|
CHG US, BREAST(S), REAL TIME
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 76645
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$102.90 |
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.90
|
|
|
CHG US CHEST REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 76604
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$2,617.20 |
| Rate for Payer: Aetna Commercial |
$73.08
|
| Rate for Payer: Aetna Medicare |
$54.54
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$54.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,617.20
|
| Rate for Payer: BCN Commercial |
$83.07
|
| Rate for Payer: BCN Medicare Advantage |
$54.54
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$73.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.54
|
| Rate for Payer: Healthscope Commercial |
$65.45
|
| Rate for Payer: Healthscope Whirlpool |
$65.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.27
|
| Rate for Payer: PACE SWMI |
$54.54
|
| Rate for Payer: PHP Medicare Advantage |
$54.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.07
|
| Rate for Payer: Priority Health Medicare |
$54.54
|
| Rate for Payer: Priority Health Narrow Network |
$87.07
|
| Rate for Payer: UHC Medicare Advantage |
$56.18
|
|
|
CHG US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL
|
Professional
|
Both
|
$421.00
|
|
|
Service Code
|
HCPCS 76936
|
| Min. Negotiated Rate |
$168.40 |
| Max. Negotiated Rate |
$397.44 |
| Rate for Payer: Aetna Commercial |
$331.01
|
| Rate for Payer: Aetna Medicare |
$247.02
|
| Rate for Payer: BCBS Complete |
$168.40
|
| Rate for Payer: BCBS MAPPO |
$247.02
|
| Rate for Payer: BCBS Trust/PPO |
$293.21
|
| Rate for Payer: BCN Commercial |
$379.21
|
| Rate for Payer: BCN Medicare Advantage |
$247.02
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cash Price |
$336.80
|
| Rate for Payer: Cofinity Commercial |
$355.71
|
| Rate for Payer: Cofinity Commercial |
$331.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.02
|
| Rate for Payer: Healthscope Commercial |
$296.42
|
| Rate for Payer: Healthscope Whirlpool |
$296.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$259.37
|
| Rate for Payer: PACE SWMI |
$247.02
|
| Rate for Payer: PHP Medicare Advantage |
$247.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$294.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$397.44
|
| Rate for Payer: Priority Health Medicare |
$247.02
|
| Rate for Payer: Priority Health Narrow Network |
$397.44
|
| Rate for Payer: UHC Medicare Advantage |
$254.43
|
|
|
CHG US COMPL JOINT R-T W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 76881
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$763.39 |
| Rate for Payer: Aetna Commercial |
$70.62
|
| Rate for Payer: Aetna Commercial |
$70.62
|
| Rate for Payer: Aetna Medicare |
$52.70
|
| Rate for Payer: Aetna Medicare |
$52.70
|
| Rate for Payer: BCBS Complete |
$121.60
|
| Rate for Payer: BCBS Complete |
$33.60
|
| Rate for Payer: BCBS MAPPO |
$52.70
|
| Rate for Payer: BCBS MAPPO |
$52.70
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCBS Trust/PPO |
$763.39
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Commercial |
$78.68
|
| Rate for Payer: BCN Medicare Advantage |
$52.70
|
| Rate for Payer: BCN Medicare Advantage |
$52.70
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cofinity Commercial |
$75.89
|
| Rate for Payer: Cofinity Commercial |
$70.62
|
| Rate for Payer: Cofinity Commercial |
$70.62
|
| Rate for Payer: Cofinity Commercial |
$75.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.70
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Commercial |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$63.24
|
| Rate for Payer: Healthscope Whirlpool |
$63.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$55.34
|
| Rate for Payer: PACE SWMI |
$52.70
|
| Rate for Payer: PACE SWMI |
$52.70
|
| Rate for Payer: PHP Medicare Advantage |
$52.70
|
| Rate for Payer: PHP Medicare Advantage |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.46
|
| Rate for Payer: Priority Health Medicare |
$52.70
|
| Rate for Payer: Priority Health Medicare |
$52.70
|
| Rate for Payer: Priority Health Narrow Network |
$82.46
|
| Rate for Payer: Priority Health Narrow Network |
$82.46
|
| Rate for Payer: UHC Medicare Advantage |
$54.28
|
| Rate for Payer: UHC Medicare Advantage |
$54.28
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 76813
|
| Min. Negotiated Rate |
$112.51 |
| Max. Negotiated Rate |
$675.17 |
| Rate for Payer: Aetna Commercial |
$150.76
|
| Rate for Payer: Aetna Medicare |
$112.51
|
| Rate for Payer: BCBS Complete |
$114.40
|
| Rate for Payer: BCBS MAPPO |
$112.51
|
| Rate for Payer: BCBS Trust/PPO |
$675.17
|
| Rate for Payer: BCN Commercial |
$172.01
|
| Rate for Payer: BCN Medicare Advantage |
$112.51
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$150.76
|
| Rate for Payer: Cofinity Commercial |
$162.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.51
|
| Rate for Payer: Healthscope Commercial |
$135.01
|
| Rate for Payer: Healthscope Whirlpool |
$135.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.14
|
| Rate for Payer: PACE SWMI |
$112.51
|
| Rate for Payer: PHP Medicare Advantage |
$112.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.28
|
| Rate for Payer: Priority Health Medicare |
$112.51
|
| Rate for Payer: Priority Health Narrow Network |
$180.28
|
| Rate for Payer: UHC Medicare Advantage |
$115.89
|
|
|
CHG US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION
|
Professional
|
Both
|
$191.00
|
|
|
Service Code
|
HCPCS 76814
|
| Min. Negotiated Rate |
$72.31 |
| Max. Negotiated Rate |
$696.30 |
| Rate for Payer: Aetna Commercial |
$96.90
|
| Rate for Payer: Aetna Medicare |
$72.31
|
| Rate for Payer: BCBS Complete |
$76.40
|
| Rate for Payer: BCBS MAPPO |
$72.31
|
| Rate for Payer: BCBS Trust/PPO |
$696.30
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$72.31
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Cofinity Commercial |
$104.13
|
| Rate for Payer: Cofinity Commercial |
$96.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.31
|
| Rate for Payer: Healthscope Commercial |
$86.77
|
| Rate for Payer: Healthscope Whirlpool |
$86.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$75.93
|
| Rate for Payer: PACE SWMI |
$72.31
|
| Rate for Payer: PHP Medicare Advantage |
$72.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.73
|
| Rate for Payer: Priority Health Medicare |
$72.31
|
| Rate for Payer: Priority Health Narrow Network |
$114.73
|
| Rate for Payer: UHC Medicare Advantage |
$74.48
|
|
|
CHG US GUIDANCE AMNIOCENTESIS IMG S&I
|
Professional
|
Both
|
$314.00
|
|
|
Service Code
|
HCPCS 76946
|
| Min. Negotiated Rate |
$31.51 |
| Max. Negotiated Rate |
$219.80 |
| Rate for Payer: Aetna Commercial |
$42.22
|
| Rate for Payer: Aetna Medicare |
$31.51
|
| Rate for Payer: BCBS Complete |
$125.60
|
| Rate for Payer: BCBS MAPPO |
$31.51
|
| Rate for Payer: BCBS Trust/PPO |
$194.41
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Medicare Advantage |
$31.51
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cash Price |
$251.20
|
| Rate for Payer: Cofinity Commercial |
$45.37
|
| Rate for Payer: Cofinity Commercial |
$42.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.51
|
| Rate for Payer: Healthscope Commercial |
$37.81
|
| Rate for Payer: Healthscope Whirlpool |
$37.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.09
|
| Rate for Payer: PACE SWMI |
$31.51
|
| Rate for Payer: PHP Medicare Advantage |
$31.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$219.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.19
|
| Rate for Payer: Priority Health Medicare |
$31.51
|
| Rate for Payer: Priority Health Narrow Network |
$50.19
|
| Rate for Payer: UHC Medicare Advantage |
$32.46
|
|
|
CHG US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION
|
Professional
|
Both
|
$372.00
|
|
|
Service Code
|
HCPCS 76965
|
| Min. Negotiated Rate |
$90.45 |
| Max. Negotiated Rate |
$260.40 |
| Rate for Payer: Aetna Commercial |
$121.20
|
| Rate for Payer: Aetna Commercial |
$121.20
|
| Rate for Payer: Aetna Medicare |
$90.45
|
| Rate for Payer: Aetna Medicare |
$90.45
|
| Rate for Payer: BCBS Complete |
$104.80
|
| Rate for Payer: BCBS Complete |
$148.80
|
| Rate for Payer: BCBS MAPPO |
$90.45
|
| Rate for Payer: BCBS MAPPO |
$90.45
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCBS Trust/PPO |
$133.13
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Medicare Advantage |
$90.45
|
| Rate for Payer: BCN Medicare Advantage |
$90.45
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$297.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cash Price |
$209.60
|
| Rate for Payer: Cofinity Commercial |
$130.25
|
| Rate for Payer: Cofinity Commercial |
$121.20
|
| Rate for Payer: Cofinity Commercial |
$130.25
|
| Rate for Payer: Cofinity Commercial |
$121.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.45
|
| Rate for Payer: Healthscope Commercial |
$108.54
|
| Rate for Payer: Healthscope Commercial |
$108.54
|
| Rate for Payer: Healthscope Whirlpool |
$108.54
|
| Rate for Payer: Healthscope Whirlpool |
$108.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$94.97
|
| Rate for Payer: PACE SWMI |
$90.45
|
| Rate for Payer: PACE SWMI |
$90.45
|
| Rate for Payer: PHP Medicare Advantage |
$90.45
|
| Rate for Payer: PHP Medicare Advantage |
$90.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$260.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.90
|
| Rate for Payer: Priority Health Medicare |
$90.45
|
| Rate for Payer: Priority Health Medicare |
$90.45
|
| Rate for Payer: Priority Health Narrow Network |
$142.90
|
| Rate for Payer: Priority Health Narrow Network |
$142.90
|
| Rate for Payer: UHC Medicare Advantage |
$93.16
|
| Rate for Payer: UHC Medicare Advantage |
$93.16
|
|
|
CHG US GUIDANCE NEEDLE PLACEMENT IMG S&I
|
Professional
|
Both
|
$457.00
|
|
|
Service Code
|
HCPCS 76942
|
| Min. Negotiated Rate |
$56.02 |
| Max. Negotiated Rate |
$319.90 |
| Rate for Payer: Aetna Commercial |
$75.07
|
| Rate for Payer: Aetna Commercial |
$75.07
|
| Rate for Payer: Aetna Medicare |
$56.02
|
| Rate for Payer: Aetna Medicare |
$56.02
|
| Rate for Payer: BCBS Complete |
$182.80
|
| Rate for Payer: BCBS Complete |
$44.40
|
| Rate for Payer: BCBS MAPPO |
$56.02
|
| Rate for Payer: BCBS MAPPO |
$56.02
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCBS Trust/PPO |
$103.55
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: BCN Commercial |
$85.03
|
| Rate for Payer: BCN Medicare Advantage |
$56.02
|
| Rate for Payer: BCN Medicare Advantage |
$56.02
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$88.80
|
| Rate for Payer: Cash Price |
$365.60
|
| Rate for Payer: Cofinity Commercial |
$80.67
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Cofinity Commercial |
$80.67
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.02
|
| Rate for Payer: Healthscope Commercial |
$67.22
|
| Rate for Payer: Healthscope Commercial |
$67.22
|
| Rate for Payer: Healthscope Whirlpool |
$67.22
|
| Rate for Payer: Healthscope Whirlpool |
$67.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.82
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.82
|
| Rate for Payer: PACE SWMI |
$56.02
|
| Rate for Payer: PACE SWMI |
$56.02
|
| Rate for Payer: PHP Medicare Advantage |
$56.02
|
| Rate for Payer: PHP Medicare Advantage |
$56.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$319.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.11
|
| Rate for Payer: Priority Health Medicare |
$56.02
|
| Rate for Payer: Priority Health Medicare |
$56.02
|
| Rate for Payer: Priority Health Narrow Network |
$89.11
|
| Rate for Payer: Priority Health Narrow Network |
$89.11
|
| Rate for Payer: UHC Medicare Advantage |
$57.70
|
| Rate for Payer: UHC Medicare Advantage |
$57.70
|
|
|
CHG US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I
|
Professional
|
Both
|
$183.00
|
|
|
Service Code
|
HCPCS 76941
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$180.28 |
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: BCBS Complete |
$73.20
|
| Rate for Payer: BCBS Trust/PPO |
$145.81
|
| Rate for Payer: BCN Commercial |
$171.52
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Cash Price |
$146.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.28
|
| Rate for Payer: Priority Health Narrow Network |
$180.28
|
|
|
CHG US LMTD JT/FCL EVAL NONVASC XTR STRUX R-T W/IMG
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 76882
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$884.90 |
| Rate for Payer: Aetna Commercial |
$55.29
|
| Rate for Payer: Aetna Commercial |
$55.29
|
| Rate for Payer: Aetna Medicare |
$41.26
|
| Rate for Payer: Aetna Medicare |
$41.26
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCBS Complete |
$34.80
|
| Rate for Payer: BCBS MAPPO |
$41.26
|
| Rate for Payer: BCBS MAPPO |
$41.26
|
| Rate for Payer: BCBS Trust/PPO |
$884.90
|
| Rate for Payer: BCBS Trust/PPO |
$884.90
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Commercial |
$61.58
|
| Rate for Payer: BCN Medicare Advantage |
$41.26
|
| Rate for Payer: BCN Medicare Advantage |
$41.26
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cofinity Commercial |
$55.29
|
| Rate for Payer: Cofinity Commercial |
$55.29
|
| Rate for Payer: Cofinity Commercial |
$59.41
|
| Rate for Payer: Cofinity Commercial |
$59.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.26
|
| Rate for Payer: Healthscope Commercial |
$49.51
|
| Rate for Payer: Healthscope Commercial |
$49.51
|
| Rate for Payer: Healthscope Whirlpool |
$49.51
|
| Rate for Payer: Healthscope Whirlpool |
$49.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.32
|
| Rate for Payer: PACE SWMI |
$41.26
|
| Rate for Payer: PACE SWMI |
$41.26
|
| Rate for Payer: PHP Medicare Advantage |
$41.26
|
| Rate for Payer: PHP Medicare Advantage |
$41.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.54
|
| Rate for Payer: Priority Health Medicare |
$41.26
|
| Rate for Payer: Priority Health Medicare |
$41.26
|
| Rate for Payer: Priority Health Narrow Network |
$64.54
|
| Rate for Payer: Priority Health Narrow Network |
$64.54
|
| Rate for Payer: UHC Medicare Advantage |
$42.50
|
| Rate for Payer: UHC Medicare Advantage |
$42.50
|
|
|
CHG US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U
|
Professional
|
Both
|
$221.00
|
|
|
Service Code
|
HCPCS 76857
|
| Min. Negotiated Rate |
$46.75 |
| Max. Negotiated Rate |
$839.47 |
| Rate for Payer: Aetna Commercial |
$62.64
|
| Rate for Payer: Aetna Medicare |
$46.75
|
| Rate for Payer: BCBS Complete |
$88.40
|
| Rate for Payer: BCBS MAPPO |
$46.75
|
| Rate for Payer: BCBS Trust/PPO |
$839.47
|
| Rate for Payer: BCN Commercial |
$71.35
|
| Rate for Payer: BCN Medicare Advantage |
$46.75
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cash Price |
$176.80
|
| Rate for Payer: Cofinity Commercial |
$67.32
|
| Rate for Payer: Cofinity Commercial |
$62.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.75
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Healthscope Whirlpool |
$56.10
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.09
|
| Rate for Payer: PACE SWMI |
$46.75
|
| Rate for Payer: PHP Medicare Advantage |
$46.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$74.78
|
| Rate for Payer: Priority Health Medicare |
$46.75
|
| Rate for Payer: Priority Health Narrow Network |
$74.78
|
| Rate for Payer: UHC Medicare Advantage |
$48.15
|
|
|
CHG US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE
|
Professional
|
Both
|
$295.00
|
|
|
Service Code
|
HCPCS 76856
|
| Min. Negotiated Rate |
$100.53 |
| Max. Negotiated Rate |
$764.98 |
| Rate for Payer: Aetna Commercial |
$134.71
|
| Rate for Payer: Aetna Medicare |
$100.53
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS MAPPO |
$100.53
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$155.40
|
| Rate for Payer: BCN Medicare Advantage |
$100.53
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$144.76
|
| Rate for Payer: Cofinity Commercial |
$134.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.53
|
| Rate for Payer: Healthscope Commercial |
$120.64
|
| Rate for Payer: Healthscope Whirlpool |
$120.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$105.56
|
| Rate for Payer: PACE SWMI |
$100.53
|
| Rate for Payer: PHP Medicare Advantage |
$100.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$162.87
|
| Rate for Payer: Priority Health Medicare |
$100.53
|
| Rate for Payer: Priority Health Narrow Network |
$162.87
|
| Rate for Payer: UHC Medicare Advantage |
$103.55
|
|
|
CHG US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 76801
|
| Min. Negotiated Rate |
$111.60 |
| Max. Negotiated Rate |
$269.43 |
| Rate for Payer: Aetna Commercial |
$150.82
|
| Rate for Payer: Aetna Medicare |
$112.55
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: BCBS MAPPO |
$112.55
|
| Rate for Payer: BCBS Trust/PPO |
$269.43
|
| Rate for Payer: BCN Commercial |
$172.99
|
| Rate for Payer: BCN Medicare Advantage |
$112.55
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$150.82
|
| Rate for Payer: Cofinity Commercial |
$162.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.55
|
| Rate for Payer: Healthscope Commercial |
$135.06
|
| Rate for Payer: Healthscope Whirlpool |
$135.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$118.18
|
| Rate for Payer: PACE SWMI |
$112.55
|
| Rate for Payer: PHP Medicare Advantage |
$112.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.31
|
| Rate for Payer: Priority Health Medicare |
$112.55
|
| Rate for Payer: Priority Health Narrow Network |
$181.31
|
| Rate for Payer: UHC Medicare Advantage |
$115.93
|
|
|
CHG US PREGNANT UTERUS LIMITED 1/> FETUSES
|
Professional
|
Both
|
$260.00
|
|
|
Service Code
|
HCPCS 76815
|
| Min. Negotiated Rate |
$77.87 |
| Max. Negotiated Rate |
$182.00 |
| Rate for Payer: Aetna Commercial |
$104.35
|
| Rate for Payer: Aetna Medicare |
$77.87
|
| Rate for Payer: BCBS Complete |
$104.00
|
| Rate for Payer: BCBS MAPPO |
$77.87
|
| Rate for Payer: BCBS Trust/PPO |
$160.60
|
| Rate for Payer: BCN Commercial |
$119.72
|
| Rate for Payer: BCN Medicare Advantage |
$77.87
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cofinity Commercial |
$112.13
|
| Rate for Payer: Cofinity Commercial |
$104.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.87
|
| Rate for Payer: Healthscope Commercial |
$93.44
|
| Rate for Payer: Healthscope Whirlpool |
$93.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$81.76
|
| Rate for Payer: PACE SWMI |
$77.87
|
| Rate for Payer: PHP Medicare Advantage |
$77.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.48
|
| Rate for Payer: Priority Health Medicare |
$77.87
|
| Rate for Payer: Priority Health Narrow Network |
$125.48
|
| Rate for Payer: UHC Medicare Advantage |
$80.21
|
|
|
CHG US PREG UTERUS 14 WK TRANSABDL EACH GESTATION
|
Professional
|
Both
|
$140.00
|
|
|
Service Code
|
HCPCS 76802
|
| Min. Negotiated Rate |
$56.00 |
| Max. Negotiated Rate |
$304.83 |
| Rate for Payer: Aetna Commercial |
$79.35
|
| Rate for Payer: Aetna Medicare |
$59.22
|
| Rate for Payer: BCBS Complete |
$56.00
|
| Rate for Payer: BCBS MAPPO |
$59.22
|
| Rate for Payer: BCBS Trust/PPO |
$304.83
|
| Rate for Payer: BCN Commercial |
$89.43
|
| Rate for Payer: BCN Medicare Advantage |
$59.22
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$79.35
|
| Rate for Payer: Cofinity Commercial |
$85.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.22
|
| Rate for Payer: Healthscope Commercial |
$71.06
|
| Rate for Payer: Healthscope Whirlpool |
$71.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.18
|
| Rate for Payer: PACE SWMI |
$59.22
|
| Rate for Payer: PHP Medicare Advantage |
$59.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$93.72
|
| Rate for Payer: Priority Health Medicare |
$59.22
|
| Rate for Payer: Priority Health Narrow Network |
$93.72
|
| Rate for Payer: UHC Medicare Advantage |
$61.00
|
|
|
CHG US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO
|
Professional
|
Both
|
$415.00
|
|
|
Service Code
|
HCPCS 76810
|
| Min. Negotiated Rate |
$85.04 |
| Max. Negotiated Rate |
$290.50 |
| Rate for Payer: Aetna Commercial |
$113.95
|
| Rate for Payer: Aetna Medicare |
$85.04
|
| Rate for Payer: BCBS Complete |
$166.00
|
| Rate for Payer: BCBS MAPPO |
$85.04
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$129.50
|
| Rate for Payer: BCN Medicare Advantage |
$85.04
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cash Price |
$332.00
|
| Rate for Payer: Cofinity Commercial |
$122.46
|
| Rate for Payer: Cofinity Commercial |
$113.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.04
|
| Rate for Payer: Healthscope Commercial |
$102.05
|
| Rate for Payer: Healthscope Whirlpool |
$102.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$89.29
|
| Rate for Payer: PACE SWMI |
$85.04
|
| Rate for Payer: PHP Medicare Advantage |
$85.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$290.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.72
|
| Rate for Payer: Priority Health Medicare |
$85.04
|
| Rate for Payer: Priority Health Narrow Network |
$135.72
|
| Rate for Payer: UHC Medicare Advantage |
$87.59
|
|
|
CHG US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION
|
Professional
|
Both
|
$354.00
|
|
|
Service Code
|
HCPCS 76805
|
| Min. Negotiated Rate |
$129.28 |
| Max. Negotiated Rate |
$362.41 |
| Rate for Payer: Aetna Commercial |
$173.24
|
| Rate for Payer: Aetna Medicare |
$129.28
|
| Rate for Payer: BCBS Complete |
$141.60
|
| Rate for Payer: BCBS MAPPO |
$129.28
|
| Rate for Payer: BCBS Trust/PPO |
$362.41
|
| Rate for Payer: BCN Commercial |
$199.38
|
| Rate for Payer: BCN Medicare Advantage |
$129.28
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cash Price |
$283.20
|
| Rate for Payer: Cofinity Commercial |
$186.16
|
| Rate for Payer: Cofinity Commercial |
$173.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.28
|
| Rate for Payer: Healthscope Commercial |
$155.14
|
| Rate for Payer: Healthscope Whirlpool |
$155.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$135.74
|
| Rate for Payer: PACE SWMI |
$129.28
|
| Rate for Payer: PHP Medicare Advantage |
$129.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$247.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$208.96
|
| Rate for Payer: Priority Health Medicare |
$129.28
|
| Rate for Payer: Priority Health Narrow Network |
$208.96
|
| Rate for Payer: UHC Medicare Advantage |
$133.16
|
|
|
CHG US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT
|
Professional
|
Both
|
$339.00
|
|
|
Service Code
|
HCPCS 76812
|
| Min. Negotiated Rate |
$135.60 |
| Max. Negotiated Rate |
$294.49 |
| Rate for Payer: Aetna Commercial |
$245.50
|
| Rate for Payer: Aetna Medicare |
$183.21
|
| Rate for Payer: BCBS Complete |
$135.60
|
| Rate for Payer: BCBS MAPPO |
$183.21
|
| Rate for Payer: BCBS Trust/PPO |
$136.83
|
| Rate for Payer: BCN Commercial |
$280.99
|
| Rate for Payer: BCN Medicare Advantage |
$183.21
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cash Price |
$271.20
|
| Rate for Payer: Cofinity Commercial |
$263.82
|
| Rate for Payer: Cofinity Commercial |
$245.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.21
|
| Rate for Payer: Healthscope Commercial |
$219.85
|
| Rate for Payer: Healthscope Whirlpool |
$219.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$192.37
|
| Rate for Payer: PACE SWMI |
$183.21
|
| Rate for Payer: PHP Medicare Advantage |
$183.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$294.49
|
| Rate for Payer: Priority Health Medicare |
$183.21
|
| Rate for Payer: Priority Health Narrow Network |
$294.49
|
| Rate for Payer: UHC Medicare Advantage |
$188.71
|
|
|
CHG US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS
|
Professional
|
Both
|
$217.00
|
|
|
Service Code
|
HCPCS 76816
|
| Min. Negotiated Rate |
$86.80 |
| Max. Negotiated Rate |
$773.43 |
| Rate for Payer: Aetna Commercial |
$139.76
|
| Rate for Payer: Aetna Medicare |
$104.30
|
| Rate for Payer: BCBS Complete |
$86.80
|
| Rate for Payer: BCBS MAPPO |
$104.30
|
| Rate for Payer: BCBS Trust/PPO |
$773.43
|
| Rate for Payer: BCN Commercial |
$160.77
|
| Rate for Payer: BCN Medicare Advantage |
$104.30
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cash Price |
$173.60
|
| Rate for Payer: Cofinity Commercial |
$150.19
|
| Rate for Payer: Cofinity Commercial |
$139.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.30
|
| Rate for Payer: Healthscope Commercial |
$125.16
|
| Rate for Payer: Healthscope Whirlpool |
$125.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$109.52
|
| Rate for Payer: PACE SWMI |
$104.30
|
| Rate for Payer: PHP Medicare Advantage |
$104.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$168.50
|
| Rate for Payer: Priority Health Medicare |
$104.30
|
| Rate for Payer: Priority Health Narrow Network |
$168.50
|
| Rate for Payer: UHC Medicare Advantage |
$107.43
|
|
|
CHG US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 76817
|
| Min. Negotiated Rate |
$88.67 |
| Max. Negotiated Rate |
$432.68 |
| Rate for Payer: Aetna Commercial |
$118.82
|
| Rate for Payer: Aetna Medicare |
$88.67
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: BCBS MAPPO |
$88.67
|
| Rate for Payer: BCBS Trust/PPO |
$432.68
|
| Rate for Payer: BCN Commercial |
$136.35
|
| Rate for Payer: BCN Medicare Advantage |
$88.67
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cofinity Commercial |
$127.68
|
| Rate for Payer: Cofinity Commercial |
$118.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.67
|
| Rate for Payer: Healthscope Commercial |
$106.40
|
| Rate for Payer: Healthscope Whirlpool |
$106.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$93.10
|
| Rate for Payer: PACE SWMI |
$88.67
|
| Rate for Payer: PHP Medicare Advantage |
$88.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.90
|
| Rate for Payer: Priority Health Medicare |
$88.67
|
| Rate for Payer: Priority Health Narrow Network |
$142.90
|
| Rate for Payer: UHC Medicare Advantage |
$91.33
|
|
|
CHG US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 76811
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$269.92 |
| Rate for Payer: Aetna Commercial |
$226.29
|
| Rate for Payer: Aetna Medicare |
$168.87
|
| Rate for Payer: BCBS Complete |
$148.40
|
| Rate for Payer: BCBS MAPPO |
$168.87
|
| Rate for Payer: BCBS Trust/PPO |
$183.32
|
| Rate for Payer: BCN Commercial |
$257.53
|
| Rate for Payer: BCN Medicare Advantage |
$168.87
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$243.17
|
| Rate for Payer: Cofinity Commercial |
$226.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$168.87
|
| Rate for Payer: Healthscope Commercial |
$202.64
|
| Rate for Payer: Healthscope Whirlpool |
$202.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$177.31
|
| Rate for Payer: PACE SWMI |
$168.87
|
| Rate for Payer: PHP Medicare Advantage |
$168.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$259.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$269.92
|
| Rate for Payer: Priority Health Medicare |
$168.87
|
| Rate for Payer: Priority Health Narrow Network |
$269.92
|
| Rate for Payer: UHC Medicare Advantage |
$173.94
|
|
|
CHG US RETROPERITONEAL REAL TIME W/IMAGE LIMITED
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 76775
|
| Min. Negotiated Rate |
$56.67 |
| Max. Negotiated Rate |
$2,427.54 |
| Rate for Payer: Aetna Commercial |
$75.94
|
| Rate for Payer: Aetna Medicare |
$56.67
|
| Rate for Payer: BCBS Complete |
$76.00
|
| Rate for Payer: BCBS MAPPO |
$56.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,427.54
|
| Rate for Payer: BCN Commercial |
$86.50
|
| Rate for Payer: BCN Medicare Advantage |
$56.67
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$75.94
|
| Rate for Payer: Cofinity Commercial |
$81.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.67
|
| Rate for Payer: Healthscope Commercial |
$68.00
|
| Rate for Payer: Healthscope Whirlpool |
$68.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$59.50
|
| Rate for Payer: PACE SWMI |
$56.67
|
| Rate for Payer: PHP Medicare Advantage |
$56.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$90.65
|
| Rate for Payer: Priority Health Medicare |
$56.67
|
| Rate for Payer: Priority Health Narrow Network |
$90.65
|
| Rate for Payer: UHC Medicare Advantage |
$58.37
|
|
|
CHG US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM
|
Professional
|
Both
|
$100.00
|
|
|
Service Code
|
HCPCS 76536
|
| Min. Negotiated Rate |
$40.00 |
| Max. Negotiated Rate |
$1,090.94 |
| Rate for Payer: Aetna Commercial |
$141.22
|
| Rate for Payer: Aetna Commercial |
$141.22
|
| Rate for Payer: Aetna Medicare |
$105.39
|
| Rate for Payer: Aetna Medicare |
$105.39
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: BCBS Complete |
$89.20
|
| Rate for Payer: BCBS MAPPO |
$105.39
|
| Rate for Payer: BCBS MAPPO |
$105.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,090.94
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Commercial |
$163.71
|
| Rate for Payer: BCN Medicare Advantage |
$105.39
|
| Rate for Payer: BCN Medicare Advantage |
$105.39
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$178.40
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Cofinity Commercial |
$141.22
|
| Rate for Payer: Cofinity Commercial |
$141.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$105.39
|
| Rate for Payer: Healthscope Commercial |
$126.47
|
| Rate for Payer: Healthscope Commercial |
$126.47
|
| Rate for Payer: Healthscope Whirlpool |
$126.47
|
| Rate for Payer: Healthscope Whirlpool |
$126.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$110.66
|
| Rate for Payer: PACE SWMI |
$105.39
|
| Rate for Payer: PACE SWMI |
$105.39
|
| Rate for Payer: PHP Medicare Advantage |
$105.39
|
| Rate for Payer: PHP Medicare Advantage |
$105.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.57
|
| Rate for Payer: Priority Health Medicare |
$105.39
|
| Rate for Payer: Priority Health Medicare |
$105.39
|
| Rate for Payer: Priority Health Narrow Network |
$171.57
|
| Rate for Payer: Priority Health Narrow Network |
$171.57
|
| Rate for Payer: UHC Medicare Advantage |
$108.55
|
| Rate for Payer: UHC Medicare Advantage |
$108.55
|
|
|
CHG US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 76873
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$669.36 |
| Rate for Payer: Aetna Commercial |
$223.22
|
| Rate for Payer: Aetna Medicare |
$166.58
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: BCBS MAPPO |
$166.58
|
| Rate for Payer: BCBS Trust/PPO |
$669.36
|
| Rate for Payer: BCN Commercial |
$255.58
|
| Rate for Payer: BCN Medicare Advantage |
$166.58
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$239.88
|
| Rate for Payer: Cofinity Commercial |
$223.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$166.58
|
| Rate for Payer: Healthscope Commercial |
$199.90
|
| Rate for Payer: Healthscope Whirlpool |
$199.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$174.91
|
| Rate for Payer: PACE SWMI |
$166.58
|
| Rate for Payer: PHP Medicare Advantage |
$166.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$267.86
|
| Rate for Payer: Priority Health Medicare |
$166.58
|
| Rate for Payer: Priority Health Narrow Network |
$267.86
|
| Rate for Payer: UHC Medicare Advantage |
$171.58
|
|
