|
CHEST PAIN
|
Facility
|
IP
|
$4,054.97
|
|
|
Service Code
|
APR-DRG 2031
|
| Min. Negotiated Rate |
$3,666.18 |
| Max. Negotiated Rate |
$4,054.97 |
| Rate for Payer: BCBS Complete |
$4,054.97
|
| Rate for Payer: Mclaren Medicaid |
$3,861.88
|
| Rate for Payer: Meridian Medicaid |
$4,054.97
|
| Rate for Payer: PHP Medicaid |
$3,666.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,861.88
|
| Rate for Payer: UHC Medicaid |
$3,861.88
|
| Rate for Payer: UHCCP Medicaid |
$3,861.88
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$5,108.36
|
|
|
Service Code
|
APR-DRG 2033
|
| Min. Negotiated Rate |
$4,618.57 |
| Max. Negotiated Rate |
$5,108.36 |
| Rate for Payer: BCBS Complete |
$5,108.36
|
| Rate for Payer: Mclaren Medicaid |
$4,865.11
|
| Rate for Payer: Meridian Medicaid |
$5,108.36
|
| Rate for Payer: PHP Medicaid |
$4,618.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,865.11
|
| Rate for Payer: UHC Medicaid |
$4,865.11
|
| Rate for Payer: UHCCP Medicaid |
$4,865.11
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$8,402.58
|
|
|
Service Code
|
APR-DRG 2034
|
| Min. Negotiated Rate |
$7,596.94 |
| Max. Negotiated Rate |
$8,402.58 |
| Rate for Payer: BCBS Complete |
$8,402.58
|
| Rate for Payer: Mclaren Medicaid |
$8,002.46
|
| Rate for Payer: Meridian Medicaid |
$8,402.58
|
| Rate for Payer: PHP Medicaid |
$7,596.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,002.46
|
| Rate for Payer: UHC Medicaid |
$8,002.46
|
| Rate for Payer: UHCCP Medicaid |
$8,002.46
|
|
|
CHG 3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS
|
Professional
|
Both
|
$1,414.00
|
|
|
Service Code
|
HCPCS 77295
|
| Min. Negotiated Rate |
$457.04 |
| Max. Negotiated Rate |
$1,060.50 |
| Rate for Payer: Aetna Commercial |
$612.43
|
| Rate for Payer: Aetna Commercial |
$612.43
|
| Rate for Payer: Aetna Medicare |
$457.04
|
| Rate for Payer: Aetna Medicare |
$457.04
|
| Rate for Payer: BCBS MAPPO |
$457.04
|
| Rate for Payer: BCBS MAPPO |
$457.04
|
| Rate for Payer: BCN Commercial |
$707.55
|
| Rate for Payer: BCN Commercial |
$707.55
|
| Rate for Payer: BCN Medicare Advantage |
$457.04
|
| Rate for Payer: BCN Medicare Advantage |
$457.04
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cash Price |
$1,131.20
|
| Rate for Payer: Cash Price |
$1,440.00
|
| Rate for Payer: Cofinity Commercial |
$612.43
|
| Rate for Payer: Cofinity Commercial |
$658.14
|
| Rate for Payer: Cofinity Commercial |
$612.43
|
| Rate for Payer: Cofinity Commercial |
$658.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$457.04
|
| Rate for Payer: Healthscope Commercial |
$548.45
|
| Rate for Payer: Healthscope Commercial |
$548.45
|
| Rate for Payer: Healthscope Whirlpool |
$548.45
|
| Rate for Payer: Healthscope Whirlpool |
$548.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$479.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$502.74
|
| Rate for Payer: Nomi Health Commercial |
$548.45
|
| Rate for Payer: Nomi Health Commercial |
$548.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,350.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,060.50
|
| Rate for Payer: PACE SWMI |
$457.04
|
| Rate for Payer: PACE SWMI |
$457.04
|
| Rate for Payer: PHP Medicare Advantage |
$457.04
|
| Rate for Payer: PHP Medicare Advantage |
$457.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$732.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$732.03
|
| Rate for Payer: Priority Health Medicare |
$457.04
|
| Rate for Payer: Priority Health Medicare |
$457.04
|
| Rate for Payer: Priority Health Narrow Network |
$732.03
|
| Rate for Payer: Priority Health Narrow Network |
$732.03
|
| Rate for Payer: Railroad Medicare Medicare |
$457.04
|
| Rate for Payer: Railroad Medicare Medicare |
$457.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$699.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$699.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$457.04
|
| Rate for Payer: UHC Exchange |
$699.09
|
| Rate for Payer: UHC Exchange |
$699.09
|
| Rate for Payer: UHCCP DNSP |
$457.04
|
| Rate for Payer: UHCCP DNSP |
$457.04
|
|
|
CHG 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION
|
Professional
|
Both
|
$141.00
|
|
|
Service Code
|
HCPCS 76377
|
| Min. Negotiated Rate |
$74.71 |
| Max. Negotiated Rate |
$119.40 |
| Rate for Payer: Aetna Commercial |
$100.11
|
| Rate for Payer: Aetna Medicare |
$74.71
|
| Rate for Payer: BCBS MAPPO |
$74.71
|
| Rate for Payer: BCN Commercial |
$118.52
|
| Rate for Payer: BCN Medicare Advantage |
$74.71
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cash Price |
$112.80
|
| Rate for Payer: Cofinity Commercial |
$100.11
|
| Rate for Payer: Cofinity Commercial |
$107.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.71
|
| Rate for Payer: Healthscope Commercial |
$89.65
|
| Rate for Payer: Healthscope Whirlpool |
$89.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.18
|
| Rate for Payer: Nomi Health Commercial |
$89.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.75
|
| Rate for Payer: PACE SWMI |
$74.71
|
| Rate for Payer: PHP Medicare Advantage |
$74.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$119.40
|
| Rate for Payer: Priority Health Medicare |
$74.71
|
| Rate for Payer: Priority Health Narrow Network |
$119.40
|
| Rate for Payer: Railroad Medicare Medicare |
$74.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$103.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$74.71
|
| Rate for Payer: UHC Exchange |
$103.69
|
| Rate for Payer: UHCCP DNSP |
$74.71
|
|
|
CHG 3D RENDERING W/INTERP & POSTPROCESS SUPERVISION
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 76376
|
| Min. Negotiated Rate |
$23.90 |
| Max. Negotiated Rate |
$38.64 |
| Rate for Payer: Aetna Commercial |
$32.03
|
| Rate for Payer: Aetna Commercial |
$32.03
|
| Rate for Payer: Aetna Medicare |
$23.90
|
| Rate for Payer: Aetna Medicare |
$23.90
|
| Rate for Payer: BCBS MAPPO |
$23.90
|
| Rate for Payer: BCBS MAPPO |
$23.90
|
| Rate for Payer: BCN Commercial |
$38.34
|
| Rate for Payer: BCN Commercial |
$38.34
|
| Rate for Payer: BCN Medicare Advantage |
$23.90
|
| Rate for Payer: BCN Medicare Advantage |
$23.90
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$34.42
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Cofinity Commercial |
$34.42
|
| Rate for Payer: Cofinity Commercial |
$32.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.90
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Healthscope Whirlpool |
$28.68
|
| Rate for Payer: Healthscope Whirlpool |
$28.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.29
|
| Rate for Payer: Nomi Health Commercial |
$28.68
|
| Rate for Payer: Nomi Health Commercial |
$28.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$23.90
|
| Rate for Payer: PACE SWMI |
$23.90
|
| Rate for Payer: PHP Medicare Advantage |
$23.90
|
| Rate for Payer: PHP Medicare Advantage |
$23.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$38.64
|
| Rate for Payer: Priority Health Medicare |
$23.90
|
| Rate for Payer: Priority Health Medicare |
$23.90
|
| Rate for Payer: Priority Health Narrow Network |
$38.64
|
| Rate for Payer: Priority Health Narrow Network |
$38.64
|
| Rate for Payer: Railroad Medicare Medicare |
$23.90
|
| Rate for Payer: Railroad Medicare Medicare |
$23.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.90
|
| Rate for Payer: UHC Exchange |
$32.97
|
| Rate for Payer: UHC Exchange |
$32.97
|
| Rate for Payer: UHCCP DNSP |
$23.90
|
| Rate for Payer: UHCCP DNSP |
$23.90
|
|
|
CHG ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING
|
Professional
|
Both
|
$707.00
|
|
|
Service Code
|
HCPCS 78278
|
| Min. Negotiated Rate |
$282.57 |
| Max. Negotiated Rate |
$530.25 |
| Rate for Payer: Aetna Commercial |
$378.64
|
| Rate for Payer: Aetna Medicare |
$282.57
|
| Rate for Payer: BCBS MAPPO |
$282.57
|
| Rate for Payer: BCN Commercial |
$466.61
|
| Rate for Payer: BCN Medicare Advantage |
$282.57
|
| Rate for Payer: Cash Price |
$565.60
|
| Rate for Payer: Cash Price |
$565.60
|
| Rate for Payer: Cofinity Commercial |
$406.90
|
| Rate for Payer: Cofinity Commercial |
$378.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$282.57
|
| Rate for Payer: Healthscope Commercial |
$339.08
|
| Rate for Payer: Healthscope Whirlpool |
$339.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$296.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$310.83
|
| Rate for Payer: Nomi Health Commercial |
$339.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$530.25
|
| Rate for Payer: PACE SWMI |
$282.57
|
| Rate for Payer: PHP Medicare Advantage |
$282.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$470.13
|
| Rate for Payer: Priority Health Medicare |
$282.57
|
| Rate for Payer: Priority Health Narrow Network |
$470.13
|
| Rate for Payer: Railroad Medicare Medicare |
$282.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$495.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$282.57
|
| Rate for Payer: UHC Exchange |
$495.20
|
| Rate for Payer: UHCCP DNSP |
$282.57
|
|
|
CHG ANGIO ARCH ANGIOGRAM W CATH
|
Professional
|
Both
|
$275.00
|
|
|
Service Code
|
HCPCS 75650
|
| Min. Negotiated Rate |
$110.00 |
| Max. Negotiated Rate |
$206.25 |
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.25
|
|
|
CHG ANGIO AV SHUNT COMPLETE EVAL
|
Professional
|
Both
|
$317.00
|
|
|
Service Code
|
HCPCS 75791
|
| Min. Negotiated Rate |
$126.80 |
| Max. Negotiated Rate |
$237.75 |
| Rate for Payer: BCBS Complete |
$126.80
|
| Rate for Payer: BCBS Complete |
$208.80
|
| Rate for Payer: Cash Price |
$417.60
|
| Rate for Payer: Cash Price |
$253.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$391.50
|
|
|
CHG ANGIOGRAPHY EXTREMITY BILATERAL RS&I
|
Professional
|
Both
|
$204.00
|
|
|
Service Code
|
HCPCS 75716
|
| Min. Negotiated Rate |
$153.00 |
| Max. Negotiated Rate |
$252.85 |
| Rate for Payer: Aetna Commercial |
$208.71
|
| Rate for Payer: Aetna Medicare |
$155.75
|
| Rate for Payer: BCBS MAPPO |
$155.75
|
| Rate for Payer: BCN Commercial |
$242.52
|
| Rate for Payer: BCN Medicare Advantage |
$155.75
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cash Price |
$163.20
|
| Rate for Payer: Cofinity Commercial |
$208.71
|
| Rate for Payer: Cofinity Commercial |
$224.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.75
|
| Rate for Payer: Healthscope Commercial |
$186.90
|
| Rate for Payer: Healthscope Whirlpool |
$186.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.32
|
| Rate for Payer: Nomi Health Commercial |
$186.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$153.00
|
| Rate for Payer: PACE SWMI |
$155.75
|
| Rate for Payer: PHP Medicare Advantage |
$155.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$244.35
|
| Rate for Payer: Priority Health Medicare |
$155.75
|
| Rate for Payer: Priority Health Narrow Network |
$244.35
|
| Rate for Payer: Railroad Medicare Medicare |
$155.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$252.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.75
|
| Rate for Payer: UHC Exchange |
$252.85
|
| Rate for Payer: UHCCP DNSP |
$155.75
|
|
|
CHG ANGIOGRAPHY EXTREMITY UNILATERAL RS&I
|
Professional
|
Both
|
$443.00
|
|
|
Service Code
|
HCPCS 75710
|
| Min. Negotiated Rate |
$143.09 |
| Max. Negotiated Rate |
$332.25 |
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Commercial |
$191.74
|
| Rate for Payer: Aetna Medicare |
$143.09
|
| Rate for Payer: Aetna Medicare |
$143.09
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCBS MAPPO |
$143.09
|
| Rate for Payer: BCN Commercial |
$221.10
|
| Rate for Payer: BCN Commercial |
$221.10
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: BCN Medicare Advantage |
$143.09
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$354.40
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Cofinity Commercial |
$206.05
|
| Rate for Payer: Cofinity Commercial |
$191.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.09
|
| Rate for Payer: Healthscope Commercial |
$171.71
|
| Rate for Payer: Healthscope Commercial |
$171.71
|
| Rate for Payer: Healthscope Whirlpool |
$171.71
|
| Rate for Payer: Healthscope Whirlpool |
$171.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$157.40
|
| Rate for Payer: Nomi Health Commercial |
$171.71
|
| Rate for Payer: Nomi Health Commercial |
$171.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$140.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.25
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PACE SWMI |
$143.09
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: PHP Medicare Advantage |
$143.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$222.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$222.77
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health Medicare |
$143.09
|
| Rate for Payer: Priority Health Narrow Network |
$222.77
|
| Rate for Payer: Priority Health Narrow Network |
$222.77
|
| Rate for Payer: Railroad Medicare Medicare |
$143.09
|
| Rate for Payer: Railroad Medicare Medicare |
$143.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$143.09
|
| Rate for Payer: UHC Exchange |
$236.69
|
| Rate for Payer: UHC Exchange |
$236.69
|
| Rate for Payer: UHCCP DNSP |
$143.09
|
| Rate for Payer: UHCCP DNSP |
$143.09
|
|
|
CHG ANGIOGRAPHY INTERNAL MAMMARY RS&I
|
Professional
|
Both
|
$196.00
|
|
|
Service Code
|
HCPCS 75756
|
| Min. Negotiated Rate |
$147.00 |
| Max. Negotiated Rate |
$244.35 |
| Rate for Payer: Aetna Commercial |
$210.50
|
| Rate for Payer: Aetna Medicare |
$157.09
|
| Rate for Payer: BCBS MAPPO |
$157.09
|
| Rate for Payer: BCN Commercial |
$242.52
|
| Rate for Payer: BCN Medicare Advantage |
$157.09
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cash Price |
$156.80
|
| Rate for Payer: Cofinity Commercial |
$210.50
|
| Rate for Payer: Cofinity Commercial |
$226.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.09
|
| Rate for Payer: Healthscope Commercial |
$188.51
|
| Rate for Payer: Healthscope Whirlpool |
$188.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$172.80
|
| Rate for Payer: Nomi Health Commercial |
$188.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.00
|
| Rate for Payer: PACE SWMI |
$157.09
|
| Rate for Payer: PHP Medicare Advantage |
$157.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$244.35
|
| Rate for Payer: Priority Health Medicare |
$157.09
|
| Rate for Payer: Priority Health Narrow Network |
$244.35
|
| Rate for Payer: Railroad Medicare Medicare |
$157.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$157.09
|
| Rate for Payer: UHC Exchange |
$233.00
|
| Rate for Payer: UHCCP DNSP |
$157.09
|
|
|
CHG ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I
|
Professional
|
Both
|
$329.00
|
|
|
Service Code
|
HCPCS 75736
|
| Min. Negotiated Rate |
$134.84 |
| Max. Negotiated Rate |
$246.75 |
| Rate for Payer: Aetna Commercial |
$180.69
|
| Rate for Payer: Aetna Medicare |
$134.84
|
| Rate for Payer: BCBS MAPPO |
$134.84
|
| Rate for Payer: BCN Commercial |
$215.63
|
| Rate for Payer: BCN Medicare Advantage |
$134.84
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cash Price |
$263.20
|
| Rate for Payer: Cofinity Commercial |
$180.69
|
| Rate for Payer: Cofinity Commercial |
$194.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$134.84
|
| Rate for Payer: Healthscope Commercial |
$161.81
|
| Rate for Payer: Healthscope Whirlpool |
$161.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$141.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$148.32
|
| Rate for Payer: Nomi Health Commercial |
$161.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.75
|
| Rate for Payer: PACE SWMI |
$134.84
|
| Rate for Payer: PHP Medicare Advantage |
$134.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$217.25
|
| Rate for Payer: Priority Health Medicare |
$134.84
|
| Rate for Payer: Priority Health Narrow Network |
$217.25
|
| Rate for Payer: Railroad Medicare Medicare |
$134.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$214.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$134.84
|
| Rate for Payer: UHC Exchange |
$214.67
|
| Rate for Payer: UHCCP DNSP |
$134.84
|
|
|
CHG ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 75741
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$204.59 |
| Rate for Payer: Aetna Commercial |
$162.56
|
| Rate for Payer: Aetna Medicare |
$121.31
|
| Rate for Payer: BCBS MAPPO |
$121.31
|
| Rate for Payer: BCN Commercial |
$192.72
|
| Rate for Payer: BCN Medicare Advantage |
$121.31
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$162.56
|
| Rate for Payer: Cofinity Commercial |
$174.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.31
|
| Rate for Payer: Healthscope Commercial |
$145.57
|
| Rate for Payer: Healthscope Whirlpool |
$145.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$133.44
|
| Rate for Payer: Nomi Health Commercial |
$145.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$121.31
|
| Rate for Payer: PHP Medicare Advantage |
$121.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$194.17
|
| Rate for Payer: Priority Health Medicare |
$121.31
|
| Rate for Payer: Priority Health Narrow Network |
$194.17
|
| Rate for Payer: Railroad Medicare Medicare |
$121.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.31
|
| Rate for Payer: UHC Exchange |
$204.59
|
| Rate for Payer: UHCCP DNSP |
$121.31
|
|
|
CHG ANGIOGRAPHY SPINAL SELECTIVE RS&I
|
Professional
|
Both
|
$449.00
|
|
|
Service Code
|
HCPCS 75705
|
| Min. Negotiated Rate |
$275.41 |
| Max. Negotiated Rate |
$396.59 |
| Rate for Payer: Aetna Commercial |
$369.05
|
| Rate for Payer: Aetna Medicare |
$275.41
|
| Rate for Payer: BCBS MAPPO |
$275.41
|
| Rate for Payer: BCN Commercial |
$383.44
|
| Rate for Payer: BCN Medicare Advantage |
$275.41
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cash Price |
$359.20
|
| Rate for Payer: Cofinity Commercial |
$369.05
|
| Rate for Payer: Cofinity Commercial |
$396.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$275.41
|
| Rate for Payer: Healthscope Commercial |
$330.49
|
| Rate for Payer: Healthscope Whirlpool |
$330.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$289.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$302.95
|
| Rate for Payer: Nomi Health Commercial |
$330.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$336.75
|
| Rate for Payer: PACE SWMI |
$275.41
|
| Rate for Payer: PHP Medicare Advantage |
$275.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$386.34
|
| Rate for Payer: Priority Health Medicare |
$275.41
|
| Rate for Payer: Priority Health Narrow Network |
$386.34
|
| Rate for Payer: Railroad Medicare Medicare |
$275.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$360.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$275.41
|
| Rate for Payer: UHC Exchange |
$360.19
|
| Rate for Payer: UHCCP DNSP |
$275.41
|
|
|
CHG ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I
|
Professional
|
Both
|
$281.00
|
|
|
Service Code
|
HCPCS 75726
|
| Min. Negotiated Rate |
$160.20 |
| Max. Negotiated Rate |
$265.64 |
| Rate for Payer: Aetna Commercial |
$214.67
|
| Rate for Payer: Aetna Medicare |
$160.20
|
| Rate for Payer: BCBS MAPPO |
$160.20
|
| Rate for Payer: BCN Commercial |
$254.97
|
| Rate for Payer: BCN Medicare Advantage |
$160.20
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cash Price |
$224.80
|
| Rate for Payer: Cofinity Commercial |
$214.67
|
| Rate for Payer: Cofinity Commercial |
$230.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.20
|
| Rate for Payer: Healthscope Commercial |
$192.24
|
| Rate for Payer: Healthscope Whirlpool |
$192.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.22
|
| Rate for Payer: Nomi Health Commercial |
$192.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.75
|
| Rate for Payer: PACE SWMI |
$160.20
|
| Rate for Payer: PHP Medicare Advantage |
$160.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$256.88
|
| Rate for Payer: Priority Health Medicare |
$160.20
|
| Rate for Payer: Priority Health Narrow Network |
$256.88
|
| Rate for Payer: Railroad Medicare Medicare |
$160.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$265.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$160.20
|
| Rate for Payer: UHC Exchange |
$265.64
|
| Rate for Payer: UHCCP DNSP |
$160.20
|
|
|
CHG ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS
|
Professional
|
Both
|
$167.00
|
|
|
Service Code
|
HCPCS 75898
|
| Min. Negotiated Rate |
$125.25 |
| Max. Negotiated Rate |
$2,356.66 |
| Rate for Payer: Aetna Commercial |
$345.02
|
| Rate for Payer: Aetna Medicare |
$257.48
|
| Rate for Payer: BCBS MAPPO |
$257.48
|
| Rate for Payer: BCN Commercial |
$134.96
|
| Rate for Payer: BCN Medicare Advantage |
$257.48
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cofinity Commercial |
$345.02
|
| Rate for Payer: Cofinity Commercial |
$370.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.48
|
| Rate for Payer: Healthscope Commercial |
$308.98
|
| Rate for Payer: Healthscope Whirlpool |
$308.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.23
|
| Rate for Payer: Nomi Health Commercial |
$308.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.25
|
| Rate for Payer: PACE SWMI |
$257.48
|
| Rate for Payer: PHP Medicare Advantage |
$257.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$202.70
|
| Rate for Payer: Priority Health Medicare |
$257.48
|
| Rate for Payer: Priority Health Narrow Network |
$202.70
|
| Rate for Payer: Railroad Medicare Medicare |
$257.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,356.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.48
|
| Rate for Payer: UHC Exchange |
$2,356.66
|
| Rate for Payer: UHCCP DNSP |
$257.48
|
|
|
CHG ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I
|
Professional
|
Both
|
$311.00
|
|
|
Service Code
|
HCPCS 75774
|
| Min. Negotiated Rate |
$90.34 |
| Max. Negotiated Rate |
$233.25 |
| Rate for Payer: Aetna Commercial |
$121.06
|
| Rate for Payer: Aetna Medicare |
$90.34
|
| Rate for Payer: BCBS MAPPO |
$90.34
|
| Rate for Payer: BCN Commercial |
$142.92
|
| Rate for Payer: BCN Medicare Advantage |
$90.34
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cash Price |
$248.80
|
| Rate for Payer: Cofinity Commercial |
$121.06
|
| Rate for Payer: Cofinity Commercial |
$130.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.34
|
| Rate for Payer: Healthscope Commercial |
$108.41
|
| Rate for Payer: Healthscope Whirlpool |
$108.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$99.37
|
| Rate for Payer: Nomi Health Commercial |
$108.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.25
|
| Rate for Payer: PACE SWMI |
$90.34
|
| Rate for Payer: PHP Medicare Advantage |
$90.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$143.99
|
| Rate for Payer: Priority Health Medicare |
$90.34
|
| Rate for Payer: Priority Health Narrow Network |
$143.99
|
| Rate for Payer: Railroad Medicare Medicare |
$90.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$154.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$90.34
|
| Rate for Payer: UHC Exchange |
$154.54
|
| Rate for Payer: UHCCP DNSP |
$90.34
|
|
|
CHG AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I
|
Professional
|
Both
|
$489.00
|
|
|
Service Code
|
HCPCS 75630
|
| Min. Negotiated Rate |
$149.43 |
| Max. Negotiated Rate |
$366.75 |
| Rate for Payer: Aetna Commercial |
$200.24
|
| Rate for Payer: Aetna Commercial |
$200.24
|
| Rate for Payer: Aetna Medicare |
$149.43
|
| Rate for Payer: Aetna Medicare |
$149.43
|
| Rate for Payer: BCBS MAPPO |
$149.43
|
| Rate for Payer: BCBS MAPPO |
$149.43
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Commercial |
$233.06
|
| Rate for Payer: BCN Medicare Advantage |
$149.43
|
| Rate for Payer: BCN Medicare Advantage |
$149.43
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$391.20
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$215.18
|
| Rate for Payer: Cofinity Commercial |
$200.24
|
| Rate for Payer: Cofinity Commercial |
$215.18
|
| Rate for Payer: Cofinity Commercial |
$200.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$149.43
|
| Rate for Payer: Healthscope Commercial |
$179.32
|
| Rate for Payer: Healthscope Commercial |
$179.32
|
| Rate for Payer: Healthscope Whirlpool |
$179.32
|
| Rate for Payer: Healthscope Whirlpool |
$179.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$164.37
|
| Rate for Payer: Nomi Health Commercial |
$179.32
|
| Rate for Payer: Nomi Health Commercial |
$179.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$366.75
|
| Rate for Payer: PACE SWMI |
$149.43
|
| Rate for Payer: PACE SWMI |
$149.43
|
| Rate for Payer: PHP Medicare Advantage |
$149.43
|
| Rate for Payer: PHP Medicare Advantage |
$149.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$234.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$234.81
|
| Rate for Payer: Priority Health Medicare |
$149.43
|
| Rate for Payer: Priority Health Medicare |
$149.43
|
| Rate for Payer: Priority Health Narrow Network |
$234.81
|
| Rate for Payer: Priority Health Narrow Network |
$234.81
|
| Rate for Payer: Railroad Medicare Medicare |
$149.43
|
| Rate for Payer: Railroad Medicare Medicare |
$149.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$246.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$149.43
|
| Rate for Payer: UHC Exchange |
$246.55
|
| Rate for Payer: UHC Exchange |
$246.55
|
| Rate for Payer: UHCCP DNSP |
$149.43
|
| Rate for Payer: UHCCP DNSP |
$149.43
|
|
|
CHG AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 75625
|
| Min. Negotiated Rate |
$87.75 |
| Max. Negotiated Rate |
$200.18 |
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: Aetna Commercial |
$160.81
|
| Rate for Payer: Aetna Medicare |
$120.01
|
| Rate for Payer: Aetna Medicare |
$120.01
|
| Rate for Payer: BCBS MAPPO |
$120.01
|
| Rate for Payer: BCBS MAPPO |
$120.01
|
| Rate for Payer: BCN Commercial |
$187.24
|
| Rate for Payer: BCN Commercial |
$187.24
|
| Rate for Payer: BCN Medicare Advantage |
$120.01
|
| Rate for Payer: BCN Medicare Advantage |
$120.01
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Commercial |
$160.81
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Cofinity Commercial |
$160.81
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.01
|
| Rate for Payer: Healthscope Commercial |
$144.01
|
| Rate for Payer: Healthscope Commercial |
$144.01
|
| Rate for Payer: Healthscope Whirlpool |
$144.01
|
| Rate for Payer: Healthscope Whirlpool |
$144.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$126.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$132.01
|
| Rate for Payer: Nomi Health Commercial |
$144.01
|
| Rate for Payer: Nomi Health Commercial |
$144.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$120.01
|
| Rate for Payer: PACE SWMI |
$120.01
|
| Rate for Payer: PHP Medicare Advantage |
$120.01
|
| Rate for Payer: PHP Medicare Advantage |
$120.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$188.65
|
| Rate for Payer: Priority Health Medicare |
$120.01
|
| Rate for Payer: Priority Health Medicare |
$120.01
|
| Rate for Payer: Priority Health Narrow Network |
$188.65
|
| Rate for Payer: Priority Health Narrow Network |
$188.65
|
| Rate for Payer: Railroad Medicare Medicare |
$120.01
|
| Rate for Payer: Railroad Medicare Medicare |
$120.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$200.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$200.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$120.01
|
| Rate for Payer: UHC Exchange |
$200.18
|
| Rate for Payer: UHC Exchange |
$200.18
|
| Rate for Payer: UHCCP DNSP |
$120.01
|
| Rate for Payer: UHCCP DNSP |
$120.01
|
|
|
CHG AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 75605
|
| Min. Negotiated Rate |
$114.63 |
| Max. Negotiated Rate |
$204.75 |
| Rate for Payer: Aetna Commercial |
$153.60
|
| Rate for Payer: Aetna Medicare |
$114.63
|
| Rate for Payer: BCBS MAPPO |
$114.63
|
| Rate for Payer: BCN Commercial |
$179.77
|
| Rate for Payer: BCN Medicare Advantage |
$114.63
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$153.60
|
| Rate for Payer: Cofinity Commercial |
$165.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.63
|
| Rate for Payer: Healthscope Commercial |
$137.56
|
| Rate for Payer: Healthscope Whirlpool |
$137.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.09
|
| Rate for Payer: Nomi Health Commercial |
$137.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$204.75
|
| Rate for Payer: PACE SWMI |
$114.63
|
| Rate for Payer: PHP Medicare Advantage |
$114.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$181.12
|
| Rate for Payer: Priority Health Medicare |
$114.63
|
| Rate for Payer: Priority Health Narrow Network |
$181.12
|
| Rate for Payer: Railroad Medicare Medicare |
$114.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$186.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.63
|
| Rate for Payer: UHC Exchange |
$186.11
|
| Rate for Payer: UHCCP DNSP |
$114.63
|
|
|
CHG AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$110.00
|
|
|
Service Code
|
HCPCS 75600
|
| Min. Negotiated Rate |
$82.50 |
| Max. Negotiated Rate |
$280.45 |
| Rate for Payer: Aetna Commercial |
$219.72
|
| Rate for Payer: Aetna Medicare |
$163.97
|
| Rate for Payer: BCBS MAPPO |
$163.97
|
| Rate for Payer: BCN Commercial |
$258.95
|
| Rate for Payer: BCN Medicare Advantage |
$163.97
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$219.72
|
| Rate for Payer: Cofinity Commercial |
$236.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.97
|
| Rate for Payer: Healthscope Commercial |
$196.76
|
| Rate for Payer: Healthscope Whirlpool |
$196.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$180.37
|
| Rate for Payer: Nomi Health Commercial |
$196.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.50
|
| Rate for Payer: PACE SWMI |
$163.97
|
| Rate for Payer: PHP Medicare Advantage |
$163.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$260.90
|
| Rate for Payer: Priority Health Medicare |
$163.97
|
| Rate for Payer: Priority Health Narrow Network |
$260.90
|
| Rate for Payer: Railroad Medicare Medicare |
$163.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$280.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$163.97
|
| Rate for Payer: UHC Exchange |
$280.45
|
| Rate for Payer: UHCCP DNSP |
$163.97
|
|
|
CHG AQMBF PET REST AND PHARMACOLOGIC STRESS
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 78434
|
| Min. Negotiated Rate |
$46.50 |
| Max. Negotiated Rate |
$308.07 |
| Rate for Payer: Aetna Commercial |
$239.63
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$308.07
|
| Rate for Payer: Priority Health Narrow Network |
$308.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$230.59
|
| Rate for Payer: UHC Exchange |
$230.59
|
|
|
CHG ASSAY OF LEAD
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 83655
|
| Min. Negotiated Rate |
$5.09 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$12.11
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCN Commercial |
$9.08
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$17.44
|
| Rate for Payer: Cofinity Commercial |
$16.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$14.53
|
| Rate for Payer: Healthscope Whirlpool |
$14.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.32
|
| Rate for Payer: Nomi Health Commercial |
$14.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.75
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.44
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health Narrow Network |
$12.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.11
|
| Rate for Payer: UHC Exchange |
$5.09
|
| Rate for Payer: UHCCP DNSP |
$12.11
|
|
|
CHG ASSAY OF PHOSPHATASE ALKALINE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 84075
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| 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 |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| 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 Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Nomi Health Commercial |
$6.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.38
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$2.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
|
