Payer: UMR Bronson Commercial |
$214.36
|
|
|
CHG US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 76941
|
| Min. Negotiated Rate |
$40.26 |
| Max. Negotiated Rate |
$179.65 |
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: Aetna Medicare |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.84
|
| Rate for Payer: BCBS Complete |
$42.27
|
| Rate for Payer: BCBS Trust/PPO |
$145.81
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Meridian Medicaid |
$42.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.65
|
| Rate for Payer: Priority Health Narrow Network |
$179.65
|
| Rate for Payer: Priority Health SBD |
$97.00
|
| Rate for Payer: UHCCP Medicaid |
$40.26
|
| Rate for Payer: UMR Bronson Commercial |
$86.02
|
|
|
CHG US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG
|
Professional
|
Both
|
$67.00
|
|
|
Service Code
|
HCPCS 76882
|
| Min. Negotiated Rate |
$20.87 |
| Max. Negotiated Rate |
$884.90 |
| Rate for Payer: Aetna Commercial |
$79.44
|
| Rate for Payer: Aetna Commercial |
$79.44
|
| Rate for Payer: Aetna Medicare |
$61.65
|
| Rate for Payer: Aetna Medicare |
$61.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.36
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS Complete |
$21.91
|
| Rate for Payer: BCBS MAPPO |
$59.28
|
| Rate for Payer: BCBS MAPPO |
$59.28
|
| Rate for Payer: BCBS Trust/PPO |
$884.90
|
| Rate for Payer: BCBS Trust/PPO |
$884.90
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$59.28
|
| Rate for Payer: BCN Medicare Advantage |
$59.28
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$53.60
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$79.44
|
| Rate for Payer: Cofinity Commercial |
$85.36
|
| Rate for Payer: Cofinity Commercial |
$85.36
|
| Rate for Payer: Cofinity Commercial |
$79.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.24
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Meridian Medicaid |
$21.91
|
| Rate for Payer: Nomi Health Commercial |
$71.14
|
| Rate for Payer: Nomi Health Commercial |
$71.14
|
| Rate for Payer: PACE SWMI |
$59.28
|
| Rate for Payer: PACE SWMI |
$59.28
|
| Rate for Payer: PHP Commercial |
$82.99
|
| Rate for Payer: PHP Commercial |
$82.99
|
| Rate for Payer: PHP Medicare Advantage |
$59.28
|
| Rate for Payer: PHP Medicare Advantage |
$59.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$97.53
|
| Rate for Payer: Priority Health Medicare |
$59.28
|
| Rate for Payer: Priority Health Medicare |
$59.28
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health SBD |
$49.79
|
| Rate for Payer: Priority Health SBD |
$49.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.28
|
| Rate for Payer: UHC Medicare Advantage |
$59.28
|
| Rate for Payer: UHC Medicare Advantage |
$59.28
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
| Rate for Payer: UHCCP Medicaid |
$20.87
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
| Rate for Payer: UMR Bronson Commercial |
$40.94
|
|
|
CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 76857
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$839.47 |
| Rate for Payer: Aetna Commercial |
$61.51
|
| Rate for Payer: Aetna Medicare |
$47.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.10
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS MAPPO |
$45.90
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$71.35
|
| Rate for Payer: BCN Medicare Advantage |
$45.90
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$61.51
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.20
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Nomi Health Commercial |
$55.08
|
| Rate for Payer: PACE SWMI |
$45.90
|
| Rate for Payer: PHP Commercial |
$64.26
|
| Rate for Payer: PHP Medicare Advantage |
$45.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health Medicare |
$45.90
|
| Rate for Payer: Priority Health Narrow Network |
$75.97
|
| Rate for Payer: Priority Health SBD |
$35.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.90
|
| Rate for Payer: UHC Medicare Advantage |
$45.90
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
| Rate for Payer: UMR Bronson Commercial |
$103.50
|
|
|
CHG US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE
|
Professional
|
Both
|
$301.00
|
|
|
Service Code
|
HCPCS 76856
|
| Min. Negotiated Rate |
$20.66 |
| Max. Negotiated Rate |
$764.98 |
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: Aetna Medicare |
$98.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.71
|
| Rate for Payer: BCBS Complete |
$21.69
|
| Rate for Payer: BCBS MAPPO |
$94.94
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$94.94
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cash Price |
$240.80
|
| Rate for Payer: Cofinity Commercial |
$127.22
|
| Rate for Payer: Cofinity Commercial |
$136.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.69
|
| Rate for Payer: Meridian Medicaid |
$21.69
|
| Rate for Payer: Nomi Health Commercial |
$113.93
|
| Rate for Payer: PACE SWMI |
$94.94
|
| Rate for Payer: PHP Commercial |
$132.92
|
| Rate for Payer: PHP Medicare Advantage |
$94.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.19
|
| Rate for Payer: Priority Health Medicare |
$94.94
|
| Rate for Payer: Priority Health Narrow Network |
$162.19
|
| Rate for Payer: Priority Health SBD |
$49.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.94
|
| Rate for Payer: UHC Medicare Advantage |
$94.94
|
| Rate for Payer: UHCCP Medicaid |
$20.66
|
| Rate for Payer: UMR Bronson Commercial |
$138.46
|
|
|
CHG US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 76801
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$269.43 |
| Rate for Payer: Aetna Commercial |
$142.20
|
| Rate for Payer: Aetna Medicare |
$110.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.81
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCBS MAPPO |
$106.12
|
| Rate for Payer: BCBS Trust/PPO |
$269.43
|
| Rate for Payer: BCN Commercial |
$172.99
|
| Rate for Payer: BCN Medicare Advantage |
$106.12
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cofinity Commercial |
$142.20
|
| Rate for Payer: Cofinity Commercial |
$152.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.43
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Nomi Health Commercial |
$127.34
|
| Rate for Payer: PACE SWMI |
$106.12
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: PHP Medicare Advantage |
$106.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.66
|
| Rate for Payer: Priority Health Medicare |
$106.12
|
| Rate for Payer: Priority Health Narrow Network |
$180.66
|
| Rate for Payer: Priority Health SBD |
$71.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$106.12
|
| Rate for Payer: UHC Medicare Advantage |
$106.12
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
| Rate for Payer: UMR Bronson Commercial |
$131.10
|
|
|
CHG US PREGNANT UTERUS LIMITED 1/> FETUSES
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 76815
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$172.25 |
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Aetna Commercial |
$98.52
|
| Rate for Payer: Aetna Medicare |
$76.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.52
|
| Rate for Payer: BCBS Complete |
$20.58
|
| Rate for Payer: BCBS MAPPO |
$73.52
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$73.52
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$105.87
|
| Rate for Payer: Cofinity Commercial |
$98.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.20
|
| Rate for Payer: Meridian Medicaid |
$20.58
|
| Rate for Payer: Nomi Health Commercial |
$88.22
|
| Rate for Payer: PACE SWMI |
$73.52
|
| Rate for Payer: PHP Commercial |
$102.93
|
| Rate for Payer: PHP Medicare Advantage |
$73.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$124.72
|
| Rate for Payer: Priority Health Medicare |
$73.52
|
| Rate for Payer: Priority Health Narrow Network |
$124.72
|
| Rate for Payer: Priority Health SBD |
$46.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.52
|
| Rate for Payer: UHC Medicare Advantage |
$73.52
|
| Rate for Payer: UHCCP Medicaid |
$19.60
|
| Rate for Payer: UMR Bronson Commercial |
$121.90
|
|
|
CHG US PREG UTERUS 14 WK TRANSABDL EACH GESTATION
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 76802
|
| Min. Negotiated Rate |
$24.92 |
| Max. Negotiated Rate |
$304.83 |
| Rate for Payer: Aetna Commercial |
$74.22
|
| Rate for Payer: Aetna Medicare |
$57.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.76
|
| Rate for Payer: BCBS Complete |
$26.17
|
| Rate for Payer: BCBS MAPPO |
$55.39
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$89.43
|
| Rate for Payer: BCN Medicare Advantage |
$55.39
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cofinity Commercial |
$74.22
|
| Rate for Payer: Cofinity Commercial |
$79.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.16
|
| Rate for Payer: Meridian Medicaid |
$26.17
|
| Rate for Payer: Nomi Health Commercial |
$66.47
|
| Rate for Payer: PACE SWMI |
$55.39
|
| Rate for Payer: PHP Commercial |
$77.55
|
| Rate for Payer: PHP Medicare Advantage |
$55.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.39
|
| Rate for Payer: Priority Health Medicare |
$55.39
|
| Rate for Payer: Priority Health Narrow Network |
$92.39
|
| Rate for Payer: Priority Health SBD |
$60.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.39
|
| Rate for Payer: UHC Medicare Advantage |
$55.39
|
| Rate for Payer: UHCCP Medicaid |
$24.92
|
| Rate for Payer: UMR Bronson Commercial |
$65.78
|
|
|
CHG US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO
|
Professional
|
Both
|
$423.00
|
|
|
Service Code
|
HCPCS 76810
|
| Min. Negotiated Rate |
$29.39 |
| Max. Negotiated Rate |
$274.95 |
| Rate for Payer: Aetna Commercial |
$106.40
|
| Rate for Payer: Aetna Medicare |
$82.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.34
|
| Rate for Payer: BCBS Complete |
$30.86
|
| Rate for Payer: BCBS MAPPO |
$79.40
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Medicare Advantage |
$79.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cash Price |
$338.40
|
| Rate for Payer: Cofinity Commercial |
$106.40
|
| Rate for Payer: Cofinity Commercial |
$114.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.37
|
| Rate for Payer: Meridian Medicaid |
$30.86
|
| Rate for Payer: Nomi Health Commercial |
$95.28
|
| Rate for Payer: PACE SWMI |
$79.40
|
| Rate for Payer: PHP Commercial |
$111.16
|
| Rate for Payer: PHP Medicare Advantage |
$79.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$134.47
|
| Rate for Payer: Priority Health Medicare |
$79.40
|
| Rate for Payer: Priority Health Narrow Network |
$134.47
|
| Rate for Payer: Priority Health SBD |
$70.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$79.40
|
| Rate for Payer: UHC Medicare Advantage |
$79.40
|
| Rate for Payer: UHCCP Medicaid |
$29.39
|
| Rate for Payer: UMR Bronson Commercial |
$194.58
|
|
|
CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION
|
Professional
|
Both
|
$361.00
|
|
|
Service Code
|
HCPCS 76805
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$362.41 |
| Rate for Payer: Aetna Commercial |
$163.24
|
| Rate for Payer: Aetna Medicare |
$126.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.42
|
| Rate for Payer: BCBS Complete |
$31.53
|
| Rate for Payer: BCBS MAPPO |
$121.82
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$121.82
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cash Price |
$288.80
|
| Rate for Payer: Cofinity Commercial |
$163.24
|
| Rate for Payer: Cofinity Commercial |
$175.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.91
|
| Rate for Payer: Meridian Medicaid |
$31.53
|
| Rate for Payer: Nomi Health Commercial |
$146.18
|
| Rate for Payer: PACE SWMI |
$121.82
|
| Rate for Payer: PHP Commercial |
$170.55
|
| Rate for Payer: PHP Medicare Advantage |
$121.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.90
|
| Rate for Payer: Priority Health Medicare |
$121.82
|
| Rate for Payer: Priority Health Narrow Network |
$208.90
|
| Rate for Payer: Priority Health SBD |
$71.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.82
|
| Rate for Payer: UHC Medicare Advantage |
$121.82
|
| Rate for Payer: UHCCP Medicaid |
$30.03
|
| Rate for Payer: UMR Bronson Commercial |
$166.06
|
|
|
CHG US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT
|
Professional
|
Both
|
$346.00
|
|
|
Service Code
|
HCPCS 76812
|
| Min. Negotiated Rate |
$53.46 |
| Max. Negotiated Rate |
$295.12 |
| Rate for Payer: Aetna Commercial |
$231.43
|
| Rate for Payer: Aetna Medicare |
$179.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.70
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$172.71
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$280.99
|
| Rate for Payer: BCN Medicare Advantage |
$172.71
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cash Price |
$276.80
|
| Rate for Payer: Cofinity Commercial |
$231.43
|
| Rate for Payer: Cofinity Commercial |
$248.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$181.35
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Nomi Health Commercial |
$207.25
|
| Rate for Payer: PACE SWMI |
$172.71
|
| Rate for Payer: PHP Commercial |
$241.79
|
| Rate for Payer: PHP Medicare Advantage |
$172.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$295.12
|
| Rate for Payer: Priority Health Medicare |
$172.71
|
| Rate for Payer: Priority Health Narrow Network |
$295.12
|
| Rate for Payer: Priority Health SBD |
$128.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.71
|
| Rate for Payer: UHC Medicare Advantage |
$172.71
|
| Rate for Payer: UHCCP Medicaid |
$53.46
|
| Rate for Payer: UMR Bronson Commercial |
$159.16
|
|
|
CHG US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 76816
|
| Min. Negotiated Rate |
$25.56 |
| Max. Negotiated Rate |
$773.43 |
| Rate for Payer: Aetna Commercial |
$131.95
|
| Rate for Payer: Aetna Medicare |
$102.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.80
|
| Rate for Payer: BCBS Complete |
$26.84
|
| Rate for Payer: BCBS MAPPO |
$98.47
|
| Rate for Payer: BCBS Trust/PPO |
$773.43
|
| Rate for Payer: BCN Commercial |
$160.77
|
| Rate for Payer: BCN Medicare Advantage |
$98.47
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$131.95
|
| Rate for Payer: Cofinity Commercial |
$141.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.39
|
| Rate for Payer: Meridian Medicaid |
$26.84
|
| Rate for Payer: Nomi Health Commercial |
$118.16
|
| Rate for Payer: PACE SWMI |
$98.47
|
| Rate for Payer: PHP Commercial |
$137.86
|
| Rate for Payer: PHP Medicare Advantage |
$98.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.38
|
| Rate for Payer: Priority Health Medicare |
$98.47
|
| Rate for Payer: Priority Health Narrow Network |
$169.38
|
| Rate for Payer: Priority Health SBD |
$61.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.47
|
| Rate for Payer: UHC Medicare Advantage |
$98.47
|
| Rate for Payer: UHCCP Medicaid |
$25.56
|
| Rate for Payer: UMR Bronson Commercial |
$101.66
|
|
|
CHG US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG
|
Professional
|
Both
|
$285.00
|
|
|
Service Code
|
HCPCS 76817
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$432.68 |
| Rate for Payer: Aetna Commercial |
$111.93
|
| Rate for Payer: Aetna Medicare |
$86.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.28
|
| Rate for Payer: BCBS Complete |
$23.71
|
| Rate for Payer: BCBS MAPPO |
$83.53
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: BCN Commercial |
$136.35
|
| 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 |
$111.93
|
| Rate for Payer: Cofinity Commercial |
$120.28
|
| 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: Meridian Medicaid |
$23.71
|
| 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 Choice Medicaid |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$185.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.69
|
| Rate for Payer: Priority Health Medicare |
$83.53
|
| Rate for Payer: Priority Health Narrow Network |
$142.69
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.53
|
| Rate for Payer: UHC Medicare Advantage |
$83.53
|
| Rate for Payer: UHCCP Medicaid |
$22.58
|
| 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 |
$56.87 |
| Max. Negotiated Rate |
$273.05 |
| Rate for Payer: Aetna Commercial |
$218.19
|
| Rate for Payer: Aetna Medicare |
$169.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.48
|
| Rate for Payer: BCBS Complete |
$59.71
|
| Rate for Payer: BCBS MAPPO |
$162.83
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$257.53
|
| 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: Meridian Medicaid |
$59.71
|
| 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 Choice Medicaid |
$56.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$273.05
|
| Rate for Payer: Priority Health Medicare |
$162.83
|
| Rate for Payer: Priority Health Narrow Network |
$273.05
|
| Rate for Payer: Priority Health SBD |
$137.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.83
|
| Rate for Payer: UHC Medicare Advantage |
$162.83
|
| Rate for Payer: UHCCP Medicaid |
$56.87
|
| 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 |
$22.15 |
| Max. Negotiated Rate |
$166.80 |
| Rate for Payer: Aetna Commercial |
$131.08
|
| Rate for Payer: Aetna Medicare |
$101.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$140.86
|
| Rate for Payer: BCBS Complete |
$23.26
|
| Rate for Payer: BCBS MAPPO |
$97.82
|
| Rate for Payer: BCN Commercial |
$159.79
|
| 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 |
$131.08
|
| Rate for Payer: Cofinity Commercial |
$140.86
|
| 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: Meridian Medicaid |
$23.26
|
| 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 Choice Medicaid |
$22.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$166.80
|
| Rate for Payer: Priority Health Medicare |
$97.82
|
| Rate for Payer: Priority Health Narrow Network |
$166.80
|
| Rate for Payer: Priority Health SBD |
$53.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.82
|
| Rate for Payer: UHC Medicare Advantage |
$97.82
|
| Rate for Payer: UHCCP Medicaid |
$22.15
|
| 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 |
$17.47 |
| Max. Negotiated Rate |
$2,427.54 |
| Rate for Payer: Aetna Commercial |
$74.56
|
| Rate for Payer: Aetna Medicare |
$57.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.12
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS MAPPO |
$55.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,427.54
|
| Rate for Payer: BCN Commercial |
$86.50
|
| 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: Meridian Medicaid |
$18.34
|
| 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 Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.87
|
| Rate for Payer: Priority Health Medicare |
$55.64
|
| Rate for Payer: Priority Health Narrow Network |
$91.87
|
| Rate for Payer: Priority Health SBD |
$41.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.64
|
| Rate for Payer: UHC Medicare Advantage |
$55.64
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
| Rate for Payer: UMR Bronson Commercial |
$89.24
|
|
|
CHG US SCROTUM & CONTENTS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 76870
|
| Min. Negotiated Rate |
$19.17 |
| Max. Negotiated Rate |
$153.97 |
| Rate for Payer: Aetna Commercial |
$121.10
|
| Rate for Payer: Aetna Medicare |
$93.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.13
|
| Rate for Payer: BCBS Complete |
$20.13
|
| Rate for Payer: BCBS MAPPO |
$90.37
|
| Rate for Payer: BCN Commercial |
$148.56
|
| 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 |
$121.10
|
| Rate for Payer: Cofinity Commercial |
$130.13
|
| 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: Meridian Medicaid |
$20.13
|
| 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 Choice Medicaid |
$19.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.97
|
| Rate for Payer: Priority Health Medicare |
$90.37
|
| Rate for Payer: Priority Health Narrow Network |
$153.97
|
| Rate for Payer: Priority Health SBD |
$45.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.37
|
| Rate for Payer: UHC Medicare Advantage |
$90.37
|
| Rate for Payer: UHCCP Medicaid |
$19.17
|
| 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 |
$17.04 |
| Max. Negotiated Rate |
$1,090.94 |
| 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) |
$142.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.24
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS Complete |
$17.89
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCBS MAPPO |
$98.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.94
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Commercial |
$163.71
|
| 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 |
$81.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cash Price |
$181.60
|
| Rate for Payer: Cofinity Commercial |
$132.24
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| Rate for Payer: Cofinity Commercial |
$142.11
|
| 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: Meridian Medicaid |
$17.89
|
| Rate for Payer: Meridian Medicaid |
$17.89
|
| 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 Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| 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 HMO/PPO/Tiered Network |
$169.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.89
|
| Rate for Payer: Priority Health Medicare |
$98.69
|
| Rate for Payer: Priority Health Medicare |
$98.69
|
| Rate for Payer: Priority Health Narrow Network |
$169.89
|
| Rate for Payer: Priority Health Narrow Network |
$169.89
|
| Rate for Payer: Priority Health SBD |
$40.55
|
| Rate for Payer: Priority Health SBD |
$40.55
|
| 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: UHCCP Medicaid |
$17.04
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: UMR Bronson Commercial |
$46.92
|
| Rate for Payer: UMR Bronson Commercial |
$104.42
|
|
|
CHG US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 76873
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$669.36 |
| Rate for Payer: Aetna Commercial |
$213.69
|
| Rate for Payer: Aetna Medicare |
$165.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$229.64
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$159.47
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: BCN Commercial |
$255.58
|
| 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 |
$213.69
|
| Rate for Payer: Cofinity Commercial |
$229.64
|
| 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: Meridian Medicaid |
$50.77
|
| 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 Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.50
|
| Rate for Payer: Priority Health Medicare |
$159.47
|
| Rate for Payer: Priority Health Narrow Network |
$270.50
|
| Rate for Payer: Priority Health SBD |
$116.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$159.47
|
| Rate for Payer: UHC Medicare Advantage |
$159.47
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: UMR Bronson Commercial |
$119.60
|
|
|
CHG US TRANSRECTAL
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 76872
|
| Min. Negotiated Rate |
$20.45 |
| Max. Negotiated Rate |
$932.45 |
| 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) |
$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: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS Complete |
$21.47
|
| Rate for Payer: BCBS MAPPO |
$175.89
|
| Rate for Payer: BCBS MAPPO |
$175.89
|
| Rate for Payer: BCBS Trust/PPO |
$932.45
|
| Rate for Payer: BCBS Trust/PPO |
$932.45
|
| Rate for Payer: BCN Commercial |
$294.67
|
| Rate for Payer: BCN Commercial |
$294.67
|
| 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 |
$265.60
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$235.69
|
| Rate for Payer: Cofinity Commercial |
$253.28
|
| 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: Meridian Medicaid |
$21.47
|
| Rate for Payer: Meridian Medicaid |
$21.47
|
| 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 Choice Medicaid |
$20.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.45
|
| 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 HMO/PPO/Tiered Network |
$310.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$310.01
|
| Rate for Payer: Priority Health Medicare |
$175.89
|
| Rate for Payer: Priority Health Medicare |
$175.89
|
| Rate for Payer: Priority Health Narrow Network |
$310.01
|
| Rate for Payer: Priority Health Narrow Network |
$310.01
|
| Rate for Payer: Priority Health SBD |
$49.28
|
| Rate for Payer: Priority Health SBD |
$49.28
|
| 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: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UHCCP Medicaid |
$20.45
|
| Rate for Payer: UMR Bronson Commercial |
$32.66
|
| Rate for Payer: UMR Bronson Commercial |
$152.72
|
|
