|
CHG SONO GUIDE RAD THERAPY FIELDS
|
Professional
|
$135.00
|
|
|
Service Code
|
HCPCS 76950
|
| Min. Negotiated Rate |
$29.60 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: BCBS Complete |
$54.00
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.80
|
|
|
CHG SPEC DOSIM ONLY PRESCRIBED TREATING PHYS
|
Professional
|
$35.00
|
|
|
Service Code
|
HCPCS 77331
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$98.84 |
| Rate for Payer: Aetna Commercial |
$83.72
|
| Rate for Payer: Aetna Commercial |
$83.72
|
| Rate for Payer: Aetna Medicare |
$62.48
|
| Rate for Payer: Aetna Medicare |
$62.48
|
| Rate for Payer: BCBS Complete |
$49.20
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$28.00
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$83.72
|
| Rate for Payer: Cofinity Commercial |
$89.97
|
| Rate for Payer: Cofinity Commercial |
$83.72
|
| Rate for Payer: Cofinity Commercial |
$89.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$74.98
|
| Rate for Payer: Healthscope Commercial |
$74.98
|
| Rate for Payer: Healthscope Whirlpool |
$74.98
|
| Rate for Payer: Healthscope Whirlpool |
$74.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.84
|
| Rate for Payer: Priority Health Medicare |
$62.48
|
| Rate for Payer: Priority Health Medicare |
$62.48
|
| Rate for Payer: Priority Health Narrow Network |
$98.84
|
| Rate for Payer: Priority Health Narrow Network |
$98.84
|
| Rate for Payer: UHC Medicare Advantage |
$64.35
|
| Rate for Payer: UHC Medicare Advantage |
$64.35
|
|
|
CHG SPECIAL TREATMENT PROCEDURE
|
Professional
|
$691.00
|
|
|
Service Code
|
HCPCS 77470
|
| Min. Negotiated Rate |
$134.91 |
| Max. Negotiated Rate |
$483.70 |
| Rate for Payer: Aetna Commercial |
$180.78
|
| Rate for Payer: Aetna Commercial |
$180.78
|
| Rate for Payer: Aetna Medicare |
$134.91
|
| Rate for Payer: Aetna Medicare |
$134.91
|
| Rate for Payer: BCBS Complete |
$208.80
|
| Rate for Payer: BCBS Complete |
$276.40
|
| Rate for Payer: BCBS MAPPO |
$134.91
|
| Rate for Payer: BCBS MAPPO |
$134.91
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Medicare Advantage |
$134.91
|
| Rate for Payer: BCN Medicare Advantage |
$134.91
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$552.80
|
| Rate for Payer: Cofinity Commercial |
$194.27
|
| Rate for Payer: Cofinity Commercial |
$180.78
|
| Rate for Payer: Cofinity Commercial |
$194.27
|
| Rate for Payer: Cofinity Commercial |
$180.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.91
|
| Rate for Payer: Healthscope Commercial |
$161.89
|
| Rate for Payer: Healthscope Commercial |
$161.89
|
| Rate for Payer: Healthscope Whirlpool |
$161.89
|
| Rate for Payer: Healthscope Whirlpool |
$161.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$141.66
|
| Rate for Payer: PACE SWMI |
$134.91
|
| Rate for Payer: PACE SWMI |
$134.91
|
| Rate for Payer: PHP Medicare Advantage |
$134.91
|
| Rate for Payer: PHP Medicare Advantage |
$134.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$365.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$483.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.55
|
| Rate for Payer: Priority Health Medicare |
$134.91
|
| Rate for Payer: Priority Health Medicare |
$134.91
|
| Rate for Payer: Priority Health Narrow Network |
$212.55
|
| Rate for Payer: Priority Health Narrow Network |
$212.55
|
| Rate for Payer: UHC Medicare Advantage |
$138.96
|
| Rate for Payer: UHC Medicare Advantage |
$138.96
|
|
|
CHG SPEC MEDICAL RADJ PHYSICS CONSLTJ
|
Professional
|
$212.00
|
|
|
Service Code
|
HCPCS 77370
|
| Min. Negotiated Rate |
$84.80 |
| Max. Negotiated Rate |
$212.55 |
| Rate for Payer: Aetna Commercial |
$172.73
|
| Rate for Payer: Aetna Medicare |
$128.90
|
| Rate for Payer: BCBS Complete |
$84.80
|
| Rate for Payer: BCBS MAPPO |
$128.90
|
| Rate for Payer: BCN Commercial |
$202.80
|
| Rate for Payer: BCN Medicare Advantage |
$128.90
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cofinity Commercial |
$185.62
|
| Rate for Payer: Cofinity Commercial |
$172.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.90
|
| Rate for Payer: Healthscope Commercial |
$154.68
|
| Rate for Payer: Healthscope Whirlpool |
$154.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.34
|
| Rate for Payer: PACE SWMI |
$128.90
|
| Rate for Payer: PHP Medicare Advantage |
$128.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.55
|
| Rate for Payer: Priority Health Medicare |
$128.90
|
| Rate for Payer: Priority Health Narrow Network |
$212.55
|
| Rate for Payer: UHC Medicare Advantage |
$132.77
|
|
|
CHG SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY
|
Professional
|
$199.00
|
|
|
Service Code
|
HCPCS 77321
|
| Min. Negotiated Rate |
$79.60 |
| Max. Negotiated Rate |
$193.20 |
| Rate for Payer: Aetna Commercial |
$120.04
|
| Rate for Payer: Aetna Commercial |
$120.04
|
| Rate for Payer: Aetna Medicare |
$89.58
|
| Rate for Payer: Aetna Medicare |
$89.58
|
| Rate for Payer: BCBS Complete |
$110.40
|
| Rate for Payer: BCBS Complete |
$79.60
|
| Rate for Payer: BCBS MAPPO |
$89.58
|
| Rate for Payer: BCBS MAPPO |
$89.58
|
| Rate for Payer: BCN Commercial |
$136.83
|
| Rate for Payer: BCN Commercial |
$136.83
|
| Rate for Payer: BCN Medicare Advantage |
$89.58
|
| Rate for Payer: BCN Medicare Advantage |
$89.58
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cash Price |
$159.20
|
| Rate for Payer: Cash Price |
$220.80
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Cofinity Commercial |
$120.04
|
| Rate for Payer: Cofinity Commercial |
$120.04
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.58
|
| Rate for Payer: Healthscope Commercial |
$107.50
|
| Rate for Payer: Healthscope Commercial |
$107.50
|
| Rate for Payer: Healthscope Whirlpool |
$107.50
|
| Rate for Payer: Healthscope Whirlpool |
$107.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.06
|
| Rate for Payer: PACE SWMI |
$89.58
|
| Rate for Payer: PACE SWMI |
$89.58
|
| Rate for Payer: PHP Medicare Advantage |
$89.58
|
| Rate for Payer: PHP Medicare Advantage |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$143.40
|
| Rate for Payer: Priority Health Medicare |
$89.58
|
| Rate for Payer: Priority Health Medicare |
$89.58
|
| Rate for Payer: Priority Health Narrow Network |
$143.40
|
| Rate for Payer: Priority Health Narrow Network |
$143.40
|
| Rate for Payer: UHC Medicare Advantage |
$92.27
|
| Rate for Payer: UHC Medicare Advantage |
$92.27
|
|
|
CHG STEREOSCOPIC X-RAY GUIDANCE
|
Professional
|
$171.00
|
|
|
Service Code
|
HCPCS 77421
|
| Min. Negotiated Rate |
$68.40 |
| Max. Negotiated Rate |
$141.40 |
| Rate for Payer: BCBS Complete |
$68.40
|
| Rate for Payer: BCBS Complete |
$80.80
|
| Rate for Payer: Cash Price |
$161.60
|
| Rate for Payer: Cash Price |
$136.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.70
|
|
|
CHG STEREOTACTIC BODY RADIATION DELIVERY
|
Professional
|
$2,653.00
|
|
|
Service Code
|
HCPCS 77373
|
| Min. Negotiated Rate |
$929.58 |
| Max. Negotiated Rate |
$1,857.10 |
| Rate for Payer: Aetna Commercial |
$1,245.64
|
| Rate for Payer: Aetna Medicare |
$929.58
|
| Rate for Payer: BCBS Complete |
$1,061.20
|
| Rate for Payer: BCBS MAPPO |
$929.58
|
| Rate for Payer: BCN Commercial |
$1,469.46
|
| Rate for Payer: BCN Medicare Advantage |
$929.58
|
| Rate for Payer: Cash Price |
$2,122.40
|
| Rate for Payer: Cash Price |
$2,122.40
|
| Rate for Payer: Cofinity Commercial |
$1,338.60
|
| Rate for Payer: Cofinity Commercial |
$1,245.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.58
|
| Rate for Payer: Healthscope Commercial |
$1,115.50
|
| Rate for Payer: Healthscope Whirlpool |
$1,115.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$976.06
|
| Rate for Payer: PACE SWMI |
$929.58
|
| Rate for Payer: PHP Medicare Advantage |
$929.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,857.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,540.09
|
| Rate for Payer: Priority Health Medicare |
$929.58
|
| Rate for Payer: Priority Health Narrow Network |
$1,540.09
|
| Rate for Payer: UHC Medicare Advantage |
$957.47
|
|
|
CHG STEREOTACTIC BODY RADIATION MANAGEMENT
|
Professional
|
$1,236.00
|
|
|
Service Code
|
HCPCS 77435
|
| Min. Negotiated Rate |
$408.11 |
| Max. Negotiated Rate |
$977.73 |
| Rate for Payer: Aetna Commercial |
$844.49
|
| Rate for Payer: Aetna Medicare |
$630.22
|
| Rate for Payer: BCBS Complete |
$428.52
|
| Rate for Payer: BCBS MAPPO |
$630.22
|
| Rate for Payer: BCN Commercial |
$932.88
|
| Rate for Payer: BCN Medicare Advantage |
$630.22
|
| Rate for Payer: Cash Price |
$988.80
|
| Rate for Payer: Cash Price |
$988.80
|
| Rate for Payer: Cofinity Commercial |
$844.49
|
| Rate for Payer: Cofinity Commercial |
$907.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$630.22
|
| Rate for Payer: Healthscope Commercial |
$756.26
|
| Rate for Payer: Healthscope Whirlpool |
$756.26
|
| Rate for Payer: Meridian Medicaid |
$428.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$661.73
|
| Rate for Payer: PACE SWMI |
$630.22
|
| Rate for Payer: PHP Medicare Advantage |
$630.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$977.73
|
| Rate for Payer: Priority Health Medicare |
$630.22
|
| Rate for Payer: Priority Health Narrow Network |
$977.73
|
| Rate for Payer: UHC Medicare Advantage |
$649.13
|
|
|
CHG STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION
|
Professional
|
$855.00
|
|
|
Service Code
|
HCPCS 77432
|
| Min. Negotiated Rate |
$269.87 |
| Max. Negotiated Rate |
$647.37 |
| Rate for Payer: Aetna Commercial |
$559.38
|
| Rate for Payer: Aetna Medicare |
$417.45
|
| Rate for Payer: BCBS Complete |
$283.36
|
| Rate for Payer: BCBS MAPPO |
$417.45
|
| Rate for Payer: BCN Commercial |
$617.69
|
| Rate for Payer: BCN Medicare Advantage |
$417.45
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cash Price |
$684.00
|
| Rate for Payer: Cofinity Commercial |
$601.13
|
| Rate for Payer: Cofinity Commercial |
$559.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$417.45
|
| Rate for Payer: Healthscope Commercial |
$500.94
|
| Rate for Payer: Healthscope Whirlpool |
$500.94
|
| Rate for Payer: Meridian Medicaid |
$283.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$438.32
|
| Rate for Payer: PACE SWMI |
$417.45
|
| Rate for Payer: PHP Medicare Advantage |
$417.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$269.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$647.37
|
| Rate for Payer: Priority Health Medicare |
$417.45
|
| Rate for Payer: Priority Health Narrow Network |
$647.37
|
| Rate for Payer: UHC Medicare Advantage |
$429.97
|
|
|
CHG SUPERVISION HANDLING LOADING RADIATION SOURCE
|
Professional
|
$184.00
|
|
|
Service Code
|
HCPCS 77790
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$128.80 |
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Commercial |
$21.65
|
| Rate for Payer: Aetna Medicare |
$16.16
|
| Rate for Payer: Aetna Medicare |
$16.16
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: BCBS Complete |
$31.60
|
| Rate for Payer: BCBS MAPPO |
$16.16
|
| Rate for Payer: BCBS MAPPO |
$16.16
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: BCN Medicare Advantage |
$16.16
|
| Rate for Payer: BCN Medicare Advantage |
$16.16
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cofinity Commercial |
$23.27
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Cofinity Commercial |
$23.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.16
|
| Rate for Payer: Healthscope Commercial |
$19.39
|
| Rate for Payer: Healthscope Commercial |
$19.39
|
| Rate for Payer: Healthscope Whirlpool |
$19.39
|
| Rate for Payer: Healthscope Whirlpool |
$19.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.97
|
| Rate for Payer: PACE SWMI |
$16.16
|
| Rate for Payer: PACE SWMI |
$16.16
|
| Rate for Payer: PHP Medicare Advantage |
$16.16
|
| Rate for Payer: PHP Medicare Advantage |
$16.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.63
|
| Rate for Payer: Priority Health Medicare |
$16.16
|
| Rate for Payer: Priority Health Medicare |
$16.16
|
| Rate for Payer: Priority Health Narrow Network |
$26.63
|
| Rate for Payer: Priority Health Narrow Network |
$26.63
|
| Rate for Payer: UHC Medicare Advantage |
$16.64
|
| Rate for Payer: UHC Medicare Advantage |
$16.64
|
|
|
CHG TELETHER ISODOSE PLAN COMPLX
|
Professional
|
$142.00
|
|
|
Service Code
|
HCPCS 77315
|
| Min. Negotiated Rate |
$56.80 |
| Max. Negotiated Rate |
$188.30 |
| Rate for Payer: BCBS Complete |
$56.80
|
| Rate for Payer: BCBS Complete |
$107.60
|
| Rate for Payer: Cash Price |
$215.20
|
| Rate for Payer: Cash Price |
$113.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$188.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.40
|
|
|
CHG TELETHER ISODOSE PLAN SIMPLE
|
Professional
|
$95.00
|
|
|
Service Code
|
HCPCS 77305
|
| Min. Negotiated Rate |
$38.00 |
| Max. Negotiated Rate |
$106.40 |
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS Complete |
$60.80
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.50
|
|
|
CHG TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY
|
Professional
|
$822.00
|
|
|
Service Code
|
HCPCS 77307
|
| Min. Negotiated Rate |
$172.00 |
| Max. Negotiated Rate |
$575.40 |
| Rate for Payer: Aetna Commercial |
$366.20
|
| Rate for Payer: Aetna Commercial |
$366.20
|
| Rate for Payer: Aetna Medicare |
$273.28
|
| Rate for Payer: Aetna Medicare |
$273.28
|
| Rate for Payer: BCBS Complete |
$172.00
|
| Rate for Payer: BCBS Complete |
$328.80
|
| Rate for Payer: BCBS MAPPO |
$273.28
|
| Rate for Payer: BCBS MAPPO |
$273.28
|
| Rate for Payer: BCN Commercial |
$417.33
|
| Rate for Payer: BCN Commercial |
$417.33
|
| Rate for Payer: BCN Medicare Advantage |
$273.28
|
| Rate for Payer: BCN Medicare Advantage |
$273.28
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$657.60
|
| Rate for Payer: Cofinity Commercial |
$393.52
|
| Rate for Payer: Cofinity Commercial |
$393.52
|
| Rate for Payer: Cofinity Commercial |
$366.20
|
| Rate for Payer: Cofinity Commercial |
$366.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$273.28
|
| Rate for Payer: Healthscope Commercial |
$327.94
|
| Rate for Payer: Healthscope Commercial |
$327.94
|
| Rate for Payer: Healthscope Whirlpool |
$327.94
|
| Rate for Payer: Healthscope Whirlpool |
$327.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$286.94
|
| Rate for Payer: PACE SWMI |
$273.28
|
| Rate for Payer: PACE SWMI |
$273.28
|
| Rate for Payer: PHP Medicare Advantage |
$273.28
|
| Rate for Payer: PHP Medicare Advantage |
$273.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$575.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.40
|
| Rate for Payer: Priority Health Medicare |
$273.28
|
| Rate for Payer: Priority Health Medicare |
$273.28
|
| Rate for Payer: Priority Health Narrow Network |
$437.40
|
| Rate for Payer: Priority Health Narrow Network |
$437.40
|
| Rate for Payer: UHC Medicare Advantage |
$281.48
|
| Rate for Payer: UHC Medicare Advantage |
$281.48
|
|
|
CHG TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION
|
Professional
|
$228.00
|
|
|
Service Code
|
HCPCS 77306
|
| Min. Negotiated Rate |
$91.20 |
| Max. Negotiated Rate |
$271.60 |
| Rate for Payer: Aetna Commercial |
$188.69
|
| Rate for Payer: Aetna Commercial |
$188.69
|
| Rate for Payer: Aetna Medicare |
$140.81
|
| Rate for Payer: Aetna Medicare |
$140.81
|
| Rate for Payer: BCBS Complete |
$155.20
|
| Rate for Payer: BCBS Complete |
$91.20
|
| Rate for Payer: BCBS MAPPO |
$140.81
|
| Rate for Payer: BCBS MAPPO |
$140.81
|
| Rate for Payer: BCN Commercial |
$215.51
|
| Rate for Payer: BCN Commercial |
$215.51
|
| Rate for Payer: BCN Medicare Advantage |
$140.81
|
| Rate for Payer: BCN Medicare Advantage |
$140.81
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$310.40
|
| Rate for Payer: Cash Price |
$182.40
|
| Rate for Payer: Cofinity Commercial |
$188.69
|
| Rate for Payer: Cofinity Commercial |
$202.77
|
| Rate for Payer: Cofinity Commercial |
$188.69
|
| Rate for Payer: Cofinity Commercial |
$202.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.81
|
| Rate for Payer: Healthscope Commercial |
$168.97
|
| Rate for Payer: Healthscope Commercial |
$168.97
|
| Rate for Payer: Healthscope Whirlpool |
$168.97
|
| Rate for Payer: Healthscope Whirlpool |
$168.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.85
|
| Rate for Payer: PACE SWMI |
$140.81
|
| Rate for Payer: PACE SWMI |
$140.81
|
| Rate for Payer: PHP Medicare Advantage |
$140.81
|
| Rate for Payer: PHP Medicare Advantage |
$140.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$271.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$225.86
|
| Rate for Payer: Priority Health Medicare |
$140.81
|
| Rate for Payer: Priority Health Medicare |
$140.81
|
| Rate for Payer: Priority Health Narrow Network |
$225.86
|
| Rate for Payer: Priority Health Narrow Network |
$225.86
|
| Rate for Payer: UHC Medicare Advantage |
$145.03
|
| Rate for Payer: UHC Medicare Advantage |
$145.03
|
|
|
CHG THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ
|
Professional
|
$272.00
|
|
|
Service Code
|
HCPCS 74283
|
| Min. Negotiated Rate |
$108.80 |
| Max. Negotiated Rate |
$394.37 |
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna Medicare |
$244.47
|
| Rate for Payer: BCBS Complete |
$108.80
|
| Rate for Payer: BCBS MAPPO |
$244.47
|
| Rate for Payer: BCN Commercial |
$376.28
|
| Rate for Payer: BCN Medicare Advantage |
$244.47
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cash Price |
$217.60
|
| Rate for Payer: Cofinity Commercial |
$352.04
|
| Rate for Payer: Cofinity Commercial |
$327.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.47
|
| Rate for Payer: Healthscope Commercial |
$293.36
|
| Rate for Payer: Healthscope Whirlpool |
$293.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$256.69
|
| Rate for Payer: PACE SWMI |
$244.47
|
| Rate for Payer: PHP Medicare Advantage |
$244.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$394.37
|
| Rate for Payer: Priority Health Medicare |
$244.47
|
| Rate for Payer: Priority Health Narrow Network |
$394.37
|
| Rate for Payer: UHC Medicare Advantage |
$251.80
|
|
|
CHG THERAPEUTIC RADIOLOGY PORT IMAGES(S)
|
Professional
|
$33.00
|
|
|
Service Code
|
HCPCS 77417
|
| Min. Negotiated Rate |
$12.71 |
| Max. Negotiated Rate |
$23.10 |
| Rate for Payer: Aetna Commercial |
$17.03
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: BCBS Complete |
$13.20
|
| Rate for Payer: BCBS MAPPO |
$12.71
|
| Rate for Payer: BCN Commercial |
$20.04
|
| Rate for Payer: BCN Medicare Advantage |
$12.71
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Commercial |
$18.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.71
|
| Rate for Payer: Healthscope Commercial |
$15.25
|
| Rate for Payer: Healthscope Whirlpool |
$15.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.35
|
| Rate for Payer: PACE SWMI |
$12.71
|
| Rate for Payer: PHP Medicare Advantage |
$12.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.99
|
| Rate for Payer: Priority Health Medicare |
$12.71
|
| Rate for Payer: Priority Health Narrow Network |
$20.99
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX
|
Professional
|
$296.00
|
|
|
Service Code
|
HCPCS 77263
|
| Min. Negotiated Rate |
$106.71 |
| Max. Negotiated Rate |
$257.10 |
| Rate for Payer: Aetna Commercial |
$222.23
|
| Rate for Payer: Aetna Medicare |
$165.84
|
| Rate for Payer: BCBS Complete |
$112.05
|
| Rate for Payer: BCBS MAPPO |
$165.84
|
| Rate for Payer: BCN Commercial |
$245.32
|
| Rate for Payer: BCN Medicare Advantage |
$165.84
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cash Price |
$236.80
|
| Rate for Payer: Cofinity Commercial |
$238.81
|
| Rate for Payer: Cofinity Commercial |
$222.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$165.84
|
| Rate for Payer: Healthscope Commercial |
$199.01
|
| Rate for Payer: Healthscope Whirlpool |
$199.01
|
| Rate for Payer: Meridian Medicaid |
$112.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.13
|
| Rate for Payer: PACE SWMI |
$165.84
|
| Rate for Payer: PHP Medicare Advantage |
$165.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$257.10
|
| Rate for Payer: Priority Health Medicare |
$165.84
|
| Rate for Payer: Priority Health Narrow Network |
$257.10
|
| Rate for Payer: UHC Medicare Advantage |
$170.82
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE
|
Professional
|
$198.00
|
|
|
Service Code
|
HCPCS 77262
|
| Min. Negotiated Rate |
$68.80 |
| Max. Negotiated Rate |
$164.41 |
| Rate for Payer: Aetna Commercial |
$141.92
|
| Rate for Payer: Aetna Medicare |
$105.91
|
| Rate for Payer: BCBS Complete |
$72.24
|
| Rate for Payer: BCBS MAPPO |
$105.91
|
| Rate for Payer: BCN Commercial |
$156.86
|
| Rate for Payer: BCN Medicare Advantage |
$105.91
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$141.92
|
| Rate for Payer: Cofinity Commercial |
$152.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.91
|
| Rate for Payer: Healthscope Commercial |
$127.09
|
| Rate for Payer: Healthscope Whirlpool |
$127.09
|
| Rate for Payer: Meridian Medicaid |
$72.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$111.21
|
| Rate for Payer: PACE SWMI |
$105.91
|
| Rate for Payer: PHP Medicare Advantage |
$105.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.41
|
| Rate for Payer: Priority Health Medicare |
$105.91
|
| Rate for Payer: Priority Health Narrow Network |
$164.41
|
| Rate for Payer: UHC Medicare Advantage |
$109.09
|
|
|
CHG THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE
|
Professional
|
$132.00
|
|
|
Service Code
|
HCPCS 77261
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$107.55 |
| Rate for Payer: Aetna Commercial |
$92.73
|
| Rate for Payer: Aetna Medicare |
$69.20
|
| Rate for Payer: BCBS Complete |
$47.19
|
| Rate for Payer: BCBS MAPPO |
$69.20
|
| Rate for Payer: BCN Commercial |
$102.62
|
| Rate for Payer: BCN Medicare Advantage |
$69.20
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$92.73
|
| Rate for Payer: Cofinity Commercial |
$99.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.20
|
| Rate for Payer: Healthscope Commercial |
$83.04
|
| Rate for Payer: Healthscope Whirlpool |
$83.04
|
| Rate for Payer: Meridian Medicaid |
$47.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.66
|
| Rate for Payer: PACE SWMI |
$69.20
|
| Rate for Payer: PHP Medicare Advantage |
$69.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$107.55
|
| Rate for Payer: Priority Health Medicare |
$69.20
|
| Rate for Payer: Priority Health Narrow Network |
$107.55
|
| Rate for Payer: UHC Medicare Advantage |
$71.28
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX
|
Professional
|
$787.00
|
|
|
Service Code
|
HCPCS 77290
|
| Min. Negotiated Rate |
$314.80 |
| Max. Negotiated Rate |
$693.47 |
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Aetna Commercial |
$567.09
|
| Rate for Payer: Aetna Commercial |
$567.09
|
| Rate for Payer: Aetna Medicare |
$423.20
|
| Rate for Payer: Aetna Medicare |
$423.20
|
| Rate for Payer: BCBS Complete |
$314.80
|
| Rate for Payer: BCBS Complete |
$378.00
|
| Rate for Payer: BCBS MAPPO |
$423.20
|
| Rate for Payer: BCBS MAPPO |
$423.20
|
| Rate for Payer: BCN Commercial |
$661.67
|
| Rate for Payer: BCN Commercial |
$661.67
|
| Rate for Payer: BCN Medicare Advantage |
$423.20
|
| Rate for Payer: BCN Medicare Advantage |
$423.20
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cash Price |
$629.60
|
| Rate for Payer: Cash Price |
$756.00
|
| Rate for Payer: Cofinity Commercial |
$609.41
|
| Rate for Payer: Cofinity Commercial |
$609.41
|
| Rate for Payer: Cofinity Commercial |
$567.09
|
| Rate for Payer: Cofinity Commercial |
$567.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$423.20
|
| Rate for Payer: Healthscope Commercial |
$507.84
|
| Rate for Payer: Healthscope Commercial |
$507.84
|
| Rate for Payer: Healthscope Whirlpool |
$507.84
|
| Rate for Payer: Healthscope Whirlpool |
$507.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$444.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$444.36
|
| Rate for Payer: PACE SWMI |
$423.20
|
| Rate for Payer: PACE SWMI |
$423.20
|
| Rate for Payer: PHP Medicare Advantage |
$423.20
|
| Rate for Payer: PHP Medicare Advantage |
$423.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$550.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$661.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$693.47
|
| Rate for Payer: Priority Health Medicare |
$423.20
|
| Rate for Payer: Priority Health Medicare |
$423.20
|
| Rate for Payer: Priority Health Narrow Network |
$693.47
|
| Rate for Payer: Priority Health Narrow Network |
$693.47
|
| Rate for Payer: UHC Medicare Advantage |
$435.90
|
| Rate for Payer: UHC Medicare Advantage |
$435.90
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED
|
Professional
|
$112.00
|
|
|
Service Code
|
HCPCS 77285
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$676.57 |
| Rate for Payer: Aetna Commercial |
$551.16
|
| Rate for Payer: Aetna Medicare |
$411.31
|
| Rate for Payer: BCBS Complete |
$44.80
|
| Rate for Payer: BCBS MAPPO |
$411.31
|
| Rate for Payer: BCN Commercial |
$645.54
|
| Rate for Payer: BCN Medicare Advantage |
$411.31
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$592.29
|
| Rate for Payer: Cofinity Commercial |
$551.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$411.31
|
| Rate for Payer: Healthscope Commercial |
$493.57
|
| Rate for Payer: Healthscope Whirlpool |
$493.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$431.88
|
| Rate for Payer: PACE SWMI |
$411.31
|
| Rate for Payer: PHP Medicare Advantage |
$411.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$676.57
|
| Rate for Payer: Priority Health Medicare |
$411.31
|
| Rate for Payer: Priority Health Narrow Network |
$676.57
|
| Rate for Payer: UHC Medicare Advantage |
$423.65
|
|
|
CHG THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE
|
Professional
|
$505.00
|
|
|
Service Code
|
HCPCS 77280
|
| Min. Negotiated Rate |
$174.00 |
| Max. Negotiated Rate |
$413.32 |
| Rate for Payer: Aetna Commercial |
$337.04
|
| Rate for Payer: Aetna Commercial |
$337.04
|
| Rate for Payer: Aetna Medicare |
$251.52
|
| Rate for Payer: Aetna Medicare |
$251.52
|
| Rate for Payer: BCBS Complete |
$202.00
|
| Rate for Payer: BCBS Complete |
$174.00
|
| Rate for Payer: BCBS MAPPO |
$251.52
|
| Rate for Payer: BCBS MAPPO |
$251.52
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Commercial |
$394.36
|
| Rate for Payer: BCN Medicare Advantage |
$251.52
|
| Rate for Payer: BCN Medicare Advantage |
$251.52
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$404.00
|
| Rate for Payer: Cash Price |
$348.00
|
| Rate for Payer: Cofinity Commercial |
$337.04
|
| Rate for Payer: Cofinity Commercial |
$362.19
|
| Rate for Payer: Cofinity Commercial |
$337.04
|
| Rate for Payer: Cofinity Commercial |
$362.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$251.52
|
| Rate for Payer: Healthscope Commercial |
$301.82
|
| Rate for Payer: Healthscope Commercial |
$301.82
|
| Rate for Payer: Healthscope Whirlpool |
$301.82
|
| Rate for Payer: Healthscope Whirlpool |
$301.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$264.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$264.10
|
| Rate for Payer: PACE SWMI |
$251.52
|
| Rate for Payer: PACE SWMI |
$251.52
|
| Rate for Payer: PHP Medicare Advantage |
$251.52
|
| Rate for Payer: PHP Medicare Advantage |
$251.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$413.32
|
| Rate for Payer: Priority Health Medicare |
$251.52
|
| Rate for Payer: Priority Health Medicare |
$251.52
|
| Rate for Payer: Priority Health Narrow Network |
$413.32
|
| Rate for Payer: Priority Health Narrow Network |
$413.32
|
| Rate for Payer: UHC Medicare Advantage |
$259.07
|
| Rate for Payer: UHC Medicare Advantage |
$259.07
|
|
|
CHG TISS CUL NON-NEO DISORDERS SKN/OTH SOLID TISS BX
|
Professional
|
$293.00
|
|
|
Service Code
|
HCPCS 88233
|
| Min. Negotiated Rate |
$105.55 |
| Max. Negotiated Rate |
$215.54 |
| Rate for Payer: Aetna Commercial |
$188.58
|
| Rate for Payer: Aetna Medicare |
$140.73
|
| Rate for Payer: BCBS Complete |
$117.20
|
| Rate for Payer: BCBS MAPPO |
$140.73
|
| Rate for Payer: BCN Commercial |
$105.55
|
| Rate for Payer: BCN Medicare Advantage |
$140.73
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cofinity Commercial |
$202.65
|
| Rate for Payer: Cofinity Commercial |
$188.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.73
|
| Rate for Payer: Healthscope Commercial |
$168.88
|
| Rate for Payer: Healthscope Whirlpool |
$168.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.77
|
| Rate for Payer: PACE SWMI |
$140.73
|
| Rate for Payer: PHP Medicare Advantage |
$140.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$215.54
|
| Rate for Payer: Priority Health Medicare |
$140.73
|
| Rate for Payer: Priority Health Narrow Network |
$215.54
|
| Rate for Payer: UHC Medicare Advantage |
$144.95
|
|
|
CHG TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT
|
Professional
|
$22.00
|
|
|
Service Code
|
HCPCS 87220
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$15.40 |
| Rate for Payer: Aetna Commercial |
$5.72
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: BCBS Complete |
$8.80
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCN Commercial |
$3.20
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$6.15
|
| Rate for Payer: Cofinity Commercial |
$5.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$5.12
|
| Rate for Payer: Healthscope Whirlpool |
$5.12
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.57
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
|
|
CHG TRANSCATHETER EMBOLIZATION ANY METH RS&I
|
Professional
|
$352.00
|
|
|
Service Code
|
HCPCS 75894
|
| Min. Negotiated Rate |
$140.80 |
| Max. Negotiated Rate |
$1,537.01 |
| Rate for Payer: Aetna Commercial |
$1,126.65
|
| Rate for Payer: BCBS Complete |
$140.80
|
| Rate for Payer: BCN Commercial |
$1,451.37
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Cash Price |
$281.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,537.01
|
| Rate for Payer: Priority Health Narrow Network |
$1,537.01
|
|
