|
CHG DRUG SCREEN LIST A ANY NMBR NON TLC DEVICES
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 80300
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
|
|
CHG DRUG SCREEN MULT CLASSES
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 80100
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
CHG DRUG SCREEN, QUAL,1+ DRUG CLASS,NON-CHROMOTOGRAPHIC,EACH
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 80104
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
|
|
CHG DRUG SCREEN SINGL CLASS
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 80101
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: BCBS Complete |
$12.80
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
|
|
CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 80305
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$30.00 |
| Rate for Payer: Aetna Commercial |
$16.88
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCN Commercial |
$9.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$18.14
|
| Rate for Payer: Cofinity Commercial |
$16.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$15.12
|
| Rate for Payer: Healthscope Whirlpool |
$15.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Nomi Health Commercial |
$15.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.12
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$13.12
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$5.29
|
| Rate for Payer: UHCCP DNSP |
$12.60
|
|
|
CHG DRUG TST PRSMV INSTRMNT CHEM ANALYZERS PR DATE
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 80307
|
| Min. Negotiated Rate |
$26.10 |
| Max. Negotiated Rate |
$89.48 |
| Rate for Payer: Aetna Commercial |
$83.27
|
| Rate for Payer: Aetna Medicare |
$62.14
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCN Commercial |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$83.27
|
| Rate for Payer: Cofinity Commercial |
$89.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$74.57
|
| Rate for Payer: Healthscope Whirlpool |
$74.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Nomi Health Commercial |
$74.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.56
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$64.56
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$26.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$26.10
|
| Rate for Payer: UHCCP DNSP |
$62.14
|
|
|
CHG DRUG TST PRSMV READ INSTRMNT ASSTD DIR OPT OBS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 80306
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna Commercial |
$22.97
|
| Rate for Payer: Aetna Medicare |
$17.14
|
| Rate for Payer: BCBS MAPPO |
$17.14
|
| Rate for Payer: BCN Commercial |
$12.86
|
| Rate for Payer: BCN Medicare Advantage |
$17.14
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$22.97
|
| Rate for Payer: Cofinity Commercial |
$24.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$20.57
|
| Rate for Payer: Healthscope Whirlpool |
$20.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.85
|
| Rate for Payer: Nomi Health Commercial |
$20.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: PACE SWMI |
$17.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$17.82
|
| Rate for Payer: Priority Health Medicare |
$17.14
|
| Rate for Payer: Priority Health Narrow Network |
$17.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.14
|
| Rate for Payer: UHC Exchange |
$7.20
|
| Rate for Payer: UHCCP DNSP |
$17.14
|
|
|
CHG DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 77081
|
| Min. Negotiated Rate |
$29.70 |
| Max. Negotiated Rate |
$124.50 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$29.70
|
| Rate for Payer: Aetna Medicare |
$29.70
|
| Rate for Payer: BCBS MAPPO |
$29.70
|
| Rate for Payer: BCBS MAPPO |
$29.70
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Commercial |
$47.81
|
| Rate for Payer: BCN Medicare Advantage |
$29.70
|
| Rate for Payer: BCN Medicare Advantage |
$29.70
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cofinity Commercial |
$39.80
|
| Rate for Payer: Cofinity Commercial |
$42.77
|
| Rate for Payer: Cofinity Commercial |
$39.80
|
| Rate for Payer: Cofinity Commercial |
$42.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.70
|
| Rate for Payer: Healthscope Commercial |
$35.64
|
| Rate for Payer: Healthscope Commercial |
$35.64
|
| Rate for Payer: Healthscope Whirlpool |
$35.64
|
| Rate for Payer: Healthscope Whirlpool |
$35.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.67
|
| Rate for Payer: Nomi Health Commercial |
$35.64
|
| Rate for Payer: Nomi Health Commercial |
$35.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$29.70
|
| Rate for Payer: PACE SWMI |
$29.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$48.16
|
| Rate for Payer: Priority Health Medicare |
$29.70
|
| Rate for Payer: Priority Health Medicare |
$29.70
|
| Rate for Payer: Priority Health Narrow Network |
$48.16
|
| Rate for Payer: Priority Health Narrow Network |
$48.16
|
| Rate for Payer: Railroad Medicare Medicare |
$29.70
|
| Rate for Payer: Railroad Medicare Medicare |
$29.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$45.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.70
|
| Rate for Payer: UHC Exchange |
$45.74
|
| Rate for Payer: UHC Exchange |
$45.74
|
| Rate for Payer: UHCCP DNSP |
$29.70
|
| Rate for Payer: UHCCP DNSP |
$29.70
|
|
|
CHG DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL
|
Professional
|
Both
|
$176.00
|
|
|
Service Code
|
HCPCS 77080
|
| Min. Negotiated Rate |
$36.71 |
| Max. Negotiated Rate |
$132.00 |
| Rate for Payer: Aetna Commercial |
$49.19
|
| Rate for Payer: Aetna Commercial |
$49.19
|
| Rate for Payer: Aetna Medicare |
$36.71
|
| Rate for Payer: Aetna Medicare |
$36.71
|
| Rate for Payer: BCBS MAPPO |
$36.71
|
| Rate for Payer: BCBS MAPPO |
$36.71
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.71
|
| Rate for Payer: BCN Medicare Advantage |
$36.71
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cofinity Commercial |
$49.19
|
| Rate for Payer: Cofinity Commercial |
$52.86
|
| Rate for Payer: Cofinity Commercial |
$49.19
|
| Rate for Payer: Cofinity Commercial |
$52.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.71
|
| Rate for Payer: Healthscope Commercial |
$44.05
|
| Rate for Payer: Healthscope Commercial |
$44.05
|
| Rate for Payer: Healthscope Whirlpool |
$44.05
|
| Rate for Payer: Healthscope Whirlpool |
$44.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.38
|
| Rate for Payer: Nomi Health Commercial |
$44.05
|
| Rate for Payer: Nomi Health Commercial |
$44.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$184.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: PACE SWMI |
$36.71
|
| Rate for Payer: PACE SWMI |
$36.71
|
| Rate for Payer: PHP Medicare Advantage |
$36.71
|
| Rate for Payer: PHP Medicare Advantage |
$36.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.21
|
| Rate for Payer: Priority Health Medicare |
$36.71
|
| Rate for Payer: Priority Health Medicare |
$36.71
|
| Rate for Payer: Priority Health Narrow Network |
$59.21
|
| Rate for Payer: Priority Health Narrow Network |
$59.21
|
| Rate for Payer: Railroad Medicare Medicare |
$36.71
|
| Rate for Payer: Railroad Medicare Medicare |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.71
|
| Rate for Payer: UHC Exchange |
$55.58
|
| Rate for Payer: UHC Exchange |
$55.58
|
| Rate for Payer: UHCCP DNSP |
$36.71
|
| Rate for Payer: UHCCP DNSP |
$36.71
|
|
|
CHG DX INTRAOPERATIVE THORACIC AORTA ULTRASOUND
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 76984
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCN Commercial |
$46.32
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$46.66
|
| Rate for Payer: Priority Health Narrow Network |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.48
|
| Rate for Payer: UHC Exchange |
$48.48
|
|
|
CHG DX NTRAOP EPCAR CAR US CHD PLMT MNPJ&IMG ACQUISJ
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 76988
|
| Min. Negotiated Rate |
$87.20 |
| Max. Negotiated Rate |
$163.50 |
| Rate for Payer: BCBS Complete |
$87.20
|
| Rate for Payer: BCN Commercial |
$89.65
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$90.31
|
| Rate for Payer: Priority Health Narrow Network |
$90.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$94.33
|
| Rate for Payer: UHC Exchange |
$94.33
|
|
|
CHG ECHOENCEPHALOGRAPHY REAL TIME IMAGING
|
Professional
|
Both
|
$330.00
|
|
|
Service Code
|
HCPCS 76506
|
| Min. Negotiated Rate |
$101.55 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$136.08
|
| Rate for Payer: Aetna Medicare |
$101.55
|
| Rate for Payer: BCBS MAPPO |
$101.55
|
| Rate for Payer: BCN Commercial |
$163.34
|
| Rate for Payer: BCN Medicare Advantage |
$101.55
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cofinity Commercial |
$146.23
|
| Rate for Payer: Cofinity Commercial |
$136.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.55
|
| Rate for Payer: Healthscope Commercial |
$121.86
|
| Rate for Payer: Healthscope Whirlpool |
$121.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.70
|
| Rate for Payer: Nomi Health Commercial |
$121.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.50
|
| Rate for Payer: PACE SWMI |
$101.55
|
| Rate for Payer: PHP Medicare Advantage |
$101.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$164.57
|
| Rate for Payer: Priority Health Medicare |
$101.55
|
| Rate for Payer: Priority Health Narrow Network |
$164.57
|
| Rate for Payer: Railroad Medicare Medicare |
$101.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$162.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.55
|
| Rate for Payer: UHC Exchange |
$162.96
|
| Rate for Payer: UHCCP DNSP |
$101.55
|
|
|
CHG ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING
|
Professional
|
Both
|
$286.00
|
|
|
Service Code
|
HCPCS 76825
|
| Min. Negotiated Rate |
$214.50 |
| Max. Negotiated Rate |
$387.04 |
| Rate for Payer: Aetna Commercial |
$327.59
|
| Rate for Payer: Aetna Medicare |
$244.47
|
| Rate for Payer: BCBS MAPPO |
$244.47
|
| Rate for Payer: BCN Commercial |
$381.95
|
| Rate for Payer: BCN Medicare Advantage |
$244.47
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cash Price |
$228.80
|
| Rate for Payer: Cofinity Commercial |
$327.59
|
| Rate for Payer: Cofinity Commercial |
$352.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$244.47
|
| Rate for Payer: Healthscope Commercial |
$293.36
|
| Rate for Payer: Healthscope Whirlpool |
$293.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$256.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$268.92
|
| Rate for Payer: Nomi Health Commercial |
$293.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.50
|
| Rate for Payer: PACE SWMI |
$244.47
|
| Rate for Payer: PHP Medicare Advantage |
$244.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$384.83
|
| Rate for Payer: Priority Health Medicare |
$244.47
|
| Rate for Payer: Priority Health Narrow Network |
$384.83
|
| Rate for Payer: Railroad Medicare Medicare |
$244.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$387.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$244.47
|
| Rate for Payer: UHC Exchange |
$387.04
|
| Rate for Payer: UHCCP DNSP |
$244.47
|
|
|
CHG ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD
|
Professional
|
Both
|
$135.00
|
|
|
Service Code
|
HCPCS 76826
|
| Min. Negotiated Rate |
$101.25 |
| Max. Negotiated Rate |
$231.30 |
| Rate for Payer: Aetna Commercial |
$197.33
|
| Rate for Payer: Aetna Medicare |
$147.26
|
| Rate for Payer: BCBS MAPPO |
$147.26
|
| Rate for Payer: BCN Commercial |
$229.57
|
| Rate for Payer: BCN Medicare Advantage |
$147.26
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cash Price |
$108.00
|
| Rate for Payer: Cofinity Commercial |
$197.33
|
| Rate for Payer: Cofinity Commercial |
$212.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$147.26
|
| Rate for Payer: Healthscope Commercial |
$176.71
|
| Rate for Payer: Healthscope Whirlpool |
$176.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.99
|
| Rate for Payer: Nomi Health Commercial |
$176.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.25
|
| Rate for Payer: PACE SWMI |
$147.26
|
| Rate for Payer: PHP Medicare Advantage |
$147.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$231.30
|
| Rate for Payer: Priority Health Medicare |
$147.26
|
| Rate for Payer: Priority Health Narrow Network |
$231.30
|
| Rate for Payer: Railroad Medicare Medicare |
$147.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$229.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$147.26
|
| Rate for Payer: UHC Exchange |
$229.22
|
| Rate for Payer: UHCCP DNSP |
$147.26
|
|
|
CHG ENDOVASC REPAIR AAA
|
Professional
|
Both
|
$527.00
|
|
|
Service Code
|
HCPCS 75952
|
| Min. Negotiated Rate |
$210.80 |
| Max. Negotiated Rate |
$395.25 |
| Rate for Payer: BCBS Complete |
$210.80
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$395.25
|
|
|
CHG EVASC RPR DESCND THORCIC AORTA CELIAC ORIG RS&I
|
Professional
|
Both
|
$611.00
|
|
|
Service Code
|
HCPCS 75957
|
| Min. Negotiated Rate |
$244.40 |
| Max. Negotiated Rate |
$458.25 |
| Rate for Payer: Aetna Commercial |
$345.53
|
| Rate for Payer: BCBS Complete |
$244.40
|
| Rate for Payer: BCN Commercial |
$417.81
|
| Rate for Payer: Cash Price |
$488.80
|
| Rate for Payer: Cash Price |
$488.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$458.25
|
|
|
CHG EVASC RPR DESCND THORCIC AORTA SUBCLAV ORIG RS&I
|
Professional
|
Both
|
$714.00
|
|
|
Service Code
|
HCPCS 75956
|
| Min. Negotiated Rate |
$285.60 |
| Max. Negotiated Rate |
$535.50 |
| Rate for Payer: Aetna Commercial |
$403.09
|
| Rate for Payer: BCBS Complete |
$285.60
|
| Rate for Payer: BCN Commercial |
$487.54
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Cash Price |
$571.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$535.50
|
|
|
CHG FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING
|
Professional
|
Both
|
$345.00
|
|
|
Service Code
|
HCPCS 76818
|
| Min. Negotiated Rate |
$114.78 |
| Max. Negotiated Rate |
$258.75 |
| Rate for Payer: Aetna Commercial |
$153.81
|
| Rate for Payer: Aetna Medicare |
$114.78
|
| Rate for Payer: BCBS MAPPO |
$114.78
|
| Rate for Payer: BCN Commercial |
$177.29
|
| Rate for Payer: BCN Medicare Advantage |
$114.78
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cash Price |
$276.00
|
| Rate for Payer: Cofinity Commercial |
$165.28
|
| Rate for Payer: Cofinity Commercial |
$153.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.78
|
| Rate for Payer: Healthscope Commercial |
$137.74
|
| Rate for Payer: Healthscope Whirlpool |
$137.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$120.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$126.26
|
| Rate for Payer: Nomi Health Commercial |
$137.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.75
|
| Rate for Payer: PACE SWMI |
$114.78
|
| Rate for Payer: PHP Medicare Advantage |
$114.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$178.61
|
| Rate for Payer: Priority Health Medicare |
$114.78
|
| Rate for Payer: Priority Health Narrow Network |
$178.61
|
| Rate for Payer: Railroad Medicare Medicare |
$114.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$168.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$114.78
|
| Rate for Payer: UHC Exchange |
$168.76
|
| Rate for Payer: UHCCP DNSP |
$114.78
|
|
|
CHG FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING
|
Professional
|
Both
|
$237.00
|
|
|
Service Code
|
HCPCS 76819
|
| Min. Negotiated Rate |
$82.81 |
| Max. Negotiated Rate |
$177.75 |
| Rate for Payer: Aetna Commercial |
$110.97
|
| Rate for Payer: Aetna Medicare |
$82.81
|
| Rate for Payer: BCBS MAPPO |
$82.81
|
| Rate for Payer: BCN Commercial |
$127.98
|
| Rate for Payer: BCN Medicare Advantage |
$82.81
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cash Price |
$189.60
|
| Rate for Payer: Cofinity Commercial |
$110.97
|
| Rate for Payer: Cofinity Commercial |
$119.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.81
|
| Rate for Payer: Healthscope Commercial |
$99.37
|
| Rate for Payer: Healthscope Whirlpool |
$99.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$91.09
|
| Rate for Payer: Nomi Health Commercial |
$99.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.75
|
| Rate for Payer: PACE SWMI |
$82.81
|
| Rate for Payer: PHP Medicare Advantage |
$82.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$128.94
|
| Rate for Payer: Priority Health Medicare |
$82.81
|
| Rate for Payer: Priority Health Narrow Network |
$128.94
|
| Rate for Payer: Railroad Medicare Medicare |
$82.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$124.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$82.81
|
| Rate for Payer: UHC Exchange |
$124.17
|
| Rate for Payer: UHCCP DNSP |
$82.81
|
|
|
CHG FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON
|
Professional
|
Both
|
$309.00
|
|
|
Service Code
|
HCPCS 77003
|
| Min. Negotiated Rate |
$97.52 |
| Max. Negotiated Rate |
$231.75 |
| Rate for Payer: Aetna Commercial |
$130.68
|
| Rate for Payer: Aetna Medicare |
$97.52
|
| Rate for Payer: BCBS MAPPO |
$97.52
|
| Rate for Payer: BCN Commercial |
$153.38
|
| Rate for Payer: BCN Medicare Advantage |
$97.52
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$130.68
|
| Rate for Payer: Cofinity Commercial |
$140.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.52
|
| Rate for Payer: Healthscope Commercial |
$117.02
|
| Rate for Payer: Healthscope Whirlpool |
$117.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.27
|
| Rate for Payer: Nomi Health Commercial |
$117.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$231.75
|
| Rate for Payer: PACE SWMI |
$97.52
|
| Rate for Payer: PHP Medicare Advantage |
$97.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$154.54
|
| Rate for Payer: Priority Health Medicare |
$97.52
|
| Rate for Payer: Priority Health Narrow Network |
$154.54
|
| Rate for Payer: Railroad Medicare Medicare |
$97.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$143.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.52
|
| Rate for Payer: UHC Exchange |
$143.05
|
| Rate for Payer: UHCCP DNSP |
$97.52
|
|
|
CHG FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 77001
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$146.01 |
| Rate for Payer: Aetna Commercial |
$122.48
|
| Rate for Payer: Aetna Commercial |
$122.48
|
| Rate for Payer: Aetna Medicare |
$91.40
|
| Rate for Payer: Aetna Medicare |
$91.40
|
| Rate for Payer: BCBS MAPPO |
$91.40
|
| Rate for Payer: BCBS MAPPO |
$91.40
|
| Rate for Payer: BCN Commercial |
$144.92
|
| Rate for Payer: BCN Commercial |
$144.92
|
| Rate for Payer: BCN Medicare Advantage |
$91.40
|
| Rate for Payer: BCN Medicare Advantage |
$91.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$140.80
|
| Rate for Payer: Cofinity Commercial |
$122.48
|
| Rate for Payer: Cofinity Commercial |
$131.62
|
| Rate for Payer: Cofinity Commercial |
$122.48
|
| Rate for Payer: Cofinity Commercial |
$131.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.40
|
| Rate for Payer: Healthscope Commercial |
$109.68
|
| Rate for Payer: Healthscope Commercial |
$109.68
|
| Rate for Payer: Healthscope Whirlpool |
$109.68
|
| Rate for Payer: Healthscope Whirlpool |
$109.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.54
|
| Rate for Payer: Nomi Health Commercial |
$109.68
|
| Rate for Payer: Nomi Health Commercial |
$109.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$132.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.75
|
| Rate for Payer: PACE SWMI |
$91.40
|
| Rate for Payer: PACE SWMI |
$91.40
|
| Rate for Payer: PHP Medicare Advantage |
$91.40
|
| Rate for Payer: PHP Medicare Advantage |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$146.01
|
| Rate for Payer: Priority Health Medicare |
$91.40
|
| Rate for Payer: Priority Health Medicare |
$91.40
|
| Rate for Payer: Priority Health Narrow Network |
$146.01
|
| Rate for Payer: Priority Health Narrow Network |
$146.01
|
| Rate for Payer: Railroad Medicare Medicare |
$91.40
|
| Rate for Payer: Railroad Medicare Medicare |
$91.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$135.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$91.40
|
| Rate for Payer: UHC Exchange |
$135.17
|
| Rate for Payer: UHC Exchange |
$135.17
|
| Rate for Payer: UHCCP DNSP |
$91.40
|
| Rate for Payer: UHCCP DNSP |
$91.40
|
|
|
CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON
|
Professional
|
Both
|
$117.00
|
|
|
Service Code
|
HCPCS 77002
|
| Min. Negotiated Rate |
$87.75 |
| Max. Negotiated Rate |
$171.09 |
| Rate for Payer: Aetna Commercial |
$150.79
|
| Rate for Payer: Aetna Medicare |
$112.53
|
| Rate for Payer: BCBS MAPPO |
$112.53
|
| Rate for Payer: BCN Commercial |
$169.81
|
| Rate for Payer: BCN Medicare Advantage |
$112.53
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cash Price |
$93.60
|
| Rate for Payer: Cofinity Commercial |
$150.79
|
| Rate for Payer: Cofinity Commercial |
$162.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.53
|
| Rate for Payer: Healthscope Commercial |
$135.04
|
| Rate for Payer: Healthscope Whirlpool |
$135.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$118.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$123.78
|
| Rate for Payer: Nomi Health Commercial |
$135.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$87.75
|
| Rate for Payer: PACE SWMI |
$112.53
|
| Rate for Payer: PHP Medicare Advantage |
$112.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$171.09
|
| Rate for Payer: Priority Health Medicare |
$112.53
|
| Rate for Payer: Priority Health Narrow Network |
$171.09
|
| Rate for Payer: Railroad Medicare Medicare |
$112.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$112.53
|
| Rate for Payer: UHC Exchange |
$152.61
|
| Rate for Payer: UHCCP DNSP |
$112.53
|
|
|
CHG FLUOROSCOPY SPX >1 HOUR PHYS/QHP TIME
|
Professional
|
Both
|
$69.00
|
|
|
Service Code
|
HCPCS 76001
|
| Min. Negotiated Rate |
$27.60 |
| Max. Negotiated Rate |
$51.75 |
| Rate for Payer: BCBS Complete |
$27.60
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.75
|
|
|
CHG FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 76000
|
| Min. Negotiated Rate |
$41.41 |
| Max. Negotiated Rate |
$64.73 |
| Rate for Payer: Aetna Commercial |
$55.49
|
| Rate for Payer: Aetna Medicare |
$41.41
|
| Rate for Payer: BCBS MAPPO |
$41.41
|
| Rate for Payer: BCN Commercial |
$64.24
|
| Rate for Payer: BCN Medicare Advantage |
$41.41
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cofinity Commercial |
$59.63
|
| Rate for Payer: Cofinity Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.41
|
| Rate for Payer: Healthscope Commercial |
$49.69
|
| Rate for Payer: Healthscope Whirlpool |
$49.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.55
|
| Rate for Payer: Nomi Health Commercial |
$49.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.75
|
| Rate for Payer: PACE SWMI |
$41.41
|
| Rate for Payer: PHP Medicare Advantage |
$41.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$64.73
|
| Rate for Payer: Priority Health Medicare |
$41.41
|
| Rate for Payer: Priority Health Narrow Network |
$64.73
|
| Rate for Payer: Railroad Medicare Medicare |
$41.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.41
|
| Rate for Payer: UHC Exchange |
$59.57
|
| Rate for Payer: UHCCP DNSP |
$41.41
|
|
|
CHG GASTROESOPHAGEAL REFLUX STUDY
|
Professional
|
Both
|
$106.00
|
|
|
Service Code
|
HCPCS 78262
|
| Min. Negotiated Rate |
$79.50 |
| Max. Negotiated Rate |
$340.77 |
| Rate for Payer: Aetna Commercial |
$269.37
|
| Rate for Payer: Aetna Medicare |
$201.02
|
| Rate for Payer: BCBS MAPPO |
$201.02
|
| Rate for Payer: BCN Commercial |
$332.65
|
| Rate for Payer: BCN Medicare Advantage |
$201.02
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$269.37
|
| Rate for Payer: Cofinity Commercial |
$289.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.02
|
| Rate for Payer: Healthscope Commercial |
$241.22
|
| Rate for Payer: Healthscope Whirlpool |
$241.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.12
|
| Rate for Payer: Nomi Health Commercial |
$241.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.50
|
| Rate for Payer: PACE SWMI |
$201.02
|
| Rate for Payer: PHP Medicare Advantage |
$201.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$335.15
|
| Rate for Payer: Priority Health Medicare |
$201.02
|
| Rate for Payer: Priority Health Narrow Network |
$335.15
|
| Rate for Payer: Railroad Medicare Medicare |
$201.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$340.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.02
|
| Rate for Payer: UHC Exchange |
$340.77
|
| Rate for Payer: UHCCP DNSP |
$201.02
|
|
