|
CHG RADEX SPINE CERVICAL 6 OR MORE VIEWS
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 72052
|
| Min. Negotiated Rate |
$58.39 |
| Max. Negotiated Rate |
$93.31 |
| Rate for Payer: Aetna Commercial |
$78.24
|
| Rate for Payer: Aetna Commercial |
$78.24
|
| Rate for Payer: Aetna Medicare |
$58.39
|
| Rate for Payer: Aetna Medicare |
$58.39
|
| Rate for Payer: BCBS MAPPO |
$58.39
|
| Rate for Payer: BCBS MAPPO |
$58.39
|
| Rate for Payer: BCN Commercial |
$92.62
|
| Rate for Payer: BCN Commercial |
$92.62
|
| Rate for Payer: BCN Medicare Advantage |
$58.39
|
| Rate for Payer: BCN Medicare Advantage |
$58.39
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.08
|
| Rate for Payer: Cofinity Commercial |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.39
|
| Rate for Payer: Healthscope Commercial |
$70.07
|
| Rate for Payer: Healthscope Commercial |
$70.07
|
| Rate for Payer: Healthscope Whirlpool |
$70.07
|
| Rate for Payer: Healthscope Whirlpool |
$70.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.23
|
| Rate for Payer: Nomi Health Commercial |
$70.07
|
| Rate for Payer: Nomi Health Commercial |
$70.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.25
|
| Rate for Payer: PACE SWMI |
$58.39
|
| Rate for Payer: PACE SWMI |
$58.39
|
| Rate for Payer: PHP Medicare Advantage |
$58.39
|
| Rate for Payer: PHP Medicare Advantage |
$58.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$93.31
|
| Rate for Payer: Priority Health Medicare |
$58.39
|
| Rate for Payer: Priority Health Medicare |
$58.39
|
| Rate for Payer: Priority Health Narrow Network |
$93.31
|
| Rate for Payer: Priority Health Narrow Network |
$93.31
|
| Rate for Payer: Railroad Medicare Medicare |
$58.39
|
| Rate for Payer: Railroad Medicare Medicare |
$58.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.39
|
| Rate for Payer: UHC Exchange |
$83.58
|
| Rate for Payer: UHC Exchange |
$83.58
|
| Rate for Payer: UHCCP DNSP |
$58.39
|
| Rate for Payer: UHCCP DNSP |
$58.39
|
|
|
CHG RADEX SPINE LUMBOSACRAL 2/3 VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 72100
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$59.70 |
| Rate for Payer: Aetna Commercial |
$50.45
|
| Rate for Payer: Aetna Commercial |
$50.45
|
| Rate for Payer: Aetna Commercial |
$50.45
|
| Rate for Payer: Aetna Medicare |
$37.65
|
| Rate for Payer: Aetna Medicare |
$37.65
|
| Rate for Payer: Aetna Medicare |
$37.65
|
| Rate for Payer: BCBS MAPPO |
$37.65
|
| Rate for Payer: BCBS MAPPO |
$37.65
|
| Rate for Payer: BCBS MAPPO |
$37.65
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Commercial |
$59.26
|
| Rate for Payer: BCN Medicare Advantage |
$37.65
|
| Rate for Payer: BCN Medicare Advantage |
$37.65
|
| Rate for Payer: BCN Medicare Advantage |
$37.65
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cofinity Commercial |
$50.45
|
| Rate for Payer: Cofinity Commercial |
$54.22
|
| Rate for Payer: Cofinity Commercial |
$54.22
|
| Rate for Payer: Cofinity Commercial |
$54.22
|
| Rate for Payer: Cofinity Commercial |
$50.45
|
| Rate for Payer: Cofinity Commercial |
$50.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.65
|
| Rate for Payer: Healthscope Commercial |
$45.18
|
| Rate for Payer: Healthscope Commercial |
$45.18
|
| Rate for Payer: Healthscope Commercial |
$45.18
|
| Rate for Payer: Healthscope Whirlpool |
$45.18
|
| Rate for Payer: Healthscope Whirlpool |
$45.18
|
| Rate for Payer: Healthscope Whirlpool |
$45.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.41
|
| Rate for Payer: Nomi Health Commercial |
$45.18
|
| Rate for Payer: Nomi Health Commercial |
$45.18
|
| Rate for Payer: Nomi Health Commercial |
$45.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.25
|
| Rate for Payer: PACE SWMI |
$37.65
|
| Rate for Payer: PACE SWMI |
$37.65
|
| Rate for Payer: PACE SWMI |
$37.65
|
| Rate for Payer: PHP Medicare Advantage |
$37.65
|
| Rate for Payer: PHP Medicare Advantage |
$37.65
|
| Rate for Payer: PHP Medicare Advantage |
$37.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.70
|
| Rate for Payer: Priority Health Medicare |
$37.65
|
| Rate for Payer: Priority Health Medicare |
$37.65
|
| Rate for Payer: Priority Health Medicare |
$37.65
|
| Rate for Payer: Priority Health Narrow Network |
$59.70
|
| Rate for Payer: Priority Health Narrow Network |
$59.70
|
| Rate for Payer: Priority Health Narrow Network |
$59.70
|
| Rate for Payer: Railroad Medicare Medicare |
$37.65
|
| Rate for Payer: Railroad Medicare Medicare |
$37.65
|
| Rate for Payer: Railroad Medicare Medicare |
$37.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.65
|
| Rate for Payer: UHC Exchange |
$53.71
|
| Rate for Payer: UHC Exchange |
$53.71
|
| Rate for Payer: UHC Exchange |
$53.71
|
| Rate for Payer: UHCCP DNSP |
$37.65
|
| Rate for Payer: UHCCP DNSP |
$37.65
|
| Rate for Payer: UHCCP DNSP |
$37.65
|
|
|
CHG RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 72110
|
| Min. Negotiated Rate |
$49.50 |
| Max. Negotiated Rate |
$78.27 |
| Rate for Payer: Aetna Commercial |
$66.64
|
| Rate for Payer: Aetna Commercial |
$66.64
|
| Rate for Payer: Aetna Commercial |
$66.64
|
| Rate for Payer: Aetna Medicare |
$49.73
|
| Rate for Payer: Aetna Medicare |
$49.73
|
| Rate for Payer: Aetna Medicare |
$49.73
|
| Rate for Payer: BCBS MAPPO |
$49.73
|
| Rate for Payer: BCBS MAPPO |
$49.73
|
| Rate for Payer: BCBS MAPPO |
$49.73
|
| Rate for Payer: BCN Commercial |
$77.69
|
| Rate for Payer: BCN Commercial |
$77.69
|
| Rate for Payer: BCN Commercial |
$77.69
|
| Rate for Payer: BCN Medicare Advantage |
$49.73
|
| Rate for Payer: BCN Medicare Advantage |
$49.73
|
| Rate for Payer: BCN Medicare Advantage |
$49.73
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$66.64
|
| Rate for Payer: Cofinity Commercial |
$71.61
|
| Rate for Payer: Cofinity Commercial |
$71.61
|
| Rate for Payer: Cofinity Commercial |
$71.61
|
| Rate for Payer: Cofinity Commercial |
$66.64
|
| Rate for Payer: Cofinity Commercial |
$66.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.73
|
| Rate for Payer: Healthscope Commercial |
$59.68
|
| Rate for Payer: Healthscope Commercial |
$59.68
|
| Rate for Payer: Healthscope Commercial |
$59.68
|
| Rate for Payer: Healthscope Whirlpool |
$59.68
|
| Rate for Payer: Healthscope Whirlpool |
$59.68
|
| Rate for Payer: Healthscope Whirlpool |
$59.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.70
|
| Rate for Payer: Nomi Health Commercial |
$59.68
|
| Rate for Payer: Nomi Health Commercial |
$59.68
|
| Rate for Payer: Nomi Health Commercial |
$59.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$49.73
|
| Rate for Payer: PACE SWMI |
$49.73
|
| Rate for Payer: PACE SWMI |
$49.73
|
| Rate for Payer: PHP Medicare Advantage |
$49.73
|
| Rate for Payer: PHP Medicare Advantage |
$49.73
|
| Rate for Payer: PHP Medicare Advantage |
$49.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$78.27
|
| Rate for Payer: Priority Health Medicare |
$49.73
|
| Rate for Payer: Priority Health Medicare |
$49.73
|
| Rate for Payer: Priority Health Medicare |
$49.73
|
| Rate for Payer: Priority Health Narrow Network |
$78.27
|
| Rate for Payer: Priority Health Narrow Network |
$78.27
|
| Rate for Payer: Priority Health Narrow Network |
$78.27
|
| Rate for Payer: Railroad Medicare Medicare |
$49.73
|
| Rate for Payer: Railroad Medicare Medicare |
$49.73
|
| Rate for Payer: Railroad Medicare Medicare |
$49.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.73
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.73
|
| Rate for Payer: UHC Exchange |
$68.15
|
| Rate for Payer: UHC Exchange |
$68.15
|
| Rate for Payer: UHC Exchange |
$68.15
|
| Rate for Payer: UHCCP DNSP |
$49.73
|
| Rate for Payer: UHCCP DNSP |
$49.73
|
| Rate for Payer: UHCCP DNSP |
$49.73
|
|
|
CHG RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS
|
Professional
|
Both
|
$52.00
|
|
|
Service Code
|
HCPCS 72120
|
| Min. Negotiated Rate |
$39.00 |
| Max. Negotiated Rate |
$61.21 |
| Rate for Payer: Aetna Commercial |
$52.50
|
| Rate for Payer: Aetna Medicare |
$39.18
|
| Rate for Payer: BCBS MAPPO |
$39.18
|
| Rate for Payer: BCN Commercial |
$60.76
|
| Rate for Payer: BCN Medicare Advantage |
$39.18
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Cofinity Commercial |
$56.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.18
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Healthscope Whirlpool |
$47.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.10
|
| Rate for Payer: Nomi Health Commercial |
$47.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE SWMI |
$39.18
|
| Rate for Payer: PHP Medicare Advantage |
$39.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.21
|
| Rate for Payer: Priority Health Medicare |
$39.18
|
| Rate for Payer: Priority Health Narrow Network |
$61.21
|
| Rate for Payer: Railroad Medicare Medicare |
$39.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$55.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.18
|
| Rate for Payer: UHC Exchange |
$55.67
|
| Rate for Payer: UHCCP DNSP |
$39.18
|
|
|
CHG RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 72114
|
| Min. Negotiated Rate |
$57.47 |
| Max. Negotiated Rate |
$92.32 |
| Rate for Payer: Aetna Commercial |
$77.01
|
| Rate for Payer: Aetna Commercial |
$77.01
|
| Rate for Payer: Aetna Medicare |
$57.47
|
| Rate for Payer: Aetna Medicare |
$57.47
|
| Rate for Payer: BCBS MAPPO |
$57.47
|
| Rate for Payer: BCBS MAPPO |
$57.47
|
| Rate for Payer: BCN Commercial |
$91.63
|
| Rate for Payer: BCN Commercial |
$91.63
|
| Rate for Payer: BCN Medicare Advantage |
$57.47
|
| Rate for Payer: BCN Medicare Advantage |
$57.47
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cash Price |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$82.76
|
| Rate for Payer: Cofinity Commercial |
$77.01
|
| Rate for Payer: Cofinity Commercial |
$82.76
|
| Rate for Payer: Cofinity Commercial |
$77.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.47
|
| Rate for Payer: Healthscope Commercial |
$68.96
|
| Rate for Payer: Healthscope Commercial |
$68.96
|
| Rate for Payer: Healthscope Whirlpool |
$68.96
|
| Rate for Payer: Healthscope Whirlpool |
$68.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$63.22
|
| Rate for Payer: Nomi Health Commercial |
$68.96
|
| Rate for Payer: Nomi Health Commercial |
$68.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PACE SWMI |
$57.47
|
| Rate for Payer: PACE SWMI |
$57.47
|
| Rate for Payer: PHP Medicare Advantage |
$57.47
|
| Rate for Payer: PHP Medicare Advantage |
$57.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$92.32
|
| Rate for Payer: Priority Health Medicare |
$57.47
|
| Rate for Payer: Priority Health Medicare |
$57.47
|
| Rate for Payer: Priority Health Narrow Network |
$92.32
|
| Rate for Payer: Priority Health Narrow Network |
$92.32
|
| Rate for Payer: Railroad Medicare Medicare |
$57.47
|
| Rate for Payer: Railroad Medicare Medicare |
$57.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$83.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$57.47
|
| Rate for Payer: UHC Exchange |
$83.58
|
| Rate for Payer: UHC Exchange |
$83.58
|
| Rate for Payer: UHCCP DNSP |
$57.47
|
| Rate for Payer: UHCCP DNSP |
$57.47
|
|
|
CHG RADEX SPINE THORACIC 2 VIEWS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 72070
|
| Min. Negotiated Rate |
$30.92 |
| Max. Negotiated Rate |
$49.67 |
| Rate for Payer: Aetna Commercial |
$41.43
|
| Rate for Payer: Aetna Commercial |
$41.43
|
| Rate for Payer: Aetna Commercial |
$41.43
|
| Rate for Payer: Aetna Medicare |
$30.92
|
| Rate for Payer: Aetna Medicare |
$30.92
|
| Rate for Payer: Aetna Medicare |
$30.92
|
| Rate for Payer: BCBS MAPPO |
$30.92
|
| Rate for Payer: BCBS MAPPO |
$30.92
|
| Rate for Payer: BCBS MAPPO |
$30.92
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Commercial |
$49.30
|
| Rate for Payer: BCN Medicare Advantage |
$30.92
|
| Rate for Payer: BCN Medicare Advantage |
$30.92
|
| Rate for Payer: BCN Medicare Advantage |
$30.92
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Cofinity Commercial |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.92
|
| Rate for Payer: Healthscope Commercial |
$37.10
|
| Rate for Payer: Healthscope Commercial |
$37.10
|
| Rate for Payer: Healthscope Commercial |
$37.10
|
| Rate for Payer: Healthscope Whirlpool |
$37.10
|
| Rate for Payer: Healthscope Whirlpool |
$37.10
|
| Rate for Payer: Healthscope Whirlpool |
$37.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.01
|
| Rate for Payer: Nomi Health Commercial |
$37.10
|
| Rate for Payer: Nomi Health Commercial |
$37.10
|
| Rate for Payer: Nomi Health Commercial |
$37.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.50
|
| Rate for Payer: PACE SWMI |
$30.92
|
| Rate for Payer: PACE SWMI |
$30.92
|
| Rate for Payer: PACE SWMI |
$30.92
|
| Rate for Payer: PHP Medicare Advantage |
$30.92
|
| Rate for Payer: PHP Medicare Advantage |
$30.92
|
| Rate for Payer: PHP Medicare Advantage |
$30.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$49.67
|
| Rate for Payer: Priority Health Medicare |
$30.92
|
| Rate for Payer: Priority Health Medicare |
$30.92
|
| Rate for Payer: Priority Health Medicare |
$30.92
|
| Rate for Payer: Priority Health Narrow Network |
$49.67
|
| Rate for Payer: Priority Health Narrow Network |
$49.67
|
| Rate for Payer: Priority Health Narrow Network |
$49.67
|
| Rate for Payer: Railroad Medicare Medicare |
$30.92
|
| Rate for Payer: Railroad Medicare Medicare |
$30.92
|
| Rate for Payer: Railroad Medicare Medicare |
$30.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.92
|
| Rate for Payer: UHC Exchange |
$44.76
|
| Rate for Payer: UHC Exchange |
$44.76
|
| Rate for Payer: UHC Exchange |
$44.76
|
| Rate for Payer: UHCCP DNSP |
$30.92
|
| Rate for Payer: UHCCP DNSP |
$30.92
|
| Rate for Payer: UHCCP DNSP |
$30.92
|
|
|
CHG RADEX SPINE THORACIC 3 VIEWS
|
Professional
|
Both
|
$84.00
|
|
|
Service Code
|
HCPCS 72072
|
| Min. Negotiated Rate |
$36.16 |
| Max. Negotiated Rate |
$63.00 |
| Rate for Payer: Aetna Commercial |
$48.45
|
| Rate for Payer: Aetna Medicare |
$36.16
|
| Rate for Payer: BCBS MAPPO |
$36.16
|
| Rate for Payer: BCN Commercial |
$58.76
|
| Rate for Payer: BCN Medicare Advantage |
$36.16
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cofinity Commercial |
$48.45
|
| Rate for Payer: Cofinity Commercial |
$52.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.16
|
| Rate for Payer: Healthscope Commercial |
$43.39
|
| Rate for Payer: Healthscope Whirlpool |
$43.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$39.78
|
| Rate for Payer: Nomi Health Commercial |
$43.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.00
|
| Rate for Payer: PACE SWMI |
$36.16
|
| Rate for Payer: PHP Medicare Advantage |
$36.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$59.21
|
| Rate for Payer: Priority Health Medicare |
$36.16
|
| Rate for Payer: Priority Health Narrow Network |
$59.21
|
| Rate for Payer: Railroad Medicare Medicare |
$36.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$36.16
|
| Rate for Payer: UHC Exchange |
$54.24
|
| Rate for Payer: UHCCP DNSP |
$36.16
|
|
|
CHG RADEX SPINE THORACIC MINIMUM 4 VIEWS
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 72074
|
| Min. Negotiated Rate |
$41.10 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna Commercial |
$55.07
|
| Rate for Payer: Aetna Medicare |
$41.10
|
| Rate for Payer: BCBS MAPPO |
$41.10
|
| Rate for Payer: BCN Commercial |
$66.73
|
| Rate for Payer: BCN Medicare Advantage |
$41.10
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$55.07
|
| Rate for Payer: Cofinity Commercial |
$59.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.10
|
| Rate for Payer: Healthscope Commercial |
$49.32
|
| Rate for Payer: Healthscope Whirlpool |
$49.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.21
|
| Rate for Payer: Nomi Health Commercial |
$49.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.75
|
| Rate for Payer: PACE SWMI |
$41.10
|
| Rate for Payer: PHP Medicare Advantage |
$41.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.23
|
| Rate for Payer: Priority Health Medicare |
$41.10
|
| Rate for Payer: Priority Health Narrow Network |
$67.23
|
| Rate for Payer: Railroad Medicare Medicare |
$41.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$60.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$41.10
|
| Rate for Payer: UHC Exchange |
$60.72
|
| Rate for Payer: UHCCP DNSP |
$41.10
|
|
|
CHG RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 72080
|
| Min. Negotiated Rate |
$32.75 |
| Max. Negotiated Rate |
$52.18 |
| Rate for Payer: Aetna Commercial |
$43.88
|
| Rate for Payer: Aetna Commercial |
$43.88
|
| Rate for Payer: Aetna Commercial |
$43.88
|
| Rate for Payer: Aetna Medicare |
$32.75
|
| Rate for Payer: Aetna Medicare |
$32.75
|
| Rate for Payer: Aetna Medicare |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$32.75
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Commercial |
$51.79
|
| Rate for Payer: BCN Medicare Advantage |
$32.75
|
| Rate for Payer: BCN Medicare Advantage |
$32.75
|
| Rate for Payer: BCN Medicare Advantage |
$32.75
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cofinity Commercial |
$43.88
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Cofinity Commercial |
$47.16
|
| Rate for Payer: Cofinity Commercial |
$43.88
|
| Rate for Payer: Cofinity Commercial |
$43.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.75
|
| Rate for Payer: Healthscope Commercial |
$39.30
|
| Rate for Payer: Healthscope Commercial |
$39.30
|
| Rate for Payer: Healthscope Commercial |
$39.30
|
| Rate for Payer: Healthscope Whirlpool |
$39.30
|
| Rate for Payer: Healthscope Whirlpool |
$39.30
|
| Rate for Payer: Healthscope Whirlpool |
$39.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.02
|
| Rate for Payer: Nomi Health Commercial |
$39.30
|
| Rate for Payer: Nomi Health Commercial |
$39.30
|
| Rate for Payer: Nomi Health Commercial |
$39.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.00
|
| Rate for Payer: PACE SWMI |
$32.75
|
| Rate for Payer: PACE SWMI |
$32.75
|
| Rate for Payer: PACE SWMI |
$32.75
|
| Rate for Payer: PHP Medicare Advantage |
$32.75
|
| Rate for Payer: PHP Medicare Advantage |
$32.75
|
| Rate for Payer: PHP Medicare Advantage |
$32.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$52.18
|
| Rate for Payer: Priority Health Medicare |
$32.75
|
| Rate for Payer: Priority Health Medicare |
$32.75
|
| Rate for Payer: Priority Health Medicare |
$32.75
|
| Rate for Payer: Priority Health Narrow Network |
$52.18
|
| Rate for Payer: Priority Health Narrow Network |
$52.18
|
| Rate for Payer: Priority Health Narrow Network |
$52.18
|
| Rate for Payer: Railroad Medicare Medicare |
$32.75
|
| Rate for Payer: Railroad Medicare Medicare |
$32.75
|
| Rate for Payer: Railroad Medicare Medicare |
$32.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$48.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.75
|
| Rate for Payer: UHC Exchange |
$48.26
|
| Rate for Payer: UHC Exchange |
$48.26
|
| Rate for Payer: UHC Exchange |
$48.26
|
| Rate for Payer: UHCCP DNSP |
$32.75
|
| Rate for Payer: UHCCP DNSP |
$32.75
|
| Rate for Payer: UHCCP DNSP |
$32.75
|
|
|
CHG RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 71130
|
| Min. Negotiated Rate |
$34.50 |
| Max. Negotiated Rate |
$61.72 |
| Rate for Payer: Aetna Commercial |
$51.68
|
| Rate for Payer: Aetna Commercial |
$51.68
|
| Rate for Payer: Aetna Medicare |
$38.57
|
| Rate for Payer: Aetna Medicare |
$38.57
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cofinity Commercial |
$51.68
|
| Rate for Payer: Cofinity Commercial |
$55.54
|
| Rate for Payer: Cofinity Commercial |
$51.68
|
| Rate for Payer: Cofinity Commercial |
$55.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$46.28
|
| Rate for Payer: Healthscope Commercial |
$46.28
|
| Rate for Payer: Healthscope Whirlpool |
$46.28
|
| Rate for Payer: Healthscope Whirlpool |
$46.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.43
|
| Rate for Payer: Nomi Health Commercial |
$46.28
|
| Rate for Payer: Nomi Health Commercial |
$46.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.50
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$61.72
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Narrow Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$61.72
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$56.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.57
|
| Rate for Payer: UHC Exchange |
$56.17
|
| Rate for Payer: UHC Exchange |
$56.17
|
| Rate for Payer: UHCCP DNSP |
$38.57
|
| Rate for Payer: UHCCP DNSP |
$38.57
|
|
|
CHG RADEX STERNUM MINIMUM 2 VIEWS
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 71120
|
| Min. Negotiated Rate |
$30.92 |
| Max. Negotiated Rate |
$50.18 |
| Rate for Payer: Aetna Commercial |
$41.43
|
| Rate for Payer: Aetna Commercial |
$41.43
|
| Rate for Payer: Aetna Medicare |
$30.92
|
| Rate for Payer: Aetna Medicare |
$30.92
|
| Rate for Payer: BCBS MAPPO |
$30.92
|
| Rate for Payer: BCBS MAPPO |
$30.92
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: BCN Commercial |
$49.80
|
| Rate for Payer: BCN Medicare Advantage |
$30.92
|
| Rate for Payer: BCN Medicare Advantage |
$30.92
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Cofinity Commercial |
$44.52
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Cofinity Commercial |
$44.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.92
|
| Rate for Payer: Healthscope Commercial |
$37.10
|
| Rate for Payer: Healthscope Commercial |
$37.10
|
| Rate for Payer: Healthscope Whirlpool |
$37.10
|
| Rate for Payer: Healthscope Whirlpool |
$37.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.01
|
| Rate for Payer: Nomi Health Commercial |
$37.10
|
| Rate for Payer: Nomi Health Commercial |
$37.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE SWMI |
$30.92
|
| Rate for Payer: PACE SWMI |
$30.92
|
| Rate for Payer: PHP Medicare Advantage |
$30.92
|
| Rate for Payer: PHP Medicare Advantage |
$30.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.18
|
| Rate for Payer: Priority Health Medicare |
$30.92
|
| Rate for Payer: Priority Health Medicare |
$30.92
|
| Rate for Payer: Priority Health Narrow Network |
$50.18
|
| Rate for Payer: Priority Health Narrow Network |
$50.18
|
| Rate for Payer: Railroad Medicare Medicare |
$30.92
|
| Rate for Payer: Railroad Medicare Medicare |
$30.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.92
|
| Rate for Payer: UHC Exchange |
$46.23
|
| Rate for Payer: UHC Exchange |
$46.23
|
| Rate for Payer: UHCCP DNSP |
$30.92
|
| Rate for Payer: UHCCP DNSP |
$30.92
|
|
|
CHG RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT
|
Professional
|
Both
|
$27.00
|
|
|
Service Code
|
HCPCS 70330
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$79.77 |
| Rate for Payer: Aetna Commercial |
$66.46
|
| Rate for Payer: Aetna Medicare |
$49.60
|
| Rate for Payer: BCBS MAPPO |
$49.60
|
| Rate for Payer: BCN Commercial |
$79.18
|
| Rate for Payer: BCN Medicare Advantage |
$49.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cofinity Commercial |
$66.46
|
| Rate for Payer: Cofinity Commercial |
$71.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$59.52
|
| Rate for Payer: Healthscope Whirlpool |
$59.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.56
|
| Rate for Payer: Nomi Health Commercial |
$59.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.25
|
| Rate for Payer: PACE SWMI |
$49.60
|
| Rate for Payer: PHP Medicare Advantage |
$49.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$79.77
|
| Rate for Payer: Priority Health Medicare |
$49.60
|
| Rate for Payer: Priority Health Narrow Network |
$79.77
|
| Rate for Payer: Railroad Medicare Medicare |
$49.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.60
|
| Rate for Payer: UHC Exchange |
$72.48
|
| Rate for Payer: UHCCP DNSP |
$49.60
|
|
|
CHG RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 70328
|
| Min. Negotiated Rate |
$31.77 |
| Max. Negotiated Rate |
$51.68 |
| Rate for Payer: Aetna Commercial |
$42.57
|
| Rate for Payer: Aetna Medicare |
$31.77
|
| Rate for Payer: BCBS MAPPO |
$31.77
|
| Rate for Payer: BCN Commercial |
$51.29
|
| Rate for Payer: BCN Medicare Advantage |
$31.77
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$42.57
|
| Rate for Payer: Cofinity Commercial |
$45.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.77
|
| Rate for Payer: Healthscope Commercial |
$38.12
|
| Rate for Payer: Healthscope Whirlpool |
$38.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.95
|
| Rate for Payer: Nomi Health Commercial |
$38.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.75
|
| Rate for Payer: PACE SWMI |
$31.77
|
| Rate for Payer: PHP Medicare Advantage |
$31.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$51.68
|
| Rate for Payer: Priority Health Medicare |
$31.77
|
| Rate for Payer: Priority Health Narrow Network |
$51.68
|
| Rate for Payer: Railroad Medicare Medicare |
$31.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$47.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$31.77
|
| Rate for Payer: UHC Exchange |
$47.13
|
| Rate for Payer: UHCCP DNSP |
$31.77
|
|
|
CHG RADEX TOE MINIMUM 2 VIEWS
|
Professional
|
Both
|
$75.00
|
|
|
Service Code
|
HCPCS 73660
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$56.25 |
| Rate for Payer: Aetna Commercial |
$35.84
|
| Rate for Payer: Aetna Commercial |
$35.84
|
| Rate for Payer: Aetna Commercial |
$35.84
|
| Rate for Payer: Aetna Medicare |
$26.75
|
| Rate for Payer: Aetna Medicare |
$26.75
|
| Rate for Payer: Aetna Medicare |
$26.75
|
| Rate for Payer: BCBS MAPPO |
$26.75
|
| Rate for Payer: BCBS MAPPO |
$26.75
|
| Rate for Payer: BCBS MAPPO |
$26.75
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: BCN Commercial |
$43.33
|
| Rate for Payer: BCN Medicare Advantage |
$26.75
|
| Rate for Payer: BCN Medicare Advantage |
$26.75
|
| Rate for Payer: BCN Medicare Advantage |
$26.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$35.84
|
| Rate for Payer: Cofinity Commercial |
$38.52
|
| Rate for Payer: Cofinity Commercial |
$38.52
|
| Rate for Payer: Cofinity Commercial |
$38.52
|
| Rate for Payer: Cofinity Commercial |
$35.84
|
| Rate for Payer: Cofinity Commercial |
$35.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.75
|
| Rate for Payer: Healthscope Commercial |
$32.10
|
| Rate for Payer: Healthscope Commercial |
$32.10
|
| Rate for Payer: Healthscope Commercial |
$32.10
|
| Rate for Payer: Healthscope Whirlpool |
$32.10
|
| Rate for Payer: Healthscope Whirlpool |
$32.10
|
| Rate for Payer: Healthscope Whirlpool |
$32.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.43
|
| Rate for Payer: Nomi Health Commercial |
$32.10
|
| Rate for Payer: Nomi Health Commercial |
$32.10
|
| Rate for Payer: Nomi Health Commercial |
$32.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.25
|
| Rate for Payer: PACE SWMI |
$26.75
|
| Rate for Payer: PACE SWMI |
$26.75
|
| Rate for Payer: PACE SWMI |
$26.75
|
| Rate for Payer: PHP Medicare Advantage |
$26.75
|
| Rate for Payer: PHP Medicare Advantage |
$26.75
|
| Rate for Payer: PHP Medicare Advantage |
$26.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$43.65
|
| Rate for Payer: Priority Health Medicare |
$26.75
|
| Rate for Payer: Priority Health Medicare |
$26.75
|
| Rate for Payer: Priority Health Medicare |
$26.75
|
| Rate for Payer: Priority Health Narrow Network |
$43.65
|
| Rate for Payer: Priority Health Narrow Network |
$43.65
|
| Rate for Payer: Priority Health Narrow Network |
$43.65
|
| Rate for Payer: Railroad Medicare Medicare |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$26.75
|
| Rate for Payer: Railroad Medicare Medicare |
$26.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.75
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.75
|
| Rate for Payer: UHC Exchange |
$39.53
|
| Rate for Payer: UHC Exchange |
$39.53
|
| Rate for Payer: UHC Exchange |
$39.53
|
| Rate for Payer: UHCCP DNSP |
$26.75
|
| Rate for Payer: UHCCP DNSP |
$26.75
|
| Rate for Payer: UHCCP DNSP |
$26.75
|
|
|
CHG RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 73092
|
| Min. Negotiated Rate |
$10.50 |
| Max. Negotiated Rate |
$47.17 |
| Rate for Payer: Aetna Commercial |
$38.40
|
| Rate for Payer: Aetna Medicare |
$28.66
|
| Rate for Payer: BCBS MAPPO |
$28.66
|
| Rate for Payer: BCN Commercial |
$46.81
|
| Rate for Payer: BCN Medicare Advantage |
$28.66
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$38.40
|
| Rate for Payer: Cofinity Commercial |
$41.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.66
|
| Rate for Payer: Healthscope Commercial |
$34.39
|
| Rate for Payer: Healthscope Whirlpool |
$34.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.53
|
| Rate for Payer: Nomi Health Commercial |
$34.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$28.66
|
| Rate for Payer: PHP Medicare Advantage |
$28.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$47.17
|
| Rate for Payer: Priority Health Medicare |
$28.66
|
| Rate for Payer: Priority Health Narrow Network |
$47.17
|
| Rate for Payer: Railroad Medicare Medicare |
$28.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.66
|
| Rate for Payer: UHC Exchange |
$42.62
|
| Rate for Payer: UHCCP DNSP |
$28.66
|
|
|
CHG RADEX WRIST 2 VIEWS
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 73100
|
| Min. Negotiated Rate |
$32.02 |
| Max. Negotiated Rate |
$65.25 |
| Rate for Payer: Aetna Commercial |
$42.91
|
| Rate for Payer: Aetna Commercial |
$42.91
|
| Rate for Payer: Aetna Medicare |
$32.02
|
| Rate for Payer: Aetna Medicare |
$32.02
|
| Rate for Payer: BCBS MAPPO |
$32.02
|
| Rate for Payer: BCBS MAPPO |
$32.02
|
| Rate for Payer: BCN Commercial |
$50.29
|
| Rate for Payer: BCN Commercial |
$50.29
|
| Rate for Payer: BCN Medicare Advantage |
$32.02
|
| Rate for Payer: BCN Medicare Advantage |
$32.02
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$46.11
|
| Rate for Payer: Cofinity Commercial |
$42.91
|
| Rate for Payer: Cofinity Commercial |
$46.11
|
| Rate for Payer: Cofinity Commercial |
$42.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.02
|
| Rate for Payer: Healthscope Commercial |
$38.42
|
| Rate for Payer: Healthscope Commercial |
$38.42
|
| Rate for Payer: Healthscope Whirlpool |
$38.42
|
| Rate for Payer: Healthscope Whirlpool |
$38.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.22
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Nomi Health Commercial |
$38.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.25
|
| Rate for Payer: PACE SWMI |
$32.02
|
| Rate for Payer: PACE SWMI |
$32.02
|
| Rate for Payer: PHP Medicare Advantage |
$32.02
|
| Rate for Payer: PHP Medicare Advantage |
$32.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$50.67
|
| Rate for Payer: Priority Health Medicare |
$32.02
|
| Rate for Payer: Priority Health Medicare |
$32.02
|
| Rate for Payer: Priority Health Narrow Network |
$50.67
|
| Rate for Payer: Priority Health Narrow Network |
$50.67
|
| Rate for Payer: Railroad Medicare Medicare |
$32.02
|
| Rate for Payer: Railroad Medicare Medicare |
$32.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$46.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$32.02
|
| Rate for Payer: UHC Exchange |
$46.05
|
| Rate for Payer: UHC Exchange |
$46.05
|
| Rate for Payer: UHCCP DNSP |
$32.02
|
| Rate for Payer: UHCCP DNSP |
$32.02
|
|
|
CHG RADEX WRIST COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 73110
|
| Min. Negotiated Rate |
$39.67 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna Commercial |
$53.16
|
| Rate for Payer: Aetna Commercial |
$53.16
|
| Rate for Payer: Aetna Commercial |
$53.16
|
| Rate for Payer: Aetna Medicare |
$39.67
|
| Rate for Payer: Aetna Medicare |
$39.67
|
| Rate for Payer: Aetna Medicare |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$39.67
|
| Rate for Payer: BCBS MAPPO |
$39.67
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Commercial |
$61.75
|
| Rate for Payer: BCN Medicare Advantage |
$39.67
|
| Rate for Payer: BCN Medicare Advantage |
$39.67
|
| Rate for Payer: BCN Medicare Advantage |
$39.67
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Commercial |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.67
|
| Rate for Payer: Healthscope Commercial |
$47.60
|
| Rate for Payer: Healthscope Commercial |
$47.60
|
| Rate for Payer: Healthscope Commercial |
$47.60
|
| Rate for Payer: Healthscope Whirlpool |
$47.60
|
| Rate for Payer: Healthscope Whirlpool |
$47.60
|
| Rate for Payer: Healthscope Whirlpool |
$47.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.64
|
| Rate for Payer: Nomi Health Commercial |
$47.60
|
| Rate for Payer: Nomi Health Commercial |
$47.60
|
| Rate for Payer: Nomi Health Commercial |
$47.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.75
|
| Rate for Payer: PACE SWMI |
$39.67
|
| Rate for Payer: PACE SWMI |
$39.67
|
| Rate for Payer: PACE SWMI |
$39.67
|
| Rate for Payer: PHP Medicare Advantage |
$39.67
|
| Rate for Payer: PHP Medicare Advantage |
$39.67
|
| Rate for Payer: PHP Medicare Advantage |
$39.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$62.22
|
| Rate for Payer: Priority Health Medicare |
$39.67
|
| Rate for Payer: Priority Health Medicare |
$39.67
|
| Rate for Payer: Priority Health Medicare |
$39.67
|
| Rate for Payer: Priority Health Narrow Network |
$62.22
|
| Rate for Payer: Priority Health Narrow Network |
$62.22
|
| Rate for Payer: Priority Health Narrow Network |
$62.22
|
| Rate for Payer: Railroad Medicare Medicare |
$39.67
|
| Rate for Payer: Railroad Medicare Medicare |
$39.67
|
| Rate for Payer: Railroad Medicare Medicare |
$39.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$54.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.67
|
| Rate for Payer: UHC Exchange |
$54.47
|
| Rate for Payer: UHC Exchange |
$54.47
|
| Rate for Payer: UHC Exchange |
$54.47
|
| Rate for Payer: UHCCP DNSP |
$39.67
|
| Rate for Payer: UHCCP DNSP |
$39.67
|
| Rate for Payer: UHCCP DNSP |
$39.67
|
|
|
CHG RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY
|
Professional
|
Both
|
$218.00
|
|
|
Service Code
|
HCPCS 77431
|
| Min. Negotiated Rate |
$67.95 |
| Max. Negotiated Rate |
$164.57 |
| Rate for Payer: Aetna Commercial |
$138.56
|
| Rate for Payer: Aetna Medicare |
$103.40
|
| Rate for Payer: BCBS Complete |
$71.35
|
| Rate for Payer: BCBS MAPPO |
$103.40
|
| Rate for Payer: BCN Commercial |
$163.34
|
| Rate for Payer: BCN Medicare Advantage |
$103.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cash Price |
$174.40
|
| Rate for Payer: Cofinity Commercial |
$148.90
|
| Rate for Payer: Cofinity Commercial |
$138.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.40
|
| Rate for Payer: Healthscope Commercial |
$124.08
|
| Rate for Payer: Healthscope Whirlpool |
$124.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.57
|
| Rate for Payer: Meridian Medicaid |
$71.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.74
|
| Rate for Payer: Nomi Health Commercial |
$124.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.50
|
| Rate for Payer: PACE SWMI |
$103.40
|
| Rate for Payer: PHP Medicare Advantage |
$103.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$164.57
|
| Rate for Payer: Priority Health Medicare |
$103.40
|
| Rate for Payer: Priority Health Narrow Network |
$164.57
|
| Rate for Payer: Railroad Medicare Medicare |
$103.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$157.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$103.40
|
| Rate for Payer: UHC Exchange |
$157.34
|
| Rate for Payer: UHC Medicaid |
$67.95
|
| Rate for Payer: UHCCP DNSP |
$103.40
|
| Rate for Payer: UHCCP Medicaid |
$67.95
|
|
|
CHG RADIATION TREATMENT DELIVERY LEVEL 1
|
Professional
|
Both
|
$373.00
|
|
|
Service Code
|
HCPCS 77402
|
| Min. Negotiated Rate |
$75.16 |
| Max. Negotiated Rate |
$279.75 |
| Rate for Payer: Aetna Commercial |
$100.71
|
| Rate for Payer: Aetna Medicare |
$75.16
|
| Rate for Payer: BCBS MAPPO |
$75.16
|
| Rate for Payer: BCN Commercial |
$107.86
|
| Rate for Payer: BCN Medicare Advantage |
$75.16
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cash Price |
$298.40
|
| Rate for Payer: Cofinity Commercial |
$100.71
|
| Rate for Payer: Cofinity Commercial |
$108.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.16
|
| Rate for Payer: Healthscope Commercial |
$90.19
|
| Rate for Payer: Healthscope Whirlpool |
$90.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.68
|
| Rate for Payer: Nomi Health Commercial |
$90.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.75
|
| Rate for Payer: PACE SWMI |
$75.16
|
| Rate for Payer: PHP Medicare Advantage |
$75.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$184.13
|
| Rate for Payer: Priority Health Medicare |
$75.16
|
| Rate for Payer: Priority Health Narrow Network |
$184.13
|
| Rate for Payer: Railroad Medicare Medicare |
$75.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$195.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.16
|
| Rate for Payer: UHC Exchange |
$195.74
|
| Rate for Payer: UHCCP DNSP |
$75.16
|
|
|
CHG RADIATION TREATMENT MANAGEMENT 5 TREATMENTS
|
Professional
|
Both
|
$371.00
|
|
|
Service Code
|
HCPCS 77427
|
| Min. Negotiated Rate |
$124.61 |
| Max. Negotiated Rate |
$291.50 |
| Rate for Payer: Aetna Commercial |
$254.68
|
| Rate for Payer: Aetna Medicare |
$190.06
|
| Rate for Payer: BCBS Complete |
$130.84
|
| Rate for Payer: BCBS MAPPO |
$190.06
|
| Rate for Payer: BCN Commercial |
$289.33
|
| Rate for Payer: BCN Medicare Advantage |
$190.06
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cash Price |
$296.80
|
| Rate for Payer: Cofinity Commercial |
$254.68
|
| Rate for Payer: Cofinity Commercial |
$273.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.06
|
| Rate for Payer: Healthscope Commercial |
$228.07
|
| Rate for Payer: Healthscope Whirlpool |
$228.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.56
|
| Rate for Payer: Meridian Medicaid |
$130.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.07
|
| Rate for Payer: Nomi Health Commercial |
$228.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$278.25
|
| Rate for Payer: PACE SWMI |
$190.06
|
| Rate for Payer: PHP Medicare Advantage |
$190.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$291.50
|
| Rate for Payer: Priority Health Medicare |
$190.06
|
| Rate for Payer: Priority Health Narrow Network |
$291.50
|
| Rate for Payer: Railroad Medicare Medicare |
$190.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$284.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$190.06
|
| Rate for Payer: UHC Exchange |
$284.01
|
| Rate for Payer: UHC Medicaid |
$124.61
|
| Rate for Payer: UHCCP DNSP |
$190.06
|
| Rate for Payer: UHCCP Medicaid |
$124.61
|
|
|
CHG RADIATION TX DELIVERY SUPERFICIAL&/ORTHO VOLTAGE
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 77401
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Aetna Commercial |
$48.09
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCN Commercial |
$61.25
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
|
|
CHG RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS
|
Professional
|
Both
|
$26.00
|
|
|
Service Code
|
HCPCS 70110
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$65.72 |
| Rate for Payer: Aetna Commercial |
$53.84
|
| Rate for Payer: Aetna Medicare |
$40.18
|
| Rate for Payer: BCBS MAPPO |
$40.18
|
| Rate for Payer: BCN Commercial |
$65.23
|
| Rate for Payer: BCN Medicare Advantage |
$40.18
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$57.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.18
|
| Rate for Payer: Healthscope Commercial |
$48.22
|
| Rate for Payer: Healthscope Whirlpool |
$48.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$48.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.50
|
| Rate for Payer: PACE SWMI |
$40.18
|
| Rate for Payer: PHP Medicare Advantage |
$40.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$65.72
|
| Rate for Payer: Priority Health Medicare |
$40.18
|
| Rate for Payer: Priority Health Narrow Network |
$65.72
|
| Rate for Payer: Railroad Medicare Medicare |
$40.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$59.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.18
|
| Rate for Payer: UHC Exchange |
$59.74
|
| Rate for Payer: UHCCP DNSP |
$40.18
|
|
|
CHG RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I
|
Professional
|
Both
|
$238.00
|
|
|
Service Code
|
HCPCS 75989
|
| Min. Negotiated Rate |
$106.79 |
| Max. Negotiated Rate |
$178.50 |
| Rate for Payer: Aetna Commercial |
$143.10
|
| Rate for Payer: Aetna Medicare |
$106.79
|
| Rate for Payer: BCBS MAPPO |
$106.79
|
| Rate for Payer: BCN Commercial |
$165.33
|
| Rate for Payer: BCN Medicare Advantage |
$106.79
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$143.10
|
| Rate for Payer: Cofinity Commercial |
$153.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.79
|
| Rate for Payer: Healthscope Commercial |
$128.15
|
| Rate for Payer: Healthscope Whirlpool |
$128.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.47
|
| Rate for Payer: Nomi Health Commercial |
$128.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.50
|
| Rate for Payer: PACE SWMI |
$106.79
|
| Rate for Payer: PHP Medicare Advantage |
$106.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$166.57
|
| Rate for Payer: Priority Health Medicare |
$106.79
|
| Rate for Payer: Priority Health Narrow Network |
$166.57
|
| Rate for Payer: Railroad Medicare Medicare |
$106.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$106.79
|
| Rate for Payer: UHC Exchange |
$174.50
|
| Rate for Payer: UHCCP DNSP |
$106.79
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$55.00
|
|
|
Service Code
|
HCPCS 74018
|
| Min. Negotiated Rate |
$27.81 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna Commercial |
$37.27
|
| Rate for Payer: Aetna Medicare |
$27.81
|
| Rate for Payer: BCBS MAPPO |
$27.81
|
| Rate for Payer: BCN Commercial |
$44.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.81
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cofinity Commercial |
$37.27
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.81
|
| Rate for Payer: Healthscope Commercial |
$33.37
|
| Rate for Payer: Healthscope Whirlpool |
$33.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.59
|
| Rate for Payer: Nomi Health Commercial |
$33.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.25
|
| Rate for Payer: PACE SWMI |
$27.81
|
| Rate for Payer: PHP Medicare Advantage |
$27.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$45.15
|
| Rate for Payer: Priority Health Medicare |
$27.81
|
| Rate for Payer: Priority Health Narrow Network |
$45.15
|
| Rate for Payer: Railroad Medicare Medicare |
$27.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$41.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.81
|
| Rate for Payer: UHC Exchange |
$41.23
|
| Rate for Payer: UHCCP DNSP |
$27.81
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 74019
|
| Min. Negotiated Rate |
$33.72 |
| Max. Negotiated Rate |
$59.25 |
| Rate for Payer: Aetna Commercial |
$45.18
|
| Rate for Payer: Aetna Commercial |
$45.18
|
| Rate for Payer: Aetna Medicare |
$33.72
|
| Rate for Payer: Aetna Medicare |
$33.72
|
| Rate for Payer: BCBS MAPPO |
$33.72
|
| Rate for Payer: BCBS MAPPO |
$33.72
|
| Rate for Payer: BCN Commercial |
$55.28
|
| Rate for Payer: BCN Commercial |
$55.28
|
| Rate for Payer: BCN Medicare Advantage |
$33.72
|
| Rate for Payer: BCN Medicare Advantage |
$33.72
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$48.56
|
| Rate for Payer: Cofinity Commercial |
$45.18
|
| Rate for Payer: Cofinity Commercial |
$48.56
|
| Rate for Payer: Cofinity Commercial |
$45.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.72
|
| Rate for Payer: Healthscope Commercial |
$40.46
|
| Rate for Payer: Healthscope Commercial |
$40.46
|
| Rate for Payer: Healthscope Whirlpool |
$40.46
|
| Rate for Payer: Healthscope Whirlpool |
$40.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.09
|
| Rate for Payer: Nomi Health Commercial |
$40.46
|
| Rate for Payer: Nomi Health Commercial |
$40.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.25
|
| Rate for Payer: PACE SWMI |
$33.72
|
| Rate for Payer: PACE SWMI |
$33.72
|
| Rate for Payer: PHP Medicare Advantage |
$33.72
|
| Rate for Payer: PHP Medicare Advantage |
$33.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$55.68
|
| Rate for Payer: Priority Health Medicare |
$33.72
|
| Rate for Payer: Priority Health Medicare |
$33.72
|
| Rate for Payer: Priority Health Narrow Network |
$55.68
|
| Rate for Payer: Priority Health Narrow Network |
$55.68
|
| Rate for Payer: Railroad Medicare Medicare |
$33.72
|
| Rate for Payer: Railroad Medicare Medicare |
$33.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$50.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$33.72
|
| Rate for Payer: UHC Exchange |
$50.80
|
| Rate for Payer: UHC Exchange |
$50.80
|
| Rate for Payer: UHCCP DNSP |
$33.72
|
| Rate for Payer: UHCCP DNSP |
$33.72
|
|
