|
CHG TRANSFERASE ALANINE AMINO ALT SGPT
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 84460
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$7.10
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$7.63
|
| Rate for Payer: Cofinity Commercial |
$7.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$6.36
|
| Rate for Payer: Healthscope Whirlpool |
$6.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.83
|
| Rate for Payer: Nomi Health Commercial |
$6.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.38
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.30
|
| Rate for Payer: UHC Exchange |
$2.23
|
| Rate for Payer: UHCCP DNSP |
$5.30
|
|
|
CHG TRANSFERASE ASPARTATE AMINO AST SGOT
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 84450
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Commercial |
$1.08
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$6.22
|
| Rate for Payer: Healthscope Whirlpool |
$6.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Nomi Health Commercial |
$6.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$5.38
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$2.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION COMPLEX
|
Professional
|
Both
|
$300.00
|
|
|
Service Code
|
HCPCS 77334
|
| Min. Negotiated Rate |
$118.96 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna Commercial |
$159.41
|
| Rate for Payer: Aetna Commercial |
$159.41
|
| Rate for Payer: Aetna Medicare |
$118.96
|
| Rate for Payer: Aetna Medicare |
$118.96
|
| Rate for Payer: BCBS MAPPO |
$118.96
|
| Rate for Payer: BCBS MAPPO |
$118.96
|
| Rate for Payer: BCN Commercial |
$220.17
|
| Rate for Payer: BCN Commercial |
$220.17
|
| Rate for Payer: BCN Medicare Advantage |
$118.96
|
| Rate for Payer: BCN Medicare Advantage |
$118.96
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$171.30
|
| Rate for Payer: Cofinity Commercial |
$159.41
|
| Rate for Payer: Cofinity Commercial |
$171.30
|
| Rate for Payer: Cofinity Commercial |
$159.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.96
|
| Rate for Payer: Healthscope Commercial |
$142.75
|
| Rate for Payer: Healthscope Commercial |
$142.75
|
| Rate for Payer: Healthscope Whirlpool |
$142.75
|
| Rate for Payer: Healthscope Whirlpool |
$142.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$130.86
|
| Rate for Payer: Nomi Health Commercial |
$142.75
|
| Rate for Payer: Nomi Health Commercial |
$142.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PACE SWMI |
$118.96
|
| Rate for Payer: PACE SWMI |
$118.96
|
| Rate for Payer: PHP Medicare Advantage |
$118.96
|
| Rate for Payer: PHP Medicare Advantage |
$118.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$190.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$190.66
|
| Rate for Payer: Priority Health Medicare |
$118.96
|
| Rate for Payer: Priority Health Medicare |
$118.96
|
| Rate for Payer: Priority Health Narrow Network |
$190.66
|
| Rate for Payer: Priority Health Narrow Network |
$190.66
|
| Rate for Payer: Railroad Medicare Medicare |
$118.96
|
| Rate for Payer: Railroad Medicare Medicare |
$118.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$183.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$118.96
|
| Rate for Payer: UHC Exchange |
$183.03
|
| Rate for Payer: UHC Exchange |
$183.03
|
| Rate for Payer: UHCCP DNSP |
$118.96
|
| Rate for Payer: UHCCP DNSP |
$118.96
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 77333
|
| Min. Negotiated Rate |
$76.63 |
| Max. Negotiated Rate |
$206.21 |
| Rate for Payer: Aetna Commercial |
$171.59
|
| Rate for Payer: Aetna Commercial |
$171.59
|
| Rate for Payer: Aetna Medicare |
$128.05
|
| Rate for Payer: Aetna Medicare |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$128.05
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Commercial |
$76.63
|
| Rate for Payer: BCN Medicare Advantage |
$128.05
|
| Rate for Payer: BCN Medicare Advantage |
$128.05
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$171.59
|
| Rate for Payer: Cofinity Commercial |
$184.39
|
| Rate for Payer: Cofinity Commercial |
$171.59
|
| Rate for Payer: Cofinity Commercial |
$184.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.05
|
| Rate for Payer: Healthscope Commercial |
$153.66
|
| Rate for Payer: Healthscope Commercial |
$153.66
|
| Rate for Payer: Healthscope Whirlpool |
$153.66
|
| Rate for Payer: Healthscope Whirlpool |
$153.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$140.85
|
| Rate for Payer: Nomi Health Commercial |
$153.66
|
| Rate for Payer: Nomi Health Commercial |
$153.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.50
|
| Rate for Payer: PACE SWMI |
$128.05
|
| Rate for Payer: PACE SWMI |
$128.05
|
| Rate for Payer: PHP Medicare Advantage |
$128.05
|
| Rate for Payer: PHP Medicare Advantage |
$128.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$206.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$206.21
|
| Rate for Payer: Priority Health Medicare |
$128.05
|
| Rate for Payer: Priority Health Medicare |
$128.05
|
| Rate for Payer: Priority Health Narrow Network |
$206.21
|
| Rate for Payer: Priority Health Narrow Network |
$206.21
|
| Rate for Payer: Railroad Medicare Medicare |
$128.05
|
| Rate for Payer: Railroad Medicare Medicare |
$128.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$171.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.05
|
| Rate for Payer: UHC Exchange |
$171.28
|
| Rate for Payer: UHC Exchange |
$171.28
|
| Rate for Payer: UHCCP DNSP |
$128.05
|
| Rate for Payer: UHCCP DNSP |
$128.05
|
|
|
CHG TX DEVICES DESIGN & CONSTRUCTION SIMPLE
|
Professional
|
Both
|
$102.00
|
|
|
Service Code
|
HCPCS 77332
|
| Min. Negotiated Rate |
$38.70 |
| Max. Negotiated Rate |
$119.55 |
| Rate for Payer: Aetna Commercial |
$51.86
|
| Rate for Payer: Aetna Commercial |
$51.86
|
| Rate for Payer: Aetna Medicare |
$38.70
|
| Rate for Payer: Aetna Medicare |
$38.70
|
| Rate for Payer: BCBS MAPPO |
$38.70
|
| Rate for Payer: BCBS MAPPO |
$38.70
|
| Rate for Payer: BCN Commercial |
$119.55
|
| Rate for Payer: BCN Commercial |
$119.55
|
| Rate for Payer: BCN Medicare Advantage |
$38.70
|
| Rate for Payer: BCN Medicare Advantage |
$38.70
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$81.60
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Cofinity Commercial |
$55.73
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Cofinity Commercial |
$55.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.70
|
| Rate for Payer: Healthscope Commercial |
$46.44
|
| Rate for Payer: Healthscope Commercial |
$46.44
|
| Rate for Payer: Healthscope Whirlpool |
$46.44
|
| Rate for Payer: Healthscope Whirlpool |
$46.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.57
|
| Rate for Payer: Nomi Health Commercial |
$46.44
|
| Rate for Payer: Nomi Health Commercial |
$46.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.50
|
| Rate for Payer: PACE SWMI |
$38.70
|
| Rate for Payer: PACE SWMI |
$38.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.70
|
| 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 |
$38.70
|
| Rate for Payer: Priority Health Medicare |
$38.70
|
| Rate for Payer: Priority Health Narrow Network |
$61.72
|
| Rate for Payer: Priority Health Narrow Network |
$61.72
|
| Rate for Payer: Railroad Medicare Medicare |
$38.70
|
| Rate for Payer: Railroad Medicare Medicare |
$38.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$68.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.70
|
| Rate for Payer: UHC Exchange |
$68.08
|
| Rate for Payer: UHC Exchange |
$68.08
|
| Rate for Payer: UHCCP DNSP |
$38.70
|
| Rate for Payer: UHCCP DNSP |
$38.70
|
|
|
CHG ULTRASONIC GUIDANCE INTRAOPERATIVE
|
Professional
|
Both
|
$304.00
|
|
|
Service Code
|
HCPCS 76998
|
| Min. Negotiated Rate |
$69.23 |
| Max. Negotiated Rate |
$228.00 |
| Rate for Payer: Aetna Commercial |
$74.11
|
| Rate for Payer: BCN Commercial |
$69.23
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Cash Price |
$243.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$69.74
|
| Rate for Payer: Priority Health Narrow Network |
$69.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$175.14
|
| Rate for Payer: UHC Exchange |
$175.14
|
|
|
CHG ULTRASOUND ELASTOGRAPHY PARENCHYMA
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 76981
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$159.05 |
| Rate for Payer: Aetna Commercial |
$140.35
|
| Rate for Payer: Aetna Medicare |
$104.74
|
| Rate for Payer: BCBS MAPPO |
$104.74
|
| Rate for Payer: BCN Commercial |
$157.86
|
| Rate for Payer: BCN Medicare Advantage |
$104.74
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$150.83
|
| Rate for Payer: Cofinity Commercial |
$140.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.74
|
| Rate for Payer: Healthscope Commercial |
$125.69
|
| Rate for Payer: Healthscope Whirlpool |
$125.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$115.21
|
| Rate for Payer: Nomi Health Commercial |
$125.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$104.74
|
| Rate for Payer: PHP Medicare Advantage |
$104.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$159.05
|
| Rate for Payer: Priority Health Medicare |
$104.74
|
| Rate for Payer: Priority Health Narrow Network |
$159.05
|
| Rate for Payer: Railroad Medicare Medicare |
$104.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$152.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.74
|
| Rate for Payer: UHC Exchange |
$152.35
|
| Rate for Payer: UHCCP DNSP |
$104.74
|
|
|
CHG ULTRASOUND SPINAL CANAL & CONTENTS
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 76800
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$271.94 |
| Rate for Payer: Aetna Commercial |
$239.53
|
| Rate for Payer: Aetna Medicare |
$178.75
|
| Rate for Payer: BCBS MAPPO |
$178.75
|
| Rate for Payer: BCN Commercial |
$269.91
|
| Rate for Payer: BCN Medicare Advantage |
$178.75
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$239.53
|
| Rate for Payer: Cofinity Commercial |
$257.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.75
|
| Rate for Payer: Healthscope Commercial |
$214.50
|
| Rate for Payer: Healthscope Whirlpool |
$214.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$196.62
|
| Rate for Payer: Nomi Health Commercial |
$214.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.50
|
| Rate for Payer: PACE SWMI |
$178.75
|
| Rate for Payer: PHP Medicare Advantage |
$178.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$271.94
|
| Rate for Payer: Priority Health Medicare |
$178.75
|
| Rate for Payer: Priority Health Narrow Network |
$271.94
|
| Rate for Payer: Railroad Medicare Medicare |
$178.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$204.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$178.75
|
| Rate for Payer: UHC Exchange |
$204.44
|
| Rate for Payer: UHCCP DNSP |
$178.75
|
|
|
CHG UNLISTED FLUOROSCOPIC PROCEDURE
|
Professional
|
Both
|
$263.00
|
|
|
Service Code
|
HCPCS 76496
|
| Min. Negotiated Rate |
$74.70 |
| Max. Negotiated Rate |
$197.25 |
| Rate for Payer: Aetna Commercial |
$74.70
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$197.25
|
|
|
CHG URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM
|
Professional
|
Both
|
$500.00
|
|
|
Service Code
|
HCPCS 78740
|
| Min. Negotiated Rate |
$203.63 |
| Max. Negotiated Rate |
$375.00 |
| Rate for Payer: Aetna Commercial |
$272.86
|
| Rate for Payer: Aetna Medicare |
$203.63
|
| Rate for Payer: BCBS MAPPO |
$203.63
|
| Rate for Payer: BCN Commercial |
$312.23
|
| Rate for Payer: BCN Medicare Advantage |
$203.63
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$293.23
|
| Rate for Payer: Cofinity Commercial |
$272.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.63
|
| Rate for Payer: Healthscope Commercial |
$244.36
|
| Rate for Payer: Healthscope Whirlpool |
$244.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$223.99
|
| Rate for Payer: Nomi Health Commercial |
$244.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.00
|
| Rate for Payer: PACE SWMI |
$203.63
|
| Rate for Payer: PHP Medicare Advantage |
$203.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$314.58
|
| Rate for Payer: Priority Health Medicare |
$203.63
|
| Rate for Payer: Priority Health Narrow Network |
$314.58
|
| Rate for Payer: Railroad Medicare Medicare |
$203.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$308.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$203.63
|
| Rate for Payer: UHC Exchange |
$308.27
|
| Rate for Payer: UHCCP DNSP |
$203.63
|
|
|
CHG URETHROCYSTOGRAPHY RETROGRADE RS&I
|
Professional
|
Both
|
$115.00
|
|
|
Service Code
|
HCPCS 74450
|
| Min. Negotiated Rate |
$22.92 |
| Max. Negotiated Rate |
$341.84 |
| Rate for Payer: Aetna Commercial |
$256.77
|
| Rate for Payer: BCN Commercial |
$22.92
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$100.34
|
| Rate for Payer: Priority Health Narrow Network |
$100.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$341.84
|
| Rate for Payer: UHC Exchange |
$341.84
|
|
|
CHG URETHROCYSTOGRAPHY VOIDING RS&I
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 74455
|
| Min. Negotiated Rate |
$25.50 |
| Max. Negotiated Rate |
$152.52 |
| Rate for Payer: Aetna Commercial |
$130.66
|
| Rate for Payer: Aetna Medicare |
$97.51
|
| Rate for Payer: BCBS MAPPO |
$97.51
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$97.51
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$140.41
|
| Rate for Payer: Cofinity Commercial |
$130.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.51
|
| Rate for Payer: Healthscope Commercial |
$117.01
|
| Rate for Payer: Healthscope Whirlpool |
$117.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.26
|
| Rate for Payer: Nomi Health Commercial |
$117.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.50
|
| Rate for Payer: PACE SWMI |
$97.51
|
| Rate for Payer: PHP Medicare Advantage |
$97.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$152.52
|
| Rate for Payer: Priority Health Medicare |
$97.51
|
| Rate for Payer: Priority Health Narrow Network |
$152.52
|
| Rate for Payer: Railroad Medicare Medicare |
$97.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$136.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$97.51
|
| Rate for Payer: UHC Exchange |
$136.32
|
| Rate for Payer: UHCCP DNSP |
$97.51
|
|
|
CHG URINALYSIS MICROSCOPIC ONLY
|
Professional
|
Both
|
$7.00
|
|
|
Service Code
|
HCPCS 81015
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$5.25 |
| Rate for Payer: Aetna Commercial |
$4.09
|
| Rate for Payer: Aetna Medicare |
$3.05
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCN Commercial |
$3.05
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cash Price |
$5.60
|
| Rate for Payer: Cofinity Commercial |
$4.09
|
| Rate for Payer: Cofinity Commercial |
$4.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$3.66
|
| Rate for Payer: Healthscope Whirlpool |
$3.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.35
|
| Rate for Payer: Nomi Health Commercial |
$3.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5.25
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.02
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health Narrow Network |
$3.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.05
|
| Rate for Payer: UHC Exchange |
$1.83
|
| Rate for Payer: UHCCP DNSP |
$3.05
|
|
|
CHG URINALYSIS QUAL/SEMIQUANT EXCEPT IMMUNOASSAYS
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81005
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$2.91
|
| Rate for Payer: Aetna Medicare |
$2.17
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$2.60
|
| Rate for Payer: Healthscope Whirlpool |
$2.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Nomi Health Commercial |
$2.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.35
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$2.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$1.30
|
| Rate for Payer: UHCCP DNSP |
$2.17
|
|
|
CHG URINARY BLADDER RESIDUAL STUDY
|
Professional
|
Both
|
$245.00
|
|
|
Service Code
|
HCPCS 78730
|
| Min. Negotiated Rate |
$67.29 |
| Max. Negotiated Rate |
$183.75 |
| Rate for Payer: Aetna Commercial |
$90.17
|
| Rate for Payer: Aetna Medicare |
$67.29
|
| Rate for Payer: BCBS MAPPO |
$67.29
|
| Rate for Payer: BCN Commercial |
$98.60
|
| Rate for Payer: BCN Medicare Advantage |
$67.29
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$90.17
|
| Rate for Payer: Cofinity Commercial |
$96.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.29
|
| Rate for Payer: Healthscope Commercial |
$80.75
|
| Rate for Payer: Healthscope Whirlpool |
$80.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$74.02
|
| Rate for Payer: Nomi Health Commercial |
$80.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.75
|
| Rate for Payer: PACE SWMI |
$67.29
|
| Rate for Payer: PHP Medicare Advantage |
$67.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$99.35
|
| Rate for Payer: Priority Health Medicare |
$67.29
|
| Rate for Payer: Priority Health Narrow Network |
$99.35
|
| Rate for Payer: Railroad Medicare Medicare |
$67.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$67.29
|
| Rate for Payer: UHC Exchange |
$107.43
|
| Rate for Payer: UHCCP DNSP |
$67.29
|
|
|
CHG URINE ALBUMIN SEMIQUANTITATIVE
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82044
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$8.35
|
| Rate for Payer: Aetna Medicare |
$6.23
|
| Rate for Payer: BCBS MAPPO |
$6.23
|
| Rate for Payer: BCN Commercial |
$4.67
|
| Rate for Payer: BCN Medicare Advantage |
$6.23
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$8.35
|
| Rate for Payer: Cofinity Commercial |
$8.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.23
|
| Rate for Payer: Healthscope Commercial |
$7.48
|
| Rate for Payer: Healthscope Whirlpool |
$7.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.85
|
| Rate for Payer: Nomi Health Commercial |
$7.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$6.23
|
| Rate for Payer: PHP Medicare Advantage |
$6.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6.39
|
| Rate for Payer: Priority Health Medicare |
$6.23
|
| Rate for Payer: Priority Health Narrow Network |
$6.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.23
|
| Rate for Payer: UHC Exchange |
$3.74
|
| Rate for Payer: UHCCP DNSP |
$6.23
|
|
|
CHG URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS
|
Professional
|
Both
|
$24.00
|
|
|
Service Code
|
HCPCS 81025
|
| Min. Negotiated Rate |
$5.17 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna Commercial |
$11.54
|
| Rate for Payer: Aetna Medicare |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$11.54
|
| Rate for Payer: Cofinity Commercial |
$12.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$10.33
|
| Rate for Payer: Healthscope Whirlpool |
$10.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.47
|
| Rate for Payer: Nomi Health Commercial |
$10.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.00
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$9.07
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health Narrow Network |
$9.07
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.61
|
| Rate for Payer: UHC Exchange |
$5.17
|
| Rate for Payer: UHCCP DNSP |
$8.61
|
|
|
CHG URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 81000
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna Commercial |
$5.39
|
| Rate for Payer: Aetna Medicare |
$4.02
|
| Rate for Payer: BCBS MAPPO |
$4.02
|
| Rate for Payer: BCN Commercial |
$4.02
|
| Rate for Payer: BCN Medicare Advantage |
$4.02
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$5.39
|
| Rate for Payer: Cofinity Commercial |
$5.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.02
|
| Rate for Payer: Healthscope Commercial |
$4.82
|
| Rate for Payer: Healthscope Whirlpool |
$4.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.42
|
| Rate for Payer: Nomi Health Commercial |
$4.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.50
|
| Rate for Payer: PACE SWMI |
$4.02
|
| Rate for Payer: PHP Medicare Advantage |
$4.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$4.03
|
| Rate for Payer: Priority Health Medicare |
$4.02
|
| Rate for Payer: Priority Health Narrow Network |
$4.03
|
| Rate for Payer: Railroad Medicare Medicare |
$4.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.02
|
| Rate for Payer: UHC Exchange |
$2.41
|
| Rate for Payer: UHCCP DNSP |
$4.02
|
|
|
CHG URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 81001
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$24.00 |
| Rate for Payer: Aetna Commercial |
$4.25
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCN Commercial |
$3.17
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cofinity Commercial |
$4.25
|
| Rate for Payer: Cofinity Commercial |
$4.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
| Rate for Payer: Healthscope Commercial |
$3.80
|
| Rate for Payer: Healthscope Whirlpool |
$3.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.49
|
| Rate for Payer: Nomi Health Commercial |
$3.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.00
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.36
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health Narrow Network |
$3.36
|
| Rate for Payer: Railroad Medicare Medicare |
$3.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.17
|
| Rate for Payer: UHC Exchange |
$1.90
|
| Rate for Payer: UHCCP DNSP |
$3.17
|
|
|
CHG URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 81003
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$10.50 |
| Rate for Payer: Aetna Commercial |
$3.02
|
| Rate for Payer: Aetna Medicare |
$2.25
|
| Rate for Payer: BCBS MAPPO |
$2.25
|
| Rate for Payer: BCN Commercial |
$2.25
|
| Rate for Payer: BCN Medicare Advantage |
$2.25
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.02
|
| Rate for Payer: Cofinity Commercial |
$3.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
| Rate for Payer: Healthscope Commercial |
$2.70
|
| Rate for Payer: Healthscope Whirlpool |
$2.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.48
|
| Rate for Payer: Nomi Health Commercial |
$2.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.50
|
| Rate for Payer: PACE SWMI |
$2.25
|
| Rate for Payer: PHP Medicare Advantage |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$2.35
|
| Rate for Payer: Priority Health Medicare |
$2.25
|
| Rate for Payer: Priority Health Narrow Network |
$2.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.25
|
| Rate for Payer: UHC Exchange |
$1.35
|
| Rate for Payer: UHCCP DNSP |
$2.25
|
|
|
CHG URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 81002
|
| Min. Negotiated Rate |
$2.09 |
| Max. Negotiated Rate |
$9.00 |
| Rate for Payer: Aetna Commercial |
$4.66
|
| Rate for Payer: Aetna Medicare |
$3.48
|
| Rate for Payer: BCBS MAPPO |
$3.48
|
| Rate for Payer: BCN Commercial |
$3.48
|
| Rate for Payer: BCN Medicare Advantage |
$3.48
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$4.66
|
| Rate for Payer: Cofinity Commercial |
$5.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.48
|
| Rate for Payer: Healthscope Commercial |
$4.18
|
| Rate for Payer: Healthscope Whirlpool |
$4.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.83
|
| Rate for Payer: Nomi Health Commercial |
$4.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.00
|
| Rate for Payer: PACE SWMI |
$3.48
|
| Rate for Payer: PHP Medicare Advantage |
$3.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3.70
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow Network |
$3.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.48
|
| Rate for Payer: UHC Exchange |
$2.09
|
| Rate for Payer: UHCCP DNSP |
$3.48
|
|
|
CHG UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 74400
|
| Min. Negotiated Rate |
$122.21 |
| Max. Negotiated Rate |
$199.19 |
| Rate for Payer: Aetna Commercial |
$163.76
|
| Rate for Payer: Aetna Commercial |
$163.76
|
| Rate for Payer: Aetna Medicare |
$122.21
|
| Rate for Payer: Aetna Medicare |
$122.21
|
| Rate for Payer: BCBS MAPPO |
$122.21
|
| Rate for Payer: BCBS MAPPO |
$122.21
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Commercial |
$197.70
|
| Rate for Payer: BCN Medicare Advantage |
$122.21
|
| Rate for Payer: BCN Medicare Advantage |
$122.21
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Cofinity Commercial |
$175.98
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.21
|
| Rate for Payer: Healthscope Commercial |
$146.65
|
| Rate for Payer: Healthscope Commercial |
$146.65
|
| Rate for Payer: Healthscope Whirlpool |
$146.65
|
| Rate for Payer: Healthscope Whirlpool |
$146.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.43
|
| Rate for Payer: Nomi Health Commercial |
$146.65
|
| Rate for Payer: Nomi Health Commercial |
$146.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$108.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$122.21
|
| Rate for Payer: PACE SWMI |
$122.21
|
| Rate for Payer: PHP Medicare Advantage |
$122.21
|
| Rate for Payer: PHP Medicare Advantage |
$122.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$199.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$199.19
|
| Rate for Payer: Priority Health Medicare |
$122.21
|
| Rate for Payer: Priority Health Medicare |
$122.21
|
| Rate for Payer: Priority Health Narrow Network |
$199.19
|
| Rate for Payer: Priority Health Narrow Network |
$199.19
|
| Rate for Payer: Railroad Medicare Medicare |
$122.21
|
| Rate for Payer: Railroad Medicare Medicare |
$122.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$179.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.21
|
| Rate for Payer: UHC Exchange |
$179.38
|
| Rate for Payer: UHC Exchange |
$179.38
|
| Rate for Payer: UHCCP DNSP |
$122.21
|
| Rate for Payer: UHCCP DNSP |
$122.21
|
|
|
CHG UROGRAPHY RETROGRADE WITH/WO KUB
|
Professional
|
Both
|
$61.00
|
|
|
Service Code
|
HCPCS 74420
|
| Min. Negotiated Rate |
$45.75 |
| Max. Negotiated Rate |
$117.40 |
| Rate for Payer: Aetna Commercial |
$101.57
|
| Rate for Payer: Aetna Medicare |
$75.80
|
| Rate for Payer: BCBS MAPPO |
$75.80
|
| Rate for Payer: BCN Commercial |
$116.53
|
| Rate for Payer: BCN Medicare Advantage |
$75.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$101.57
|
| Rate for Payer: Cofinity Commercial |
$109.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.80
|
| Rate for Payer: Healthscope Commercial |
$90.96
|
| Rate for Payer: Healthscope Whirlpool |
$90.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$83.38
|
| Rate for Payer: Nomi Health Commercial |
$90.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$45.75
|
| Rate for Payer: PACE SWMI |
$75.80
|
| Rate for Payer: PHP Medicare Advantage |
$75.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$117.40
|
| Rate for Payer: Priority Health Medicare |
$75.80
|
| Rate for Payer: Priority Health Narrow Network |
$117.40
|
| Rate for Payer: Railroad Medicare Medicare |
$75.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$104.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$75.80
|
| Rate for Payer: UHC Exchange |
$104.78
|
| Rate for Payer: UHCCP DNSP |
$75.80
|
|
|
CHG US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 76706
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$160.56 |
| Rate for Payer: Aetna Commercial |
$132.12
|
| Rate for Payer: Aetna Medicare |
$98.60
|
| Rate for Payer: BCBS MAPPO |
$98.60
|
| Rate for Payer: BCN Commercial |
$159.35
|
| Rate for Payer: BCN Medicare Advantage |
$98.60
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cofinity Commercial |
$132.12
|
| Rate for Payer: Cofinity Commercial |
$141.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.60
|
| Rate for Payer: Healthscope Commercial |
$118.32
|
| Rate for Payer: Healthscope Whirlpool |
$118.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.46
|
| Rate for Payer: Nomi Health Commercial |
$118.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.25
|
| Rate for Payer: PACE SWMI |
$98.60
|
| Rate for Payer: PHP Medicare Advantage |
$98.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$160.56
|
| Rate for Payer: Priority Health Medicare |
$98.60
|
| Rate for Payer: Priority Health Narrow Network |
$160.56
|
| Rate for Payer: Railroad Medicare Medicare |
$98.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$160.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.60
|
| Rate for Payer: UHC Exchange |
$160.53
|
| Rate for Payer: UHCCP DNSP |
$98.60
|
|
|
CHG US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION
|
Professional
|
Both
|
$219.00
|
|
|
Service Code
|
HCPCS 76700
|
| Min. Negotiated Rate |
$107.02 |
| Max. Negotiated Rate |
$174.59 |
| Rate for Payer: Aetna Commercial |
$143.41
|
| Rate for Payer: Aetna Medicare |
$107.02
|
| Rate for Payer: BCBS MAPPO |
$107.02
|
| Rate for Payer: BCN Commercial |
$172.30
|
| Rate for Payer: BCN Medicare Advantage |
$107.02
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cash Price |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$143.41
|
| Rate for Payer: Cofinity Commercial |
$154.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.02
|
| Rate for Payer: Healthscope Commercial |
$128.42
|
| Rate for Payer: Healthscope Whirlpool |
$128.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$117.72
|
| Rate for Payer: Nomi Health Commercial |
$128.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.25
|
| Rate for Payer: PACE SWMI |
$107.02
|
| Rate for Payer: PHP Medicare Advantage |
$107.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$173.60
|
| Rate for Payer: Priority Health Medicare |
$107.02
|
| Rate for Payer: Priority Health Narrow Network |
$173.60
|
| Rate for Payer: Railroad Medicare Medicare |
$107.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$174.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$107.02
|
| Rate for Payer: UHC Exchange |
$174.59
|
| Rate for Payer: UHCCP DNSP |
$107.02
|
|
