|
CHG IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ
|
Professional
|
$75.00
|
|
|
Service Code
|
HCPCS 87591
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$52.50 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Commercial |
$26.32
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$47.02
|
| Rate for Payer: Cofinity Commercial |
$50.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$42.11
|
| Rate for Payer: Healthscope Whirlpool |
$42.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.55
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$36.55
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
|
|
CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ
|
Professional
|
$145.00
|
|
|
Service Code
|
HCPCS 87635
|
| Min. Negotiated Rate |
$51.31 |
| Max. Negotiated Rate |
$101.50 |
| Rate for Payer: Aetna Commercial |
$68.76
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: BCBS Complete |
$58.00
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Commercial |
$70.00
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cofinity Commercial |
$68.76
|
| Rate for Payer: Cofinity Commercial |
$73.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$61.57
|
| Rate for Payer: Healthscope Whirlpool |
$61.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$53.07
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health Narrow Network |
$53.07
|
| Rate for Payer: UHC Medicare Advantage |
$52.85
|
|
|
CHG IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH
|
Professional
|
$46.00
|
|
|
Service Code
|
HCPCS 86318
|
| Min. Negotiated Rate |
$18.09 |
| Max. Negotiated Rate |
$32.20 |
| Rate for Payer: Aetna Commercial |
$24.24
|
| Rate for Payer: Aetna Medicare |
$18.09
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: BCBS MAPPO |
$18.09
|
| Rate for Payer: BCN Commercial |
$18.09
|
| Rate for Payer: BCN Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.09
|
| Rate for Payer: Healthscope Commercial |
$21.71
|
| Rate for Payer: Healthscope Whirlpool |
$21.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.99
|
| Rate for Payer: PACE SWMI |
$18.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.63
|
| Rate for Payer: Priority Health Medicare |
$18.09
|
| Rate for Payer: Priority Health Narrow Network |
$18.63
|
| Rate for Payer: UHC Medicare Advantage |
$18.63
|
|
|
CHG IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE
|
Professional
|
$39.00
|
|
|
Service Code
|
HCPCS 86294
|
| Min. Negotiated Rate |
$15.60 |
| Max. Negotiated Rate |
$36.82 |
| Rate for Payer: Aetna Commercial |
$34.26
|
| Rate for Payer: Aetna Medicare |
$25.57
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS MAPPO |
$25.57
|
| Rate for Payer: BCN Commercial |
$19.18
|
| Rate for Payer: BCN Medicare Advantage |
$25.57
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$36.82
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.57
|
| Rate for Payer: Healthscope Commercial |
$30.68
|
| Rate for Payer: Healthscope Whirlpool |
$30.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.85
|
| Rate for Payer: PACE SWMI |
$25.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.36
|
| Rate for Payer: Priority Health Medicare |
$25.57
|
| Rate for Payer: Priority Health Narrow Network |
$26.36
|
| Rate for Payer: UHC Medicare Advantage |
$26.34
|
|
|
CHG INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Professional
|
$144.00
|
|
|
Service Code
|
HCPCS 87502
|
| Min. Negotiated Rate |
$57.60 |
| Max. Negotiated Rate |
$137.95 |
| Rate for Payer: Aetna Commercial |
$128.37
|
| Rate for Payer: Aetna Medicare |
$95.80
|
| Rate for Payer: BCBS Complete |
$57.60
|
| Rate for Payer: BCBS MAPPO |
$95.80
|
| Rate for Payer: BCN Commercial |
$71.85
|
| Rate for Payer: BCN Medicare Advantage |
$95.80
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$137.95
|
| Rate for Payer: Cofinity Commercial |
$128.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.80
|
| Rate for Payer: Healthscope Commercial |
$114.96
|
| Rate for Payer: Healthscope Whirlpool |
$114.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.59
|
| Rate for Payer: PACE SWMI |
$95.80
|
| Rate for Payer: PHP Medicare Advantage |
$95.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.46
|
| Rate for Payer: Priority Health Medicare |
$95.80
|
| Rate for Payer: Priority Health Narrow Network |
$99.46
|
| Rate for Payer: UHC Medicare Advantage |
$98.67
|
|
|
CHG INTEN MOD RADIOTHER PLAN, SIN/MULT FIELD
|
Professional
|
$922.00
|
|
|
Service Code
|
HCPCS 77418
|
| Min. Negotiated Rate |
$368.80 |
| Max. Negotiated Rate |
$645.40 |
| Rate for Payer: BCBS Complete |
$368.80
|
| Rate for Payer: Cash Price |
$737.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$645.40
|
|
|
CHG INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX
|
Professional
|
$522.00
|
|
|
Service Code
|
HCPCS 77778
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$1,395.66 |
| Rate for Payer: Aetna Commercial |
$1,166.71
|
| Rate for Payer: Aetna Commercial |
$1,166.71
|
| Rate for Payer: Aetna Medicare |
$870.68
|
| Rate for Payer: Aetna Medicare |
$870.68
|
| Rate for Payer: BCBS Complete |
$670.00
|
| Rate for Payer: BCBS Complete |
$208.80
|
| Rate for Payer: BCBS MAPPO |
$870.68
|
| Rate for Payer: BCBS MAPPO |
$870.68
|
| Rate for Payer: BCN Commercial |
$1,331.65
|
| Rate for Payer: BCN Commercial |
$1,331.65
|
| Rate for Payer: BCN Medicare Advantage |
$870.68
|
| Rate for Payer: BCN Medicare Advantage |
$870.68
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cash Price |
$1,340.00
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cofinity Commercial |
$1,166.71
|
| Rate for Payer: Cofinity Commercial |
$1,253.78
|
| Rate for Payer: Cofinity Commercial |
$1,166.71
|
| Rate for Payer: Cofinity Commercial |
$1,253.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$870.68
|
| Rate for Payer: Healthscope Commercial |
$1,044.82
|
| Rate for Payer: Healthscope Commercial |
$1,044.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,044.82
|
| Rate for Payer: Healthscope Whirlpool |
$1,044.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$914.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$914.21
|
| Rate for Payer: PACE SWMI |
$870.68
|
| Rate for Payer: PACE SWMI |
$870.68
|
| Rate for Payer: PHP Medicare Advantage |
$870.68
|
| Rate for Payer: PHP Medicare Advantage |
$870.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,172.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,395.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,395.66
|
| Rate for Payer: Priority Health Medicare |
$870.68
|
| Rate for Payer: Priority Health Medicare |
$870.68
|
| Rate for Payer: Priority Health Narrow Network |
$1,395.66
|
| Rate for Payer: Priority Health Narrow Network |
$1,395.66
|
| Rate for Payer: UHC Medicare Advantage |
$896.80
|
| Rate for Payer: UHC Medicare Advantage |
$896.80
|
|
|
CHG INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE
|
Professional
|
$456.00
|
|
|
Service Code
|
HCPCS 77761
|
| Min. Negotiated Rate |
$182.40 |
| Max. Negotiated Rate |
$639.70 |
| Rate for Payer: Aetna Commercial |
$534.04
|
| Rate for Payer: Aetna Medicare |
$398.54
|
| Rate for Payer: BCBS Complete |
$182.40
|
| Rate for Payer: BCBS MAPPO |
$398.54
|
| Rate for Payer: BCN Commercial |
$610.36
|
| Rate for Payer: BCN Medicare Advantage |
$398.54
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cofinity Commercial |
$534.04
|
| Rate for Payer: Cofinity Commercial |
$573.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.54
|
| Rate for Payer: Healthscope Commercial |
$478.25
|
| Rate for Payer: Healthscope Whirlpool |
$478.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$418.47
|
| Rate for Payer: PACE SWMI |
$398.54
|
| Rate for Payer: PHP Medicare Advantage |
$398.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$639.70
|
| Rate for Payer: Priority Health Medicare |
$398.54
|
| Rate for Payer: Priority Health Narrow Network |
$639.70
|
| Rate for Payer: UHC Medicare Advantage |
$410.50
|
|
|
CHG INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I
|
Professional
|
$89.00
|
|
|
Service Code
|
HCPCS 74360
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$214.05 |
| Rate for Payer: Aetna Commercial |
$128.38
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.02
|
| Rate for Payer: Priority Health Narrow Network |
$169.02
|
|
|
CHG INTRAVASC ULTRASOUND,1ST VESSEL
|
Professional
|
$83.00
|
|
|
Service Code
|
HCPCS 75945
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$154.00 |
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
|
|
CHG INTRAVASC US, RAD SUPERISE/ INTERP, EA ADDN VESSEL
|
Professional
|
$45.00
|
|
|
Service Code
|
HCPCS 75946
|
| Min. Negotiated Rate |
$18.00 |
| Max. Negotiated Rate |
$107.10 |
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
|
|
CHG INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I
|
Professional
|
$206.00
|
|
|
Service Code
|
HCPCS 74340
|
| Min. Negotiated Rate |
$82.40 |
| Max. Negotiated Rate |
$178.86 |
| Rate for Payer: Aetna Commercial |
$119.95
|
| Rate for Payer: BCBS Complete |
$82.40
|
| Rate for Payer: BCN Commercial |
$178.86
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.74
|
| Rate for Payer: Priority Health Narrow Network |
$157.74
|
|
|
CHG JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS
|
Professional
|
$135.00
|
|
|
Service Code
|
HCPCS 77077
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial |
$59.88
|
| Rate for Payer: Aetna Commercial |
$59.88
|
| Rate for Payer: Aetna Medicare |
$44.69
|
| Rate for Payer: Aetna Medicare |
$44.69
|
| Rate for Payer: BCBS Complete |
$24.00
|
| Rate for Payer: BCBS Complete |
$54.00
|
| Rate for Payer: BCBS MAPPO |
$44.69
|
| Rate for Payer: BCBS MAPPO |
$44.69
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Medicare Advantage |
$44.69
|
| Rate for Payer: BCN Medicare Advantage |
$44.69
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$48.00
|
| Rate for Payer: Cofinity Commercial |
$59.88
|
| Rate for Payer: Cofinity Commercial |
$64.35
|
| Rate for Payer: Cofinity Commercial |
$64.35
|
| Rate for Payer: Cofinity Commercial |
$59.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.69
|
| Rate for Payer: Healthscope Commercial |
$53.63
|
| Rate for Payer: Healthscope Commercial |
$53.63
|
| Rate for Payer: Healthscope Whirlpool |
$53.63
|
| Rate for Payer: Healthscope Whirlpool |
$53.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$46.92
|
| Rate for Payer: PACE SWMI |
$44.69
|
| Rate for Payer: PACE SWMI |
$44.69
|
| Rate for Payer: PHP Medicare Advantage |
$44.69
|
| Rate for Payer: PHP Medicare Advantage |
$44.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.21
|
| Rate for Payer: Priority Health Medicare |
$44.69
|
| Rate for Payer: Priority Health Medicare |
$44.69
|
| Rate for Payer: Priority Health Narrow Network |
$72.21
|
| Rate for Payer: Priority Health Narrow Network |
$72.21
|
| Rate for Payer: UHC Medicare Advantage |
$46.03
|
| Rate for Payer: UHC Medicare Advantage |
$46.03
|
|
|
CHG LIPID PANEL
|
Professional
|
$44.00
|
|
|
Service Code
|
HCPCS 80061
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$30.80 |
| Rate for Payer: Aetna Commercial |
$17.94
|
| Rate for Payer: Aetna Medicare |
$13.39
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCN Commercial |
$16.58
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$19.28
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$16.07
|
| Rate for Payer: Healthscope Whirlpool |
$16.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.05
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health Narrow Network |
$14.05
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
|
|
CHG MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS
|
Professional
|
$92.00
|
|
|
Service Code
|
HCPCS 77071
|
| Min. Negotiated Rate |
$35.15 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial |
$70.03
|
| Rate for Payer: Aetna Commercial |
$70.03
|
| Rate for Payer: Aetna Medicare |
$52.26
|
| Rate for Payer: Aetna Medicare |
$52.26
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS Complete |
$36.91
|
| Rate for Payer: BCBS MAPPO |
$52.26
|
| Rate for Payer: BCBS MAPPO |
$52.26
|
| Rate for Payer: BCN Commercial |
$80.14
|
| Rate for Payer: BCN Commercial |
$80.14
|
| Rate for Payer: BCN Medicare Advantage |
$52.26
|
| Rate for Payer: BCN Medicare Advantage |
$52.26
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$75.25
|
| Rate for Payer: Cofinity Commercial |
$70.03
|
| Rate for Payer: Cofinity Commercial |
$75.25
|
| Rate for Payer: Cofinity Commercial |
$70.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.26
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Healthscope Commercial |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Healthscope Whirlpool |
$62.71
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Meridian Medicaid |
$36.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.87
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.87
|
| Rate for Payer: PACE SWMI |
$52.26
|
| Rate for Payer: PACE SWMI |
$52.26
|
| Rate for Payer: PHP Medicare Advantage |
$52.26
|
| Rate for Payer: PHP Medicare Advantage |
$52.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.00
|
| Rate for Payer: Priority Health Medicare |
$52.26
|
| Rate for Payer: Priority Health Medicare |
$52.26
|
| Rate for Payer: Priority Health Narrow Network |
$84.00
|
| Rate for Payer: Priority Health Narrow Network |
$84.00
|
| Rate for Payer: UHC Medicare Advantage |
$53.83
|
| Rate for Payer: UHC Medicare Advantage |
$53.83
|
|
|
CHG MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I
|
Professional
|
$37.00
|
|
|
Service Code
|
HCPCS 75902
|
| Min. Negotiated Rate |
$14.80 |
| Max. Negotiated Rate |
$139.30 |
| Rate for Payer: Aetna Commercial |
$114.48
|
| Rate for Payer: Aetna Medicare |
$85.43
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS MAPPO |
$85.43
|
| Rate for Payer: BCN Commercial |
$132.92
|
| Rate for Payer: BCN Medicare Advantage |
$85.43
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cofinity Commercial |
$114.48
|
| Rate for Payer: Cofinity Commercial |
$123.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.43
|
| Rate for Payer: Healthscope Commercial |
$102.52
|
| Rate for Payer: Healthscope Whirlpool |
$102.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.70
|
| Rate for Payer: PACE SWMI |
$85.43
|
| Rate for Payer: PHP Medicare Advantage |
$85.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$139.30
|
| Rate for Payer: Priority Health Medicare |
$85.43
|
| Rate for Payer: Priority Health Narrow Network |
$139.30
|
| Rate for Payer: UHC Medicare Advantage |
$87.99
|
|
|
CHG MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I
|
Professional
|
$332.00
|
|
|
Service Code
|
HCPCS 75901
|
| Min. Negotiated Rate |
$132.80 |
| Max. Negotiated Rate |
$355.45 |
| Rate for Payer: Aetna Commercial |
$289.52
|
| Rate for Payer: Aetna Medicare |
$216.06
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS MAPPO |
$216.06
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: BCN Medicare Advantage |
$216.06
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cofinity Commercial |
$311.13
|
| Rate for Payer: Cofinity Commercial |
$289.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.06
|
| Rate for Payer: Healthscope Commercial |
$259.27
|
| Rate for Payer: Healthscope Whirlpool |
$259.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$226.86
|
| Rate for Payer: PACE SWMI |
$216.06
|
| Rate for Payer: PHP Medicare Advantage |
$216.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.45
|
| Rate for Payer: Priority Health Medicare |
$216.06
|
| Rate for Payer: Priority Health Narrow Network |
$355.45
|
| Rate for Payer: UHC Medicare Advantage |
$222.54
|
|
|
CHG MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN
|
Professional
|
$515.00
|
|
|
Service Code
|
HCPCS 77338
|
| Min. Negotiated Rate |
$206.00 |
| Max. Negotiated Rate |
$724.75 |
| Rate for Payer: Aetna Commercial |
$592.64
|
| Rate for Payer: Aetna Commercial |
$592.64
|
| Rate for Payer: Aetna Commercial |
$592.64
|
| Rate for Payer: Aetna Medicare |
$442.27
|
| Rate for Payer: Aetna Medicare |
$442.27
|
| Rate for Payer: Aetna Medicare |
$442.27
|
| Rate for Payer: BCBS Complete |
$380.80
|
| Rate for Payer: BCBS Complete |
$373.60
|
| Rate for Payer: BCBS Complete |
$206.00
|
| Rate for Payer: BCBS MAPPO |
$442.27
|
| Rate for Payer: BCBS MAPPO |
$442.27
|
| Rate for Payer: BCBS MAPPO |
$442.27
|
| Rate for Payer: BCN Commercial |
$724.75
|
| Rate for Payer: BCN Commercial |
$724.75
|
| Rate for Payer: BCN Commercial |
$724.75
|
| Rate for Payer: BCN Medicare Advantage |
$442.27
|
| Rate for Payer: BCN Medicare Advantage |
$442.27
|
| Rate for Payer: BCN Medicare Advantage |
$442.27
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cash Price |
$761.60
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$747.20
|
| Rate for Payer: Cash Price |
$412.00
|
| Rate for Payer: Cofinity Commercial |
$636.87
|
| Rate for Payer: Cofinity Commercial |
$592.64
|
| Rate for Payer: Cofinity Commercial |
$636.87
|
| Rate for Payer: Cofinity Commercial |
$592.64
|
| Rate for Payer: Cofinity Commercial |
$636.87
|
| Rate for Payer: Cofinity Commercial |
$592.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$442.27
|
| Rate for Payer: Healthscope Commercial |
$530.72
|
| Rate for Payer: Healthscope Commercial |
$530.72
|
| Rate for Payer: Healthscope Commercial |
$530.72
|
| Rate for Payer: Healthscope Whirlpool |
$530.72
|
| Rate for Payer: Healthscope Whirlpool |
$530.72
|
| Rate for Payer: Healthscope Whirlpool |
$530.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$464.38
|
| Rate for Payer: PACE SWMI |
$442.27
|
| Rate for Payer: PACE SWMI |
$442.27
|
| Rate for Payer: PACE SWMI |
$442.27
|
| Rate for Payer: PHP Medicare Advantage |
$442.27
|
| Rate for Payer: PHP Medicare Advantage |
$442.27
|
| Rate for Payer: PHP Medicare Advantage |
$442.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$360.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$666.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$709.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$709.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$709.87
|
| Rate for Payer: Priority Health Medicare |
$442.27
|
| Rate for Payer: Priority Health Medicare |
$442.27
|
| Rate for Payer: Priority Health Medicare |
$442.27
|
| Rate for Payer: Priority Health Narrow Network |
$709.87
|
| Rate for Payer: Priority Health Narrow Network |
$709.87
|
| Rate for Payer: Priority Health Narrow Network |
$709.87
|
| Rate for Payer: UHC Medicare Advantage |
$455.54
|
| Rate for Payer: UHC Medicare Advantage |
$455.54
|
| Rate for Payer: UHC Medicare Advantage |
$455.54
|
|
|
CHG MRA HEAD W/O CONTRST MATERIAL
|
Professional
|
$234.00
|
|
|
Service Code
|
HCPCS 70544
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$471.10 |
| Rate for Payer: Aetna Commercial |
$283.44
|
| Rate for Payer: Aetna Commercial |
$283.44
|
| Rate for Payer: Aetna Medicare |
$211.52
|
| Rate for Payer: Aetna Medicare |
$211.52
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: BCBS Complete |
$269.20
|
| Rate for Payer: BCBS MAPPO |
$211.52
|
| Rate for Payer: BCBS MAPPO |
$211.52
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Commercial |
$328.39
|
| Rate for Payer: BCN Medicare Advantage |
$211.52
|
| Rate for Payer: BCN Medicare Advantage |
$211.52
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Cash Price |
$538.40
|
| Rate for Payer: Cofinity Commercial |
$304.59
|
| Rate for Payer: Cofinity Commercial |
$283.44
|
| Rate for Payer: Cofinity Commercial |
$283.44
|
| Rate for Payer: Cofinity Commercial |
$304.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.52
|
| Rate for Payer: Healthscope Commercial |
$253.82
|
| Rate for Payer: Healthscope Commercial |
$253.82
|
| Rate for Payer: Healthscope Whirlpool |
$253.82
|
| Rate for Payer: Healthscope Whirlpool |
$253.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.10
|
| Rate for Payer: PACE SWMI |
$211.52
|
| Rate for Payer: PACE SWMI |
$211.52
|
| Rate for Payer: PHP Medicare Advantage |
$211.52
|
| Rate for Payer: PHP Medicare Advantage |
$211.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.17
|
| Rate for Payer: Priority Health Medicare |
$211.52
|
| Rate for Payer: Priority Health Medicare |
$211.52
|
| Rate for Payer: Priority Health Narrow Network |
$344.17
|
| Rate for Payer: Priority Health Narrow Network |
$344.17
|
| Rate for Payer: UHC Medicare Advantage |
$217.87
|
| Rate for Payer: UHC Medicare Advantage |
$217.87
|
|
|
CHG MRA NECK W/O CONTRST MATERIAL
|
Professional
|
$231.00
|
|
|
Service Code
|
HCPCS 70547
|
| Min. Negotiated Rate |
$92.40 |
| Max. Negotiated Rate |
$344.69 |
| Rate for Payer: Aetna Commercial |
$283.85
|
| Rate for Payer: Aetna Medicare |
$211.83
|
| Rate for Payer: BCBS Complete |
$92.40
|
| Rate for Payer: BCBS MAPPO |
$211.83
|
| Rate for Payer: BCN Commercial |
$328.88
|
| Rate for Payer: BCN Medicare Advantage |
$211.83
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$305.04
|
| Rate for Payer: Cofinity Commercial |
$283.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.83
|
| Rate for Payer: Healthscope Commercial |
$254.20
|
| Rate for Payer: Healthscope Whirlpool |
$254.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$222.42
|
| Rate for Payer: PACE SWMI |
$211.83
|
| Rate for Payer: PHP Medicare Advantage |
$211.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$344.69
|
| Rate for Payer: Priority Health Medicare |
$211.83
|
| Rate for Payer: Priority Health Narrow Network |
$344.69
|
| Rate for Payer: UHC Medicare Advantage |
$218.18
|
|
|
CHG MRA NECK W/O &W/CONTRAST MATERIAL
|
Professional
|
$275.00
|
|
|
Service Code
|
HCPCS 70549
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$552.62 |
| Rate for Payer: Aetna Commercial |
$454.68
|
| Rate for Payer: Aetna Medicare |
$339.31
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: BCBS MAPPO |
$339.31
|
| Rate for Payer: BCN Commercial |
$527.29
|
| Rate for Payer: BCN Medicare Advantage |
$339.31
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$454.68
|
| Rate for Payer: Cofinity Commercial |
$488.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.31
|
| Rate for Payer: Healthscope Commercial |
$407.17
|
| Rate for Payer: Healthscope Whirlpool |
$407.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$356.28
|
| Rate for Payer: PACE SWMI |
$339.31
|
| Rate for Payer: PHP Medicare Advantage |
$339.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$552.62
|
| Rate for Payer: Priority Health Medicare |
$339.31
|
| Rate for Payer: Priority Health Narrow Network |
$552.62
|
| Rate for Payer: UHC Medicare Advantage |
$349.49
|
|
|
CHG MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL
|
Professional
|
$370.00
|
|
|
Service Code
|
HCPCS 70552
|
| Min. Negotiated Rate |
$148.00 |
| Max. Negotiated Rate |
$433.30 |
| Rate for Payer: Aetna Commercial |
$358.21
|
| Rate for Payer: Aetna Medicare |
$267.32
|
| Rate for Payer: BCBS Complete |
$148.00
|
| Rate for Payer: BCBS MAPPO |
$267.32
|
| Rate for Payer: BCN Commercial |
$413.42
|
| Rate for Payer: BCN Medicare Advantage |
$267.32
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cash Price |
$296.00
|
| Rate for Payer: Cofinity Commercial |
$384.94
|
| Rate for Payer: Cofinity Commercial |
$358.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$267.32
|
| Rate for Payer: Healthscope Commercial |
$320.78
|
| Rate for Payer: Healthscope Whirlpool |
$320.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$280.69
|
| Rate for Payer: PACE SWMI |
$267.32
|
| Rate for Payer: PHP Medicare Advantage |
$267.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$433.30
|
| Rate for Payer: Priority Health Medicare |
$267.32
|
| Rate for Payer: Priority Health Narrow Network |
$433.30
|
| Rate for Payer: UHC Medicare Advantage |
$275.34
|
|
|
CHG MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL
|
Professional
|
$319.00
|
|
|
Service Code
|
HCPCS 70551
|
| Min. Negotiated Rate |
$127.60 |
| Max. Negotiated Rate |
$312.93 |
| Rate for Payer: Aetna Commercial |
$259.49
|
| Rate for Payer: Aetna Medicare |
$193.65
|
| Rate for Payer: BCBS Complete |
$127.60
|
| Rate for Payer: BCBS MAPPO |
$193.65
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: BCN Medicare Advantage |
$193.65
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$259.49
|
| Rate for Payer: Cofinity Commercial |
$278.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.65
|
| Rate for Payer: Healthscope Commercial |
$232.38
|
| Rate for Payer: Healthscope Whirlpool |
$232.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$203.33
|
| Rate for Payer: PACE SWMI |
$193.65
|
| Rate for Payer: PHP Medicare Advantage |
$193.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$223.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.93
|
| Rate for Payer: Priority Health Medicare |
$193.65
|
| Rate for Payer: Priority Health Narrow Network |
$312.93
|
| Rate for Payer: UHC Medicare Advantage |
$199.46
|
|
|
CHG MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL
|
Professional
|
$341.00
|
|
|
Service Code
|
HCPCS 70553
|
| Min. Negotiated Rate |
$136.40 |
| Max. Negotiated Rate |
$510.12 |
| Rate for Payer: Aetna Commercial |
$422.48
|
| Rate for Payer: Aetna Medicare |
$315.28
|
| Rate for Payer: BCBS Complete |
$136.40
|
| Rate for Payer: BCBS MAPPO |
$315.28
|
| Rate for Payer: BCN Commercial |
$486.73
|
| Rate for Payer: BCN Medicare Advantage |
$315.28
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cash Price |
$272.80
|
| Rate for Payer: Cofinity Commercial |
$454.00
|
| Rate for Payer: Cofinity Commercial |
$422.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$315.28
|
| Rate for Payer: Healthscope Commercial |
$378.34
|
| Rate for Payer: Healthscope Whirlpool |
$378.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$331.04
|
| Rate for Payer: PACE SWMI |
$315.28
|
| Rate for Payer: PHP Medicare Advantage |
$315.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$238.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$510.12
|
| Rate for Payer: Priority Health Medicare |
$315.28
|
| Rate for Payer: Priority Health Narrow Network |
$510.12
|
| Rate for Payer: UHC Medicare Advantage |
$324.74
|
|
|
CHG MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL
|
Professional
|
$296.00
|
|
|
Service Code
|
HCPCS 72141
|
| Min. Negotiated Rate |
$118.40 |
| Max. Negotiated Rate |
$304.23 |
| Rate for Payer: Aetna Commercial |
$252.46
|
| Rate for Payer: Aetna Medicare |
$188.40
|
| Rate for Payer: BCBS Complete |
$118.40
|
| Rate for Payer: BCBS MAPPO |
$188.40
|
| Rate for Payer: BCN Commercial |
$290.27
|
| Rate for Payer: BCN Medicare Advantage |
$188.40
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cofinity Commercial |
$252.46
|
| Rate for Payer: Cofinity Commercial |
$271.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.40
|
| Rate for Payer: Healthscope Commercial |
$226.08
|
| Rate for Payer: Healthscope Whirlpool |
$226.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$197.82
|
| Rate for Payer: PACE SWMI |
$188.40
|
| Rate for Payer: PHP Medicare Advantage |
$188.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$304.23
|
| Rate for Payer: Priority Health Medicare |
$188.40
|
| Rate for Payer: Priority Health Narrow Network |
$304.23
|
| Rate for Payer: UHC Medicare Advantage |
$194.05
|
|
