|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
Both
|
$946.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$381.59 |
| Max. Negotiated Rate |
$709.50 |
| Rate for Payer: Aetna Commercial |
$511.33
|
| Rate for Payer: Aetna Commercial |
$511.33
|
| Rate for Payer: Aetna Medicare |
$381.59
|
| Rate for Payer: Aetna Medicare |
$381.59
|
| Rate for Payer: BCBS MAPPO |
$381.59
|
| Rate for Payer: BCBS MAPPO |
$381.59
|
| Rate for Payer: BCN Commercial |
$622.48
|
| Rate for Payer: BCN Commercial |
$622.48
|
| Rate for Payer: BCN Medicare Advantage |
$381.59
|
| Rate for Payer: BCN Medicare Advantage |
$381.59
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$756.80
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cash Price |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$549.49
|
| Rate for Payer: Cofinity Commercial |
$511.33
|
| Rate for Payer: Cofinity Commercial |
$549.49
|
| Rate for Payer: Cofinity Commercial |
$511.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$381.59
|
| Rate for Payer: Healthscope Commercial |
$457.91
|
| Rate for Payer: Healthscope Commercial |
$457.91
|
| Rate for Payer: Healthscope Whirlpool |
$457.91
|
| Rate for Payer: Healthscope Whirlpool |
$457.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$400.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$419.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$419.75
|
| Rate for Payer: Nomi Health Commercial |
$457.91
|
| Rate for Payer: Nomi Health Commercial |
$457.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$709.50
|
| Rate for Payer: PACE SWMI |
$381.59
|
| Rate for Payer: PACE SWMI |
$381.59
|
| Rate for Payer: PHP Medicare Advantage |
$381.59
|
| Rate for Payer: PHP Medicare Advantage |
$381.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$627.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$627.16
|
| Rate for Payer: Priority Health Medicare |
$381.59
|
| Rate for Payer: Priority Health Medicare |
$381.59
|
| Rate for Payer: Priority Health Narrow Network |
$627.16
|
| Rate for Payer: Priority Health Narrow Network |
$627.16
|
| Rate for Payer: Railroad Medicare Medicare |
$381.59
|
| Rate for Payer: Railroad Medicare Medicare |
$381.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$672.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$672.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$381.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$381.59
|
| Rate for Payer: UHC Exchange |
$672.39
|
| Rate for Payer: UHC Exchange |
$672.39
|
| Rate for Payer: UHCCP DNSP |
$381.59
|
| Rate for Payer: UHCCP DNSP |
$381.59
|
|
|
CHG CT GUIDANCE &MONITORING VISC TISS ABLATION
|
Professional
|
Both
|
$409.00
|
|
|
Service Code
|
HCPCS 77013
|
| Min. Negotiated Rate |
$269.92 |
| Max. Negotiated Rate |
$950.99 |
| Rate for Payer: Aetna Commercial |
$620.14
|
| Rate for Payer: BCN Commercial |
$269.92
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Cash Price |
$327.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$306.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$755.61
|
| Rate for Payer: Priority Health Narrow Network |
$755.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$950.99
|
| Rate for Payer: UHC Exchange |
$950.99
|
|
|
CHG CT GUIDANCE NEEDLE PLACEMENT
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 77012
|
| Min. Negotiated Rate |
$117.19 |
| Max. Negotiated Rate |
$216.77 |
| Rate for Payer: Aetna Commercial |
$157.03
|
| Rate for Payer: Aetna Medicare |
$117.19
|
| Rate for Payer: BCBS MAPPO |
$117.19
|
| Rate for Payer: BCN Commercial |
$188.23
|
| Rate for Payer: BCN Medicare Advantage |
$117.19
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$168.75
|
| Rate for Payer: Cofinity Commercial |
$157.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.19
|
| Rate for Payer: Healthscope Commercial |
$140.63
|
| Rate for Payer: Healthscope Whirlpool |
$140.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$128.91
|
| Rate for Payer: Nomi Health Commercial |
$140.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE SWMI |
$117.19
|
| Rate for Payer: PHP Medicare Advantage |
$117.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$189.65
|
| Rate for Payer: Priority Health Medicare |
$117.19
|
| Rate for Payer: Priority Health Narrow Network |
$189.65
|
| Rate for Payer: Railroad Medicare Medicare |
$117.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$216.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$117.19
|
| Rate for Payer: UHC Exchange |
$216.77
|
| Rate for Payer: UHCCP DNSP |
$117.19
|
|
|
CHG CT GUIDANCE RADIATION THERAPY FLDS PLACEMENT
|
Professional
|
Both
|
$332.00
|
|
|
Service Code
|
HCPCS 77014
|
| Min. Negotiated Rate |
$132.80 |
| Max. Negotiated Rate |
$249.00 |
| Rate for Payer: Aetna Commercial |
$149.64
|
| Rate for Payer: Aetna Commercial |
$149.64
|
| Rate for Payer: BCBS Complete |
$132.80
|
| Rate for Payer: BCBS Complete |
$100.00
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: BCN Commercial |
$178.28
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$265.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$249.00
|
|
|
CHG CT GUIDANCE STEREOTACTIC LOCALIZATION
|
Professional
|
Both
|
$480.00
|
|
|
Service Code
|
HCPCS 77011
|
| Min. Negotiated Rate |
$206.19 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Aetna Commercial |
$276.29
|
| Rate for Payer: Aetna Commercial |
$276.29
|
| Rate for Payer: Aetna Medicare |
$206.19
|
| Rate for Payer: Aetna Medicare |
$206.19
|
| Rate for Payer: BCBS MAPPO |
$206.19
|
| Rate for Payer: BCBS MAPPO |
$206.19
|
| Rate for Payer: BCN Commercial |
$325.68
|
| Rate for Payer: BCN Commercial |
$325.68
|
| Rate for Payer: BCN Medicare Advantage |
$206.19
|
| Rate for Payer: BCN Medicare Advantage |
$206.19
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$384.00
|
| Rate for Payer: Cofinity Commercial |
$276.29
|
| Rate for Payer: Cofinity Commercial |
$276.29
|
| Rate for Payer: Cofinity Commercial |
$296.91
|
| Rate for Payer: Cofinity Commercial |
$296.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.19
|
| Rate for Payer: Healthscope Commercial |
$247.43
|
| Rate for Payer: Healthscope Commercial |
$247.43
|
| Rate for Payer: Healthscope Whirlpool |
$247.43
|
| Rate for Payer: Healthscope Whirlpool |
$247.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$226.81
|
| Rate for Payer: Nomi Health Commercial |
$247.43
|
| Rate for Payer: Nomi Health Commercial |
$247.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$360.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.50
|
| Rate for Payer: PACE SWMI |
$206.19
|
| Rate for Payer: PACE SWMI |
$206.19
|
| Rate for Payer: PHP Medicare Advantage |
$206.19
|
| Rate for Payer: PHP Medicare Advantage |
$206.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$328.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$328.14
|
| Rate for Payer: Priority Health Medicare |
$206.19
|
| Rate for Payer: Priority Health Medicare |
$206.19
|
| Rate for Payer: Priority Health Narrow Network |
$328.14
|
| Rate for Payer: Priority Health Narrow Network |
$328.14
|
| Rate for Payer: Railroad Medicare Medicare |
$206.19
|
| Rate for Payer: Railroad Medicare Medicare |
$206.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$329.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$206.19
|
| Rate for Payer: UHC Exchange |
$329.02
|
| Rate for Payer: UHC Exchange |
$329.02
|
| Rate for Payer: UHCCP DNSP |
$206.19
|
| Rate for Payer: UHCCP DNSP |
$206.19
|
|
|
CHG CT HEAD/BRAIN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 70460
|
| Min. Negotiated Rate |
$90.75 |
| Max. Negotiated Rate |
$231.12 |
| Rate for Payer: Aetna Commercial |
$186.58
|
| Rate for Payer: Aetna Medicare |
$139.24
|
| Rate for Payer: BCBS MAPPO |
$139.24
|
| Rate for Payer: BCN Commercial |
$225.09
|
| Rate for Payer: BCN Medicare Advantage |
$139.24
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$186.58
|
| Rate for Payer: Cofinity Commercial |
$200.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.24
|
| Rate for Payer: Healthscope Commercial |
$167.09
|
| Rate for Payer: Healthscope Whirlpool |
$167.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$146.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$153.16
|
| Rate for Payer: Nomi Health Commercial |
$167.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$139.24
|
| Rate for Payer: PHP Medicare Advantage |
$139.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$226.79
|
| Rate for Payer: Priority Health Medicare |
$139.24
|
| Rate for Payer: Priority Health Narrow Network |
$226.79
|
| Rate for Payer: Railroad Medicare Medicare |
$139.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$231.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$139.24
|
| Rate for Payer: UHC Exchange |
$231.12
|
| Rate for Payer: UHCCP DNSP |
$139.24
|
|
|
CHG CT HEAD/BRAIN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 70450
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$163.95 |
| Rate for Payer: Aetna Commercial |
$134.16
|
| Rate for Payer: Aetna Medicare |
$100.12
|
| Rate for Payer: BCBS MAPPO |
$100.12
|
| Rate for Payer: BCN Commercial |
$161.85
|
| Rate for Payer: BCN Medicare Advantage |
$100.12
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Cofinity Commercial |
$144.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.12
|
| Rate for Payer: Healthscope Commercial |
$120.14
|
| Rate for Payer: Healthscope Whirlpool |
$120.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$110.13
|
| Rate for Payer: Nomi Health Commercial |
$120.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.25
|
| Rate for Payer: PACE SWMI |
$100.12
|
| Rate for Payer: PHP Medicare Advantage |
$100.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$163.07
|
| Rate for Payer: Priority Health Medicare |
$100.12
|
| Rate for Payer: Priority Health Narrow Network |
$163.07
|
| Rate for Payer: Railroad Medicare Medicare |
$100.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$163.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$100.12
|
| Rate for Payer: UHC Exchange |
$163.95
|
| Rate for Payer: UHCCP DNSP |
$100.12
|
|
|
CHG CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$136.00
|
|
|
Service Code
|
HCPCS 70470
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$270.66 |
| Rate for Payer: Aetna Commercial |
$217.37
|
| Rate for Payer: Aetna Medicare |
$162.22
|
| Rate for Payer: BCBS MAPPO |
$162.22
|
| Rate for Payer: BCN Commercial |
$262.93
|
| Rate for Payer: BCN Medicare Advantage |
$162.22
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cofinity Commercial |
$217.37
|
| Rate for Payer: Cofinity Commercial |
$233.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.22
|
| Rate for Payer: Healthscope Commercial |
$194.66
|
| Rate for Payer: Healthscope Whirlpool |
$194.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$178.44
|
| Rate for Payer: Nomi Health Commercial |
$194.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.00
|
| Rate for Payer: PACE SWMI |
$162.22
|
| Rate for Payer: PHP Medicare Advantage |
$162.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$264.91
|
| Rate for Payer: Priority Health Medicare |
$162.22
|
| Rate for Payer: Priority Health Narrow Network |
$264.91
|
| Rate for Payer: Railroad Medicare Medicare |
$162.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$270.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$162.22
|
| Rate for Payer: UHC Exchange |
$270.66
|
| Rate for Payer: UHCCP DNSP |
$162.22
|
|
|
CHG CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH
|
Professional
|
Both
|
$184.00
|
|
|
Service Code
|
HCPCS 75572
|
| Min. Negotiated Rate |
$138.00 |
| Max. Negotiated Rate |
$353.13 |
| Rate for Payer: Aetna Commercial |
$288.35
|
| Rate for Payer: Aetna Medicare |
$215.19
|
| Rate for Payer: BCBS MAPPO |
$215.19
|
| Rate for Payer: BCN Commercial |
$345.59
|
| Rate for Payer: BCN Medicare Advantage |
$215.19
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Cofinity Commercial |
$288.35
|
| Rate for Payer: Cofinity Commercial |
$309.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.19
|
| Rate for Payer: Healthscope Commercial |
$258.23
|
| Rate for Payer: Healthscope Whirlpool |
$258.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.71
|
| Rate for Payer: Nomi Health Commercial |
$258.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.00
|
| Rate for Payer: PACE SWMI |
$215.19
|
| Rate for Payer: PHP Medicare Advantage |
$215.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$348.19
|
| Rate for Payer: Priority Health Medicare |
$215.19
|
| Rate for Payer: Priority Health Narrow Network |
$348.19
|
| Rate for Payer: Railroad Medicare Medicare |
$215.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$353.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.19
|
| Rate for Payer: UHC Exchange |
$353.13
|
| Rate for Payer: UHCCP DNSP |
$215.19
|
|
|
CHG CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 75571
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$153.53 |
| Rate for Payer: Aetna Commercial |
$124.47
|
| Rate for Payer: Aetna Medicare |
$92.89
|
| Rate for Payer: BCBS MAPPO |
$92.89
|
| Rate for Payer: BCN Commercial |
$152.39
|
| Rate for Payer: BCN Medicare Advantage |
$92.89
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$124.47
|
| Rate for Payer: Cofinity Commercial |
$133.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$92.89
|
| Rate for Payer: Healthscope Commercial |
$111.47
|
| Rate for Payer: Healthscope Whirlpool |
$111.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$97.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$102.18
|
| Rate for Payer: Nomi Health Commercial |
$111.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$92.89
|
| Rate for Payer: PHP Medicare Advantage |
$92.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$153.53
|
| Rate for Payer: Priority Health Medicare |
$92.89
|
| Rate for Payer: Priority Health Narrow Network |
$153.53
|
| Rate for Payer: Railroad Medicare Medicare |
$92.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$147.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$92.89
|
| Rate for Payer: UHC Exchange |
$147.89
|
| Rate for Payer: UHCCP DNSP |
$92.89
|
|
|
CHG CT LIMITED/LOCALIZED FOLLOW UP STUDY
|
Professional
|
Both
|
$158.00
|
|
|
Service Code
|
HCPCS 76380
|
| Min. Negotiated Rate |
$118.50 |
| Max. Negotiated Rate |
$204.87 |
| Rate for Payer: Aetna Commercial |
$166.33
|
| Rate for Payer: Aetna Medicare |
$124.13
|
| Rate for Payer: BCBS MAPPO |
$124.13
|
| Rate for Payer: BCN Commercial |
$198.19
|
| Rate for Payer: BCN Medicare Advantage |
$124.13
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cash Price |
$126.40
|
| Rate for Payer: Cofinity Commercial |
$166.33
|
| Rate for Payer: Cofinity Commercial |
$178.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.13
|
| Rate for Payer: Healthscope Commercial |
$148.96
|
| Rate for Payer: Healthscope Whirlpool |
$148.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$136.54
|
| Rate for Payer: Nomi Health Commercial |
$148.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.50
|
| Rate for Payer: PACE SWMI |
$124.13
|
| Rate for Payer: PHP Medicare Advantage |
$124.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$199.69
|
| Rate for Payer: Priority Health Medicare |
$124.13
|
| Rate for Payer: Priority Health Narrow Network |
$199.69
|
| Rate for Payer: Railroad Medicare Medicare |
$124.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.13
|
| Rate for Payer: UHC Exchange |
$204.87
|
| Rate for Payer: UHCCP DNSP |
$124.13
|
|
|
CHG CT LOWER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 73701
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$273.54 |
| Rate for Payer: Aetna Commercial |
$208.36
|
| Rate for Payer: Aetna Medicare |
$155.49
|
| Rate for Payer: BCBS MAPPO |
$155.49
|
| Rate for Payer: BCN Commercial |
$252.48
|
| Rate for Payer: BCN Medicare Advantage |
$155.49
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$208.36
|
| Rate for Payer: Cofinity Commercial |
$223.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.49
|
| Rate for Payer: Healthscope Commercial |
$186.59
|
| Rate for Payer: Healthscope Whirlpool |
$186.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$171.04
|
| Rate for Payer: Nomi Health Commercial |
$186.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: PACE SWMI |
$155.49
|
| Rate for Payer: PHP Medicare Advantage |
$155.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$254.38
|
| Rate for Payer: Priority Health Medicare |
$155.49
|
| Rate for Payer: Priority Health Narrow Network |
$254.38
|
| Rate for Payer: Railroad Medicare Medicare |
$155.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$273.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$155.49
|
| Rate for Payer: UHC Exchange |
$273.54
|
| Rate for Payer: UHCCP DNSP |
$155.49
|
|
|
CHG CT LOWER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 73700
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$219.23 |
| Rate for Payer: Aetna Commercial |
$163.86
|
| Rate for Payer: Aetna Medicare |
$122.28
|
| Rate for Payer: BCBS MAPPO |
$122.28
|
| Rate for Payer: BCN Commercial |
$196.71
|
| Rate for Payer: BCN Medicare Advantage |
$122.28
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$176.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.28
|
| Rate for Payer: Healthscope Commercial |
$146.74
|
| Rate for Payer: Healthscope Whirlpool |
$146.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.51
|
| Rate for Payer: Nomi Health Commercial |
$146.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$122.28
|
| Rate for Payer: PHP Medicare Advantage |
$122.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$198.19
|
| Rate for Payer: Priority Health Medicare |
$122.28
|
| Rate for Payer: Priority Health Narrow Network |
$198.19
|
| Rate for Payer: Railroad Medicare Medicare |
$122.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.28
|
| Rate for Payer: UHC Exchange |
$219.23
|
| Rate for Payer: UHCCP DNSP |
$122.28
|
|
|
CHG CT LOWER EXTREMITY W/O & W/CONTRAST MATRL
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 73702
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$328.44 |
| Rate for Payer: Aetna Commercial |
$243.73
|
| Rate for Payer: Aetna Medicare |
$181.89
|
| Rate for Payer: BCBS MAPPO |
$181.89
|
| Rate for Payer: BCN Commercial |
$295.80
|
| Rate for Payer: BCN Medicare Advantage |
$181.89
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$243.73
|
| Rate for Payer: Cofinity Commercial |
$261.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.89
|
| Rate for Payer: Healthscope Commercial |
$218.27
|
| Rate for Payer: Healthscope Whirlpool |
$218.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$190.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$200.08
|
| Rate for Payer: Nomi Health Commercial |
$218.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$181.89
|
| Rate for Payer: PHP Medicare Advantage |
$181.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$298.03
|
| Rate for Payer: Priority Health Medicare |
$181.89
|
| Rate for Payer: Priority Health Narrow Network |
$298.03
|
| Rate for Payer: Railroad Medicare Medicare |
$181.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$328.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$181.89
|
| Rate for Payer: UHC Exchange |
$328.44
|
| Rate for Payer: UHCCP DNSP |
$181.89
|
|
|
CHG CT LUMBAR SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 72132
|
| Min. Negotiated Rate |
$96.75 |
| Max. Negotiated Rate |
$276.82 |
| Rate for Payer: Aetna Commercial |
$211.87
|
| Rate for Payer: Aetna Medicare |
$158.11
|
| Rate for Payer: BCBS MAPPO |
$158.11
|
| Rate for Payer: BCN Commercial |
$256.46
|
| Rate for Payer: BCN Medicare Advantage |
$158.11
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$211.87
|
| Rate for Payer: Cofinity Commercial |
$227.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.11
|
| Rate for Payer: Healthscope Commercial |
$189.73
|
| Rate for Payer: Healthscope Whirlpool |
$189.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$173.92
|
| Rate for Payer: Nomi Health Commercial |
$189.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.75
|
| Rate for Payer: PACE SWMI |
$158.11
|
| Rate for Payer: PHP Medicare Advantage |
$158.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$258.38
|
| Rate for Payer: Priority Health Medicare |
$158.11
|
| Rate for Payer: Priority Health Narrow Network |
$258.38
|
| Rate for Payer: Railroad Medicare Medicare |
$158.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$276.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$158.11
|
| Rate for Payer: UHC Exchange |
$276.82
|
| Rate for Payer: UHCCP DNSP |
$158.11
|
|
|
CHG CT LUMBAR SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 72131
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$219.23 |
| Rate for Payer: Aetna Commercial |
$163.45
|
| Rate for Payer: Aetna Medicare |
$121.98
|
| Rate for Payer: BCBS MAPPO |
$121.98
|
| Rate for Payer: BCN Commercial |
$196.20
|
| Rate for Payer: BCN Medicare Advantage |
$121.98
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$163.45
|
| Rate for Payer: Cofinity Commercial |
$175.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.98
|
| Rate for Payer: Healthscope Commercial |
$146.38
|
| Rate for Payer: Healthscope Whirlpool |
$146.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.18
|
| Rate for Payer: Nomi Health Commercial |
$146.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$121.98
|
| Rate for Payer: PHP Medicare Advantage |
$121.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$197.69
|
| Rate for Payer: Priority Health Medicare |
$121.98
|
| Rate for Payer: Priority Health Narrow Network |
$197.69
|
| Rate for Payer: Railroad Medicare Medicare |
$121.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$219.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$121.98
|
| Rate for Payer: UHC Exchange |
$219.23
|
| Rate for Payer: UHCCP DNSP |
$121.98
|
|
|
CHG CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 72133
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$323.26 |
| Rate for Payer: Aetna Commercial |
$246.39
|
| Rate for Payer: Aetna Medicare |
$183.87
|
| Rate for Payer: BCBS MAPPO |
$183.87
|
| Rate for Payer: BCN Commercial |
$298.29
|
| Rate for Payer: BCN Medicare Advantage |
$183.87
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$246.39
|
| Rate for Payer: Cofinity Commercial |
$264.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$183.87
|
| Rate for Payer: Healthscope Commercial |
$220.64
|
| Rate for Payer: Healthscope Whirlpool |
$220.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$202.26
|
| Rate for Payer: Nomi Health Commercial |
$220.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$183.87
|
| Rate for Payer: PHP Medicare Advantage |
$183.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$300.54
|
| Rate for Payer: Priority Health Medicare |
$183.87
|
| Rate for Payer: Priority Health Narrow Network |
$300.54
|
| Rate for Payer: Railroad Medicare Medicare |
$183.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$323.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$183.87
|
| Rate for Payer: UHC Exchange |
$323.26
|
| Rate for Payer: UHCCP DNSP |
$183.87
|
|
|
CHG CT MAXILLOFACIAL W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 70487
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$236.53 |
| Rate for Payer: Aetna Commercial |
$190.67
|
| Rate for Payer: Aetna Medicare |
$142.29
|
| Rate for Payer: BCBS MAPPO |
$142.29
|
| Rate for Payer: BCN Commercial |
$230.56
|
| Rate for Payer: BCN Medicare Advantage |
$142.29
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cofinity Commercial |
$190.67
|
| Rate for Payer: Cofinity Commercial |
$204.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.29
|
| Rate for Payer: Healthscope Commercial |
$170.75
|
| Rate for Payer: Healthscope Whirlpool |
$170.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$149.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$156.52
|
| Rate for Payer: Nomi Health Commercial |
$170.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.25
|
| Rate for Payer: PACE SWMI |
$142.29
|
| Rate for Payer: PHP Medicare Advantage |
$142.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$232.29
|
| Rate for Payer: Priority Health Medicare |
$142.29
|
| Rate for Payer: Priority Health Narrow Network |
$232.29
|
| Rate for Payer: Railroad Medicare Medicare |
$142.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$236.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$142.29
|
| Rate for Payer: UHC Exchange |
$236.53
|
| Rate for Payer: UHCCP DNSP |
$142.29
|
|
|
CHG CT MAXILLOFACIAL W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 70486
|
| Min. Negotiated Rate |
$68.25 |
| Max. Negotiated Rate |
$196.91 |
| Rate for Payer: Aetna Commercial |
$160.73
|
| Rate for Payer: Aetna Medicare |
$119.95
|
| Rate for Payer: BCBS MAPPO |
$119.95
|
| Rate for Payer: BCN Commercial |
$194.21
|
| Rate for Payer: BCN Medicare Advantage |
$119.95
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cofinity Commercial |
$160.73
|
| Rate for Payer: Cofinity Commercial |
$172.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$119.95
|
| Rate for Payer: Healthscope Commercial |
$143.94
|
| Rate for Payer: Healthscope Whirlpool |
$143.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$125.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$131.94
|
| Rate for Payer: Nomi Health Commercial |
$143.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.25
|
| Rate for Payer: PACE SWMI |
$119.95
|
| Rate for Payer: PHP Medicare Advantage |
$119.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$195.67
|
| Rate for Payer: Priority Health Medicare |
$119.95
|
| Rate for Payer: Priority Health Narrow Network |
$195.67
|
| Rate for Payer: Railroad Medicare Medicare |
$119.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$196.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$119.95
|
| Rate for Payer: UHC Exchange |
$196.91
|
| Rate for Payer: UHCCP DNSP |
$119.95
|
|
|
CHG CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 70488
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$287.85 |
| Rate for Payer: Aetna Commercial |
$230.86
|
| Rate for Payer: Aetna Medicare |
$172.28
|
| Rate for Payer: BCBS MAPPO |
$172.28
|
| Rate for Payer: BCN Commercial |
$278.87
|
| Rate for Payer: BCN Medicare Advantage |
$172.28
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$230.86
|
| Rate for Payer: Cofinity Commercial |
$248.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.28
|
| Rate for Payer: Healthscope Commercial |
$206.74
|
| Rate for Payer: Healthscope Whirlpool |
$206.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$189.51
|
| Rate for Payer: Nomi Health Commercial |
$206.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$172.28
|
| Rate for Payer: PHP Medicare Advantage |
$172.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$280.97
|
| Rate for Payer: Priority Health Medicare |
$172.28
|
| Rate for Payer: Priority Health Narrow Network |
$280.97
|
| Rate for Payer: Railroad Medicare Medicare |
$172.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$287.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$172.28
|
| Rate for Payer: UHC Exchange |
$287.85
|
| Rate for Payer: UHCCP DNSP |
$172.28
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 70481
|
| Min. Negotiated Rate |
$90.75 |
| Max. Negotiated Rate |
$314.72 |
| Rate for Payer: Aetna Commercial |
$225.00
|
| Rate for Payer: Aetna Medicare |
$167.91
|
| Rate for Payer: BCBS MAPPO |
$167.91
|
| Rate for Payer: BCN Commercial |
$273.39
|
| Rate for Payer: BCN Medicare Advantage |
$167.91
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Cofinity Commercial |
$225.00
|
| Rate for Payer: Cofinity Commercial |
$241.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.91
|
| Rate for Payer: Healthscope Commercial |
$201.49
|
| Rate for Payer: Healthscope Whirlpool |
$201.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$184.70
|
| Rate for Payer: Nomi Health Commercial |
$201.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$90.75
|
| Rate for Payer: PACE SWMI |
$167.91
|
| Rate for Payer: PHP Medicare Advantage |
$167.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$275.45
|
| Rate for Payer: Priority Health Medicare |
$167.91
|
| Rate for Payer: Priority Health Narrow Network |
$275.45
|
| Rate for Payer: Railroad Medicare Medicare |
$167.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$167.91
|
| Rate for Payer: UHC Exchange |
$314.72
|
| Rate for Payer: UHCCP DNSP |
$167.91
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL
|
Professional
|
Both
|
$137.00
|
|
|
Service Code
|
HCPCS 70480
|
| Min. Negotiated Rate |
$102.75 |
| Max. Negotiated Rate |
$283.48 |
| Rate for Payer: Aetna Commercial |
$199.43
|
| Rate for Payer: Aetna Medicare |
$148.83
|
| Rate for Payer: BCBS MAPPO |
$148.83
|
| Rate for Payer: BCN Commercial |
$241.02
|
| Rate for Payer: BCN Medicare Advantage |
$148.83
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Cofinity Commercial |
$199.43
|
| Rate for Payer: Cofinity Commercial |
$214.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.83
|
| Rate for Payer: Healthscope Commercial |
$178.60
|
| Rate for Payer: Healthscope Whirlpool |
$178.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$156.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$163.71
|
| Rate for Payer: Nomi Health Commercial |
$178.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.75
|
| Rate for Payer: PACE SWMI |
$148.83
|
| Rate for Payer: PHP Medicare Advantage |
$148.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$242.84
|
| Rate for Payer: Priority Health Medicare |
$148.83
|
| Rate for Payer: Priority Health Narrow Network |
$242.84
|
| Rate for Payer: Railroad Medicare Medicare |
$148.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$283.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$148.83
|
| Rate for Payer: UHC Exchange |
$283.48
|
| Rate for Payer: UHCCP DNSP |
$148.83
|
|
|
CHG CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 70482
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$348.87 |
| Rate for Payer: Aetna Commercial |
$261.50
|
| Rate for Payer: Aetna Medicare |
$195.15
|
| Rate for Payer: BCBS MAPPO |
$195.15
|
| Rate for Payer: BCN Commercial |
$318.21
|
| Rate for Payer: BCN Medicare Advantage |
$195.15
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$261.50
|
| Rate for Payer: Cofinity Commercial |
$281.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.15
|
| Rate for Payer: Healthscope Commercial |
$234.18
|
| Rate for Payer: Healthscope Whirlpool |
$234.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$214.66
|
| Rate for Payer: Nomi Health Commercial |
$234.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$195.15
|
| Rate for Payer: PHP Medicare Advantage |
$195.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$320.60
|
| Rate for Payer: Priority Health Medicare |
$195.15
|
| Rate for Payer: Priority Health Narrow Network |
$320.60
|
| Rate for Payer: Railroad Medicare Medicare |
$195.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$348.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$195.15
|
| Rate for Payer: UHC Exchange |
$348.87
|
| Rate for Payer: UHCCP DNSP |
$195.15
|
|
|
CHG CT PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$123.00
|
|
|
Service Code
|
HCPCS 72193
|
| Min. Negotiated Rate |
$92.25 |
| Max. Negotiated Rate |
$346.19 |
| Rate for Payer: Aetna Commercial |
$281.51
|
| Rate for Payer: Aetna Medicare |
$210.08
|
| Rate for Payer: BCBS MAPPO |
$210.08
|
| Rate for Payer: BCN Commercial |
$343.60
|
| Rate for Payer: BCN Medicare Advantage |
$210.08
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cash Price |
$98.40
|
| Rate for Payer: Cofinity Commercial |
$281.51
|
| Rate for Payer: Cofinity Commercial |
$302.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.08
|
| Rate for Payer: Healthscope Commercial |
$252.10
|
| Rate for Payer: Healthscope Whirlpool |
$252.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.09
|
| Rate for Payer: Nomi Health Commercial |
$252.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$92.25
|
| Rate for Payer: PACE SWMI |
$210.08
|
| Rate for Payer: PHP Medicare Advantage |
$210.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$346.19
|
| Rate for Payer: Priority Health Medicare |
$210.08
|
| Rate for Payer: Priority Health Narrow Network |
$346.19
|
| Rate for Payer: Railroad Medicare Medicare |
$210.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$210.08
|
| Rate for Payer: UHC Exchange |
$340.42
|
| Rate for Payer: UHCCP DNSP |
$210.08
|
|
|
CHG CT PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 72192
|
| Min. Negotiated Rate |
$86.25 |
| Max. Negotiated Rate |
$206.36 |
| Rate for Payer: Aetna Commercial |
$167.03
|
| Rate for Payer: Aetna Medicare |
$124.65
|
| Rate for Payer: BCBS MAPPO |
$124.65
|
| Rate for Payer: BCN Commercial |
$201.68
|
| Rate for Payer: BCN Medicare Advantage |
$124.65
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$167.03
|
| Rate for Payer: Cofinity Commercial |
$179.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.65
|
| Rate for Payer: Healthscope Commercial |
$149.58
|
| Rate for Payer: Healthscope Whirlpool |
$149.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$130.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.12
|
| Rate for Payer: Nomi Health Commercial |
$149.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: PACE SWMI |
$124.65
|
| Rate for Payer: PHP Medicare Advantage |
$124.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$203.20
|
| Rate for Payer: Priority Health Medicare |
$124.65
|
| Rate for Payer: Priority Health Narrow Network |
$203.20
|
| Rate for Payer: Railroad Medicare Medicare |
$124.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$206.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$124.65
|
| Rate for Payer: UHC Exchange |
$206.36
|
| Rate for Payer: UHCCP DNSP |
$124.65
|
|
