|
CHG TRANSCATHETER INFUSION OTHER THAN THROMBOLYSIS
|
Professional
|
$278.00
|
|
|
Service Code
|
HCPCS 75896
|
| Min. Negotiated Rate |
$111.20 |
| Max. Negotiated Rate |
$194.60 |
| Rate for Payer: BCBS Complete |
$111.20
|
| Rate for Payer: Cash Price |
$222.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.60
|
|
|
CHG TRANSFERASE ALANINE AMINO ALT SGPT
|
Professional
|
$14.00
|
|
|
Service Code
|
HCPCS 84460
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.63
|
| Rate for Payer: Cofinity Commercial |
$7.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$6.36
|
| Rate for Payer: Healthscope Whirlpool |
$6.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.56
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.62
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow Network |
$5.62
|
| Rate for Payer: UHC Medicare Advantage |
$5.46
|
|
|
CHG TRANSFERASE ASPARTATE AMINO AST SGOT
|
Professional
|
$14.00
|
|
|
Service Code
|
HCPCS 84450
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$6.22
|
| Rate for Payer: Healthscope Whirlpool |
$6.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.27
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.27
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
$179.00
|
|
|
Service Code
|
HCPCS 77334
|
| Min. Negotiated Rate |
$71.60 |
| Max. Negotiated Rate |
$217.82 |
| Rate for Payer: Aetna Commercial |
$159.33
|
| Rate for Payer: Aetna Commercial |
$159.33
|
| Rate for Payer: Aetna Medicare |
$118.90
|
| Rate for Payer: Aetna Medicare |
$118.90
|
| Rate for Payer: BCBS Complete |
$71.60
|
| Rate for Payer: BCBS Complete |
$114.00
|
| Rate for Payer: BCBS MAPPO |
$118.90
|
| Rate for Payer: BCBS MAPPO |
$118.90
|
| Rate for Payer: BCN Commercial |
$217.82
|
| Rate for Payer: BCN Commercial |
$217.82
|
| Rate for Payer: BCN Medicare Advantage |
$118.90
|
| Rate for Payer: BCN Medicare Advantage |
$118.90
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cash Price |
$143.20
|
| Rate for Payer: Cofinity Commercial |
$159.33
|
| Rate for Payer: Cofinity Commercial |
$171.22
|
| Rate for Payer: Cofinity Commercial |
$159.33
|
| Rate for Payer: Cofinity Commercial |
$171.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.90
|
| Rate for Payer: Healthscope Commercial |
$142.68
|
| Rate for Payer: Healthscope Commercial |
$142.68
|
| Rate for Payer: Healthscope Whirlpool |
$142.68
|
| Rate for Payer: Healthscope Whirlpool |
$142.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$124.84
|
| Rate for Payer: PACE SWMI |
$118.90
|
| Rate for Payer: PACE SWMI |
$118.90
|
| Rate for Payer: PHP Medicare Advantage |
$118.90
|
| Rate for Payer: PHP Medicare Advantage |
$118.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$199.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$191.04
|
| Rate for Payer: Priority Health Medicare |
$118.90
|
| Rate for Payer: Priority Health Medicare |
$118.90
|
| Rate for Payer: Priority Health Narrow Network |
$191.04
|
| Rate for Payer: Priority Health Narrow Network |
$191.04
|
| Rate for Payer: UHC Medicare Advantage |
$122.47
|
| Rate for Payer: UHC Medicare Advantage |
$122.47
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
$90.00
|
|
|
Service Code
|
HCPCS 77333
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$211.02 |
| Rate for Payer: Aetna Commercial |
$173.84
|
| Rate for Payer: Aetna Commercial |
$173.84
|
| Rate for Payer: Aetna Medicare |
$129.73
|
| Rate for Payer: Aetna Medicare |
$129.73
|
| Rate for Payer: BCBS Complete |
$63.20
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: BCBS MAPPO |
$129.73
|
| Rate for Payer: BCBS MAPPO |
$129.73
|
| Rate for Payer: BCN Commercial |
$75.81
|
| Rate for Payer: BCN Commercial |
$75.81
|
| Rate for Payer: BCN Medicare Advantage |
$129.73
|
| Rate for Payer: BCN Medicare Advantage |
$129.73
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$186.81
|
| Rate for Payer: Cofinity Commercial |
$173.84
|
| Rate for Payer: Cofinity Commercial |
$186.81
|
| Rate for Payer: Cofinity Commercial |
$173.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.73
|
| Rate for Payer: Healthscope Commercial |
$155.68
|
| Rate for Payer: Healthscope Commercial |
$155.68
|
| Rate for Payer: Healthscope Whirlpool |
$155.68
|
| Rate for Payer: Healthscope Whirlpool |
$155.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$136.22
|
| Rate for Payer: PACE SWMI |
$129.73
|
| Rate for Payer: PACE SWMI |
$129.73
|
| Rate for Payer: PHP Medicare Advantage |
$129.73
|
| Rate for Payer: PHP Medicare Advantage |
$129.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$211.02
|
| Rate for Payer: Priority Health Medicare |
$129.73
|
| Rate for Payer: Priority Health Medicare |
$129.73
|
| Rate for Payer: Priority Health Narrow Network |
$211.02
|
| Rate for Payer: Priority Health Narrow Network |
$211.02
|
| Rate for Payer: UHC Medicare Advantage |
$133.62
|
| Rate for Payer: UHC Medicare Advantage |
$133.62
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
$152.00
|
|
|
Service Code
|
HCPCS 77332
|
| Min. Negotiated Rate |
$36.72 |
| Max. Negotiated Rate |
$118.27 |
| Rate for Payer: Aetna Commercial |
$49.20
|
| Rate for Payer: Aetna Commercial |
$49.20
|
| Rate for Payer: Aetna Medicare |
$36.72
|
| Rate for Payer: Aetna Medicare |
$36.72
|
| Rate for Payer: BCBS Complete |
$60.80
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: BCBS MAPPO |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$36.72
|
| Rate for Payer: BCN Commercial |
$118.27
|
| Rate for Payer: BCN Commercial |
$118.27
|
| Rate for Payer: BCN Medicare Advantage |
$36.72
|
| Rate for Payer: BCN Medicare Advantage |
$36.72
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cash Price |
$121.60
|
| Rate for Payer: Cofinity Commercial |
$49.20
|
| Rate for Payer: Cofinity Commercial |
$52.88
|
| Rate for Payer: Cofinity Commercial |
$49.20
|
| Rate for Payer: Cofinity Commercial |
$52.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Commercial |
$44.06
|
| Rate for Payer: Healthscope Whirlpool |
$44.06
|
| Rate for Payer: Healthscope Whirlpool |
$44.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.56
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.56
|
| Rate for Payer: PACE SWMI |
$36.72
|
| Rate for Payer: PACE SWMI |
$36.72
|
| Rate for Payer: PHP Medicare Advantage |
$36.72
|
| Rate for Payer: PHP Medicare Advantage |
$36.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.38
|
| Rate for Payer: Priority Health Medicare |
$36.72
|
| Rate for Payer: Priority Health Medicare |
$36.72
|
| Rate for Payer: Priority Health Narrow Network |
$58.38
|
| Rate for Payer: Priority Health Narrow Network |
$58.38
|
| Rate for Payer: UHC Medicare Advantage |
$37.82
|
| Rate for Payer: UHC Medicare Advantage |
$37.82
|
|
|
CHG ULTRASONIC GUIDANCE INTRAOPERATIVE
|
Professional
|
$289.00
|
|
|
Service Code
|
HCPCS 76998
|
| Min. Negotiated Rate |
$74.11 |
| Max. Negotiated Rate |
$266.33 |
| Rate for Payer: Aetna Commercial |
$74.11
|
| Rate for Payer: BCBS Complete |
$115.60
|
| Rate for Payer: BCN Commercial |
$266.33
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Cash Price |
$231.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$202.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.71
|
| Rate for Payer: Priority Health Narrow Network |
$92.71
|
|
|
CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
$89.00
|
|
|
Service Code
|
HCPCS 76800
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$240.72 |
| Rate for Payer: Aetna Commercial |
$200.42
|
| Rate for Payer: Aetna Medicare |
$149.57
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS MAPPO |
$149.57
|
| Rate for Payer: BCN Commercial |
$229.68
|
| Rate for Payer: BCN Medicare Advantage |
$149.57
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$215.38
|
| Rate for Payer: Cofinity Commercial |
$200.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.57
|
| Rate for Payer: Healthscope Commercial |
$179.48
|
| Rate for Payer: Healthscope Whirlpool |
$179.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.05
|
| Rate for Payer: PACE SWMI |
$149.57
|
| Rate for Payer: PHP Medicare Advantage |
$149.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$240.72
|
| Rate for Payer: Priority Health Medicare |
$149.57
|
| Rate for Payer: Priority Health Narrow Network |
$240.72
|
| Rate for Payer: UHC Medicare Advantage |
$154.06
|
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
$250.00
|
|
|
Service Code
|
HCPCS 76496
|
| Min. Negotiated Rate |
$74.70 |
| Max. Negotiated Rate |
$175.00 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.00
|
|
|
CHG URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM
|
Professional
|
$475.00
|
|
|
Service Code
|
HCPCS 78740
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$332.50 |
| Rate for Payer: Aetna Commercial |
$255.10
|
| Rate for Payer: Aetna Medicare |
$190.37
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: BCBS MAPPO |
$190.37
|
| Rate for Payer: BCN Commercial |
$298.09
|
| Rate for Payer: BCN Medicare Advantage |
$190.37
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$274.13
|
| Rate for Payer: Cofinity Commercial |
$255.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.37
|
| Rate for Payer: Healthscope Commercial |
$228.44
|
| Rate for Payer: Healthscope Whirlpool |
$228.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.89
|
| Rate for Payer: PACE SWMI |
$190.37
|
| Rate for Payer: PHP Medicare Advantage |
$190.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$332.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$312.42
|
| Rate for Payer: Priority Health Medicare |
$190.37
|
| Rate for Payer: Priority Health Narrow Network |
$312.42
|
| Rate for Payer: UHC Medicare Advantage |
$196.08
|
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
$110.00
|
|
|
Service Code
|
HCPCS 74450
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$256.77 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: BCBS Complete |
$44.00
|
| Rate for Payer: BCN Commercial |
$238.97
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.48
|
| Rate for Payer: Priority Health Narrow Network |
$104.48
|
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
$32.00
|
|
|
Service Code
|
HCPCS 74455
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$161.33 |
| Rate for Payer: Aetna Commercial |
$131.79
|
| Rate for Payer: Aetna Medicare |
$98.35
|
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: BCBS MAPPO |
$98.35
|
| Rate for Payer: BCN Commercial |
$153.93
|
| Rate for Payer: BCN Medicare Advantage |
$98.35
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$141.62
|
| Rate for Payer: Cofinity Commercial |
$131.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.35
|
| Rate for Payer: Healthscope Commercial |
$118.02
|
| Rate for Payer: Healthscope Whirlpool |
$118.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.27
|
| Rate for Payer: PACE SWMI |
$98.35
|
| Rate for Payer: PHP Medicare Advantage |
$98.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$161.33
|
| Rate for Payer: Priority Health Medicare |
$98.35
|
| Rate for Payer: Priority Health Narrow Network |
$161.33
|
| Rate for Payer: UHC Medicare Advantage |
$101.30
|
|
|
CHG URINALYSIS MICROSCOPIC ONLY
|
Professional
|
$7.00
|
|
|
Service Code
|
HCPCS 81015
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$4.90 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare |
$3.05
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Cofinity Commercial |
$4.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$3.66
|
| Rate for Payer: Healthscope Whirlpool |
$3.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.16
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$3.16
|
| Rate for Payer: UHC Medicare Advantage |
$3.14
|
|
|
CHG URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS
|
Professional
|
$14.00
|
|
|
Service Code
|
HCPCS 81005
|
| Min. Negotiated Rate |
$1.63 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$2.60
|
| Rate for Payer: Healthscope Whirlpool |
$2.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.11
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$2.11
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
|
|
CHG URINARY BLADDER RESIDUAL STUDY
|
Professional
|
$233.00
|
|
|
Service Code
|
HCPCS 78730
|
| Min. Negotiated Rate |
$63.49 |
| Max. Negotiated Rate |
$163.10 |
| Rate for Payer: Aetna Commercial |
$85.08
|
| Rate for Payer: Aetna Medicare |
$63.49
|
| Rate for Payer: BCBS Complete |
$93.20
|
| Rate for Payer: BCBS MAPPO |
$63.49
|
| Rate for Payer: BCN Commercial |
$99.69
|
| Rate for Payer: BCN Medicare Advantage |
$63.49
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cash Price |
$186.40
|
| Rate for Payer: Cofinity Commercial |
$91.43
|
| Rate for Payer: Cofinity Commercial |
$85.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.49
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Healthscope Whirlpool |
$76.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$66.66
|
| Rate for Payer: PACE SWMI |
$63.49
|
| Rate for Payer: PHP Medicare Advantage |
$63.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$104.48
|
| Rate for Payer: Priority Health Medicare |
$63.49
|
| Rate for Payer: Priority Health Narrow Network |
$104.48
|
| Rate for Payer: UHC Medicare Advantage |
$65.39
|
|
|
CHG URINE ALBUMIN SEMIQUANTITATIVE
|
Professional
|
$14.00
|
|
|
Service Code
|
HCPCS 82044
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$8.35
|
| Rate for Payer: Aetna Medicare |
$6.23
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$6.23
|
| Rate for Payer: BCN Commercial |
$4.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.23
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$8.97
|
| Rate for Payer: Cofinity Commercial |
$8.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.23
|
| Rate for Payer: Healthscope Commercial |
$7.48
|
| Rate for Payer: Healthscope Whirlpool |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.54
|
| Rate for Payer: PACE SWMI |
$6.23
|
| Rate for Payer: PHP Medicare Advantage |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.33
|
| Rate for Payer: Priority Health Medicare |
$6.23
|
| Rate for Payer: Priority Health Narrow Network |
$6.33
|
| Rate for Payer: UHC Medicare Advantage |
$6.42
|
|
|
CHG URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS
|
Professional
|
$23.00
|
|
|
Service Code
|
HCPCS 81025
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$16.10 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$10.33
|
| Rate for Payer: Healthscope Whirlpool |
$10.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.78
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$8.78
|
| Rate for Payer: UHC Medicare Advantage |
$8.87
|
|
|
CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY
|
Professional
|
$17.00
|
|
|
Service Code
|
HCPCS 81000
|
| Min. Negotiated Rate |
$4.02 |
| Max. Negotiated Rate |
$11.90 |
| Rate for Payer: Aetna Commercial |
$5.39
|
| Rate for Payer: Aetna Medicare |
$4.02
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cash Price |
$13.60
|
| Rate for Payer: Cofinity Commercial |
$5.79
|
| Rate for Payer: Cofinity Commercial |
$5.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Healthscope Whirlpool |
$4.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.22
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow Network |
$4.22
|
| Rate for Payer: UHC Medicare Advantage |
$4.14
|
|
|
CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY
|
Professional
|
$30.00
|
|
|
Service Code
|
HCPCS 81001
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$21.00 |
| Rate for Payer: Aetna Commercial |
$4.25
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$4.25
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
| Rate for Payer: Healthscope Commercial |
$3.80
|
| Rate for Payer: Healthscope Whirlpool |
$3.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.16
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow Network |
$3.16
|
| Rate for Payer: UHC Medicare Advantage |
$3.27
|
|
|
CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY
|
Professional
|
$14.00
|
|
|
Service Code
|
HCPCS 81003
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$3.02
|
| Rate for Payer: Aetna Medicare |
$2.25
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.24
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$2.70
|
| Rate for Payer: Healthscope Whirlpool |
$2.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.46
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow Network |
$2.46
|
| Rate for Payer: UHC Medicare Advantage |
$2.32
|
|
|
CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP
|
Professional
|
$12.00
|
|
|
Service Code
|
HCPCS 81002
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$8.40 |
| Rate for Payer: Aetna Commercial |
$4.66
|
| Rate for Payer: Aetna Medicare |
$3.48
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$5.01
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Healthscope Whirlpool |
$4.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.52
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$3.52
|
| Rate for Payer: UHC Medicare Advantage |
$3.58
|
|
|
CHG UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
|
Professional
|
$209.00
|
|
|
Service Code
|
HCPCS 74400
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$209.99 |
| Rate for Payer: Aetna Commercial |
$172.04
|
| Rate for Payer: Aetna Commercial |
$172.04
|
| Rate for Payer: Aetna Medicare |
$128.39
|
| Rate for Payer: Aetna Medicare |
$128.39
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: BCBS MAPPO |
$128.39
|
| Rate for Payer: BCBS MAPPO |
$128.39
|
| Rate for Payer: BCN Commercial |
$200.36
|
| Rate for Payer: BCN Commercial |
$200.36
|
| Rate for Payer: BCN Medicare Advantage |
$128.39
|
| Rate for Payer: BCN Medicare Advantage |
$128.39
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$184.88
|
| Rate for Payer: Cofinity Commercial |
$172.04
|
| Rate for Payer: Cofinity Commercial |
$172.04
|
| Rate for Payer: Cofinity Commercial |
$184.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.39
|
| Rate for Payer: Healthscope Commercial |
$154.07
|
| Rate for Payer: Healthscope Commercial |
$154.07
|
| Rate for Payer: Healthscope Whirlpool |
$154.07
|
| Rate for Payer: Healthscope Whirlpool |
$154.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$134.81
|
| Rate for Payer: PACE SWMI |
$128.39
|
| Rate for Payer: PACE SWMI |
$128.39
|
| Rate for Payer: PHP Medicare Advantage |
$128.39
|
| Rate for Payer: PHP Medicare Advantage |
$128.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$209.99
|
| Rate for Payer: Priority Health Medicare |
$128.39
|
| Rate for Payer: Priority Health Medicare |
$128.39
|
| Rate for Payer: Priority Health Narrow Network |
$209.99
|
| Rate for Payer: Priority Health Narrow Network |
$209.99
|
| Rate for Payer: UHC Medicare Advantage |
$132.24
|
| Rate for Payer: UHC Medicare Advantage |
$132.24
|
|
|
CHG UROGRAPHY RETROGRADE WITH/WO KUB
|
Professional
|
$58.00
|
|
|
Service Code
|
HCPCS 74420
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$118.31 |
| Rate for Payer: Aetna Commercial |
$97.89
|
| Rate for Payer: Aetna Medicare |
$73.05
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$73.05
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$73.05
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Cofinity Commercial |
$105.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.05
|
| Rate for Payer: Healthscope Commercial |
$87.66
|
| Rate for Payer: Healthscope Whirlpool |
$87.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$76.70
|
| Rate for Payer: PACE SWMI |
$73.05
|
| Rate for Payer: PHP Medicare Advantage |
$73.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.31
|
| Rate for Payer: Priority Health Medicare |
$73.05
|
| Rate for Payer: Priority Health Narrow Network |
$118.31
|
| Rate for Payer: UHC Medicare Advantage |
$75.24
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
$209.00
|
|
|
Service Code
|
HCPCS 76700
|
| Min. Negotiated Rate |
$83.60 |
| Max. Negotiated Rate |
$179.76 |
| Rate for Payer: Aetna Commercial |
$148.85
|
| Rate for Payer: Aetna Medicare |
$111.08
|
| Rate for Payer: BCBS Complete |
$83.60
|
| Rate for Payer: BCBS MAPPO |
$111.08
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: BCN Medicare Advantage |
$111.08
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cash Price |
$167.20
|
| Rate for Payer: Cofinity Commercial |
$159.96
|
| Rate for Payer: Cofinity Commercial |
$148.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$111.08
|
| Rate for Payer: Healthscope Commercial |
$133.30
|
| Rate for Payer: Healthscope Whirlpool |
$133.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$116.63
|
| Rate for Payer: PACE SWMI |
$111.08
|
| Rate for Payer: PHP Medicare Advantage |
$111.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.76
|
| Rate for Payer: Priority Health Medicare |
$111.08
|
| Rate for Payer: Priority Health Narrow Network |
$179.76
|
| Rate for Payer: UHC Medicare Advantage |
$114.41
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE LIMITED
|
Professional
|
$106.00
|
|
|
Service Code
|
HCPCS 76705
|
| Min. Negotiated Rate |
$42.40 |
| Max. Negotiated Rate |
$135.72 |
| Rate for Payer: Aetna Commercial |
$112.39
|
| Rate for Payer: Aetna Commercial |
$112.39
|
| Rate for Payer: Aetna Medicare |
$83.87
|
| Rate for Payer: Aetna Medicare |
$83.87
|
| Rate for Payer: BCBS Complete |
$70.40
|
| Rate for Payer: BCBS Complete |
$42.40
|
| Rate for Payer: BCBS MAPPO |
$83.87
|
| Rate for Payer: BCBS MAPPO |
$83.87
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Medicare Advantage |
$83.87
|
| Rate for Payer: BCN Medicare Advantage |
$83.87
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$112.39
|
| Rate for Payer: Cofinity Commercial |
$112.39
|
| Rate for Payer: Cofinity Commercial |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.87
|
| Rate for Payer: Healthscope Commercial |
$100.64
|
| Rate for Payer: Healthscope Commercial |
$100.64
|
| Rate for Payer: Healthscope Whirlpool |
$100.64
|
| Rate for Payer: Healthscope Whirlpool |
$100.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$88.06
|
| Rate for Payer: PACE SWMI |
$83.87
|
| Rate for Payer: PACE SWMI |
$83.87
|
| Rate for Payer: PHP Medicare Advantage |
$83.87
|
| Rate for Payer: PHP Medicare Advantage |
$83.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$83.87
|
| Rate for Payer: Priority Health Medicare |
$83.87
|
| Rate for Payer: Priority Health Narrow Network |
$135.72
|
| Rate for Payer: Priority Health Narrow Network |
$135.72
|
| Rate for Payer: UHC Medicare Advantage |
$86.39
|
| Rate for Payer: UHC Medicare Advantage |
$86.39
|
|
