|
CHG ANGIOGRAPHY EXTREMITY BILATERAL RS&I
|
Professional
|
Both
|
$198.00
|
|
|
Service Code
|
HCPCS 75716
|
| Min. Negotiated Rate |
$79.20 |
| Max. Negotiated Rate |
$217.63 |
| Rate for Payer: Aetna Commercial |
$202.51
|
| Rate for Payer: Aetna Medicare |
$151.13
|
| Rate for Payer: BCBS Complete |
$79.20
|
| Rate for Payer: BCBS MAPPO |
$151.13
|
| Rate for Payer: BCN Medicare Advantage |
$151.13
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cash Price |
$158.40
|
| Rate for Payer: Cofinity Commercial |
$217.63
|
| Rate for Payer: Cofinity Commercial |
$202.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.13
|
| Rate for Payer: Healthscope Commercial |
$181.36
|
| Rate for Payer: Healthscope Whirlpool |
$181.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$158.69
|
| Rate for Payer: Nomi Health Commercial |
$181.36
|
| Rate for Payer: PACE SWMI |
$151.13
|
| Rate for Payer: PHP Medicare Advantage |
$151.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.70
|
| Rate for Payer: Priority Health Medicare |
$151.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.13
|
| Rate for Payer: UHC Medicare Advantage |
$151.13
|
| Rate for Payer: UHCCP DNSP |
$151.13
|
|
|
CHG ANGIOGRAPHY EXTREMITY UNILATERAL RS&I
|
Professional
|
Both
|
$182.00
|
|
|
Service Code
|
HCPCS 75710
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$198.59 |
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Aetna Commercial |
$184.80
|
| Rate for Payer: Aetna Medicare |
$137.91
|
| Rate for Payer: Aetna Medicare |
$137.91
|
| Rate for Payer: BCBS Complete |
$72.80
|
| Rate for Payer: BCBS Complete |
$172.00
|
| Rate for Payer: BCBS MAPPO |
$137.91
|
| Rate for Payer: BCBS MAPPO |
$137.91
|
| Rate for Payer: BCN Medicare Advantage |
$137.91
|
| Rate for Payer: BCN Medicare Advantage |
$137.91
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cash Price |
$145.60
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$198.59
|
| Rate for Payer: Cofinity Commercial |
$184.80
|
| Rate for Payer: Cofinity Commercial |
$198.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$137.91
|
| Rate for Payer: Healthscope Commercial |
$165.49
|
| Rate for Payer: Healthscope Commercial |
$165.49
|
| Rate for Payer: Healthscope Whirlpool |
$165.49
|
| Rate for Payer: Healthscope Whirlpool |
$165.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$144.81
|
| Rate for Payer: Nomi Health Commercial |
$165.49
|
| Rate for Payer: Nomi Health Commercial |
$165.49
|
| Rate for Payer: PACE SWMI |
$137.91
|
| Rate for Payer: PACE SWMI |
$137.91
|
| Rate for Payer: PHP Medicare Advantage |
$137.91
|
| Rate for Payer: PHP Medicare Advantage |
$137.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$118.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.50
|
| Rate for Payer: Priority Health Medicare |
$137.91
|
| Rate for Payer: Priority Health Medicare |
$137.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$137.91
|
| Rate for Payer: UHC Medicare Advantage |
$137.91
|
| Rate for Payer: UHC Medicare Advantage |
$137.91
|
| Rate for Payer: UHCCP DNSP |
$137.91
|
| Rate for Payer: UHCCP DNSP |
$137.91
|
|
|
CHG ANGIOGRAPHY INTERNAL MAMMARY RS&I
|
Professional
|
Both
|
$190.00
|
|
|
Service Code
|
HCPCS 75756
|
| Min. Negotiated Rate |
$76.00 |
| Max. Negotiated Rate |
$213.21 |
| Rate for Payer: Aetna Commercial |
$198.40
|
| Rate for Payer: Aetna Medicare |
$148.06
|
| Rate for Payer: BCBS Complete |
$76.00
|
| Rate for Payer: BCBS MAPPO |
$148.06
|
| Rate for Payer: BCN Medicare Advantage |
$148.06
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cash Price |
$152.00
|
| Rate for Payer: Cofinity Commercial |
$213.21
|
| Rate for Payer: Cofinity Commercial |
$198.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$148.06
|
| Rate for Payer: Healthscope Commercial |
$177.67
|
| Rate for Payer: Healthscope Whirlpool |
$177.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$155.46
|
| Rate for Payer: Nomi Health Commercial |
$177.67
|
| Rate for Payer: PACE SWMI |
$148.06
|
| Rate for Payer: PHP Medicare Advantage |
$148.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.50
|
| Rate for Payer: Priority Health Medicare |
$148.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$148.06
|
| Rate for Payer: UHC Medicare Advantage |
$148.06
|
| Rate for Payer: UHCCP DNSP |
$148.06
|
|
|
CHG ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I
|
Professional
|
Both
|
$319.00
|
|
|
Service Code
|
HCPCS 75736
|
| Min. Negotiated Rate |
$127.60 |
| Max. Negotiated Rate |
$207.35 |
| Rate for Payer: Aetna Commercial |
$176.63
|
| Rate for Payer: Aetna Medicare |
$131.81
|
| Rate for Payer: BCBS Complete |
$127.60
|
| Rate for Payer: BCBS MAPPO |
$131.81
|
| Rate for Payer: BCN Medicare Advantage |
$131.81
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cash Price |
$255.20
|
| Rate for Payer: Cofinity Commercial |
$189.81
|
| Rate for Payer: Cofinity Commercial |
$176.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.81
|
| Rate for Payer: Healthscope Commercial |
$158.17
|
| Rate for Payer: Healthscope Whirlpool |
$158.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$138.40
|
| Rate for Payer: Nomi Health Commercial |
$158.17
|
| Rate for Payer: PACE SWMI |
$131.81
|
| Rate for Payer: PHP Medicare Advantage |
$131.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$207.35
|
| Rate for Payer: Priority Health Medicare |
$131.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.81
|
| Rate for Payer: UHC Medicare Advantage |
$131.81
|
| Rate for Payer: UHCCP DNSP |
$131.81
|
|
|
CHG ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 75741
|
| Min. Negotiated Rate |
$50.00 |
| Max. Negotiated Rate |
$170.87 |
| Rate for Payer: Aetna Commercial |
$159.00
|
| Rate for Payer: Aetna Medicare |
$118.66
|
| Rate for Payer: BCBS Complete |
$50.00
|
| Rate for Payer: BCBS MAPPO |
$118.66
|
| Rate for Payer: BCN Medicare Advantage |
$118.66
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cofinity Commercial |
$170.87
|
| Rate for Payer: Cofinity Commercial |
$159.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$118.66
|
| Rate for Payer: Healthscope Commercial |
$142.39
|
| Rate for Payer: Healthscope Whirlpool |
$142.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$124.59
|
| Rate for Payer: Nomi Health Commercial |
$142.39
|
| Rate for Payer: PACE SWMI |
$118.66
|
| Rate for Payer: PHP Medicare Advantage |
$118.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Medicare |
$118.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$118.66
|
| Rate for Payer: UHC Medicare Advantage |
$118.66
|
| Rate for Payer: UHCCP DNSP |
$118.66
|
|
|
CHG ANGIOGRAPHY SPINAL SELECTIVE RS&I
|
Professional
|
Both
|
$436.00
|
|
|
Service Code
|
HCPCS 75705
|
| Min. Negotiated Rate |
$174.40 |
| Max. Negotiated Rate |
$341.87 |
| Rate for Payer: Aetna Commercial |
$318.13
|
| Rate for Payer: Aetna Medicare |
$237.41
|
| Rate for Payer: BCBS Complete |
$174.40
|
| Rate for Payer: BCBS MAPPO |
$237.41
|
| Rate for Payer: BCN Medicare Advantage |
$237.41
|
| Rate for Payer: Cash Price |
$348.80
|
| Rate for Payer: Cash Price |
$348.80
|
| Rate for Payer: Cofinity Commercial |
$341.87
|
| Rate for Payer: Cofinity Commercial |
$318.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.41
|
| Rate for Payer: Healthscope Commercial |
$284.89
|
| Rate for Payer: Healthscope Whirlpool |
$284.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.28
|
| Rate for Payer: Nomi Health Commercial |
$284.89
|
| Rate for Payer: PACE SWMI |
$237.41
|
| Rate for Payer: PHP Medicare Advantage |
$237.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$283.40
|
| Rate for Payer: Priority Health Medicare |
$237.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.41
|
| Rate for Payer: UHC Medicare Advantage |
$237.41
|
| Rate for Payer: UHCCP DNSP |
$237.41
|
|
|
CHG ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I
|
Professional
|
Both
|
$273.00
|
|
|
Service Code
|
HCPCS 75726
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$227.95 |
| Rate for Payer: Aetna Commercial |
$212.12
|
| Rate for Payer: Aetna Medicare |
$158.30
|
| Rate for Payer: BCBS Complete |
$109.20
|
| Rate for Payer: BCBS MAPPO |
$158.30
|
| Rate for Payer: BCN Medicare Advantage |
$158.30
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cash Price |
$218.40
|
| Rate for Payer: Cofinity Commercial |
$227.95
|
| Rate for Payer: Cofinity Commercial |
$212.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$158.30
|
| Rate for Payer: Healthscope Commercial |
$189.96
|
| Rate for Payer: Healthscope Whirlpool |
$189.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$166.22
|
| Rate for Payer: Nomi Health Commercial |
$189.96
|
| Rate for Payer: PACE SWMI |
$158.30
|
| Rate for Payer: PHP Medicare Advantage |
$158.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$177.45
|
| Rate for Payer: Priority Health Medicare |
$158.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$158.30
|
| Rate for Payer: UHC Medicare Advantage |
$158.30
|
| Rate for Payer: UHCCP DNSP |
$158.30
|
|
|
CHG ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS
|
Professional
|
Both
|
$162.00
|
|
|
Service Code
|
HCPCS 75898
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna Medicare |
$81.00
|
| Rate for Payer: BCBS Complete |
$64.80
|
| Rate for Payer: Cash Price |
$129.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.30
|
|
|
CHG ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I
|
Professional
|
Both
|
$302.00
|
|
|
Service Code
|
HCPCS 75774
|
| Min. Negotiated Rate |
$88.16 |
| Max. Negotiated Rate |
$196.30 |
| Rate for Payer: Aetna Commercial |
$118.13
|
| Rate for Payer: Aetna Medicare |
$88.16
|
| Rate for Payer: BCBS Complete |
$120.80
|
| Rate for Payer: BCBS MAPPO |
$88.16
|
| Rate for Payer: BCN Medicare Advantage |
$88.16
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cash Price |
$241.60
|
| Rate for Payer: Cofinity Commercial |
$126.95
|
| Rate for Payer: Cofinity Commercial |
$118.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.16
|
| Rate for Payer: Healthscope Commercial |
$105.79
|
| Rate for Payer: Healthscope Whirlpool |
$105.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.57
|
| Rate for Payer: Nomi Health Commercial |
$105.79
|
| Rate for Payer: PACE SWMI |
$88.16
|
| Rate for Payer: PHP Medicare Advantage |
$88.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.30
|
| Rate for Payer: Priority Health Medicare |
$88.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.16
|
| Rate for Payer: UHC Medicare Advantage |
$88.16
|
| Rate for Payer: UHCCP DNSP |
$88.16
|
|
|
CHG AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 75630
|
| Min. Negotiated Rate |
$117.20 |
| Max. Negotiated Rate |
$209.69 |
| Rate for Payer: Aetna Commercial |
$195.13
|
| Rate for Payer: Aetna Commercial |
$195.13
|
| Rate for Payer: Aetna Medicare |
$145.62
|
| Rate for Payer: Aetna Medicare |
$145.62
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: BCBS Complete |
$117.20
|
| Rate for Payer: BCBS MAPPO |
$145.62
|
| Rate for Payer: BCBS MAPPO |
$145.62
|
| Rate for Payer: BCN Medicare Advantage |
$145.62
|
| Rate for Payer: BCN Medicare Advantage |
$145.62
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Cofinity Commercial |
$195.13
|
| Rate for Payer: Cofinity Commercial |
$209.69
|
| Rate for Payer: Cofinity Commercial |
$195.13
|
| Rate for Payer: Cofinity Commercial |
$209.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$145.62
|
| Rate for Payer: Healthscope Commercial |
$174.74
|
| Rate for Payer: Healthscope Commercial |
$174.74
|
| Rate for Payer: Healthscope Whirlpool |
$174.74
|
| Rate for Payer: Healthscope Whirlpool |
$174.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.90
|
| Rate for Payer: Nomi Health Commercial |
$174.74
|
| Rate for Payer: Nomi Health Commercial |
$174.74
|
| Rate for Payer: PACE SWMI |
$145.62
|
| Rate for Payer: PACE SWMI |
$145.62
|
| Rate for Payer: PHP Medicare Advantage |
$145.62
|
| Rate for Payer: PHP Medicare Advantage |
$145.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health Medicare |
$145.62
|
| Rate for Payer: Priority Health Medicare |
$145.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$145.62
|
| Rate for Payer: UHC Medicare Advantage |
$145.62
|
| Rate for Payer: UHC Medicare Advantage |
$145.62
|
| Rate for Payer: UHCCP DNSP |
$145.62
|
| Rate for Payer: UHCCP DNSP |
$145.62
|
|
|
CHG AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$114.00
|
|
|
Service Code
|
HCPCS 75625
|
| Min. Negotiated Rate |
$45.60 |
| Max. Negotiated Rate |
$168.21 |
| Rate for Payer: Aetna Commercial |
$156.53
|
| Rate for Payer: Aetna Commercial |
$156.53
|
| Rate for Payer: Aetna Medicare |
$116.81
|
| Rate for Payer: Aetna Medicare |
$116.81
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: BCBS Complete |
$45.60
|
| Rate for Payer: BCBS MAPPO |
$116.81
|
| Rate for Payer: BCBS MAPPO |
$116.81
|
| Rate for Payer: BCN Medicare Advantage |
$116.81
|
| Rate for Payer: BCN Medicare Advantage |
$116.81
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$91.20
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$168.21
|
| Rate for Payer: Cofinity Commercial |
$156.53
|
| Rate for Payer: Cofinity Commercial |
$168.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.81
|
| Rate for Payer: Healthscope Commercial |
$140.17
|
| Rate for Payer: Healthscope Commercial |
$140.17
|
| Rate for Payer: Healthscope Whirlpool |
$140.17
|
| Rate for Payer: Healthscope Whirlpool |
$140.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$122.65
|
| Rate for Payer: Nomi Health Commercial |
$140.17
|
| Rate for Payer: Nomi Health Commercial |
$140.17
|
| Rate for Payer: PACE SWMI |
$116.81
|
| Rate for Payer: PACE SWMI |
$116.81
|
| Rate for Payer: PHP Medicare Advantage |
$116.81
|
| Rate for Payer: PHP Medicare Advantage |
$116.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.10
|
| Rate for Payer: Priority Health Medicare |
$116.81
|
| Rate for Payer: Priority Health Medicare |
$116.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.81
|
| Rate for Payer: UHC Medicare Advantage |
$116.81
|
| Rate for Payer: UHC Medicare Advantage |
$116.81
|
| Rate for Payer: UHCCP DNSP |
$116.81
|
| Rate for Payer: UHCCP DNSP |
$116.81
|
|
|
CHG AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$265.00
|
|
|
Service Code
|
HCPCS 75605
|
| Min. Negotiated Rate |
$106.00 |
| Max. Negotiated Rate |
$172.25 |
| Rate for Payer: Aetna Commercial |
$148.54
|
| Rate for Payer: Aetna Medicare |
$110.85
|
| Rate for Payer: BCBS Complete |
$106.00
|
| Rate for Payer: BCBS MAPPO |
$110.85
|
| Rate for Payer: BCN Medicare Advantage |
$110.85
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cash Price |
$212.00
|
| Rate for Payer: Cofinity Commercial |
$159.62
|
| Rate for Payer: Cofinity Commercial |
$148.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.85
|
| Rate for Payer: Healthscope Commercial |
$133.02
|
| Rate for Payer: Healthscope Whirlpool |
$133.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.39
|
| Rate for Payer: Nomi Health Commercial |
$133.02
|
| Rate for Payer: PACE SWMI |
$110.85
|
| Rate for Payer: PHP Medicare Advantage |
$110.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$172.25
|
| Rate for Payer: Priority Health Medicare |
$110.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$110.85
|
| Rate for Payer: UHC Medicare Advantage |
$110.85
|
| Rate for Payer: UHCCP DNSP |
$110.85
|
|
|
CHG AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I
|
Professional
|
Both
|
$107.00
|
|
|
Service Code
|
HCPCS 75600
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$223.66 |
| Rate for Payer: Aetna Commercial |
$208.13
|
| Rate for Payer: Aetna Medicare |
$155.32
|
| Rate for Payer: BCBS Complete |
$42.80
|
| Rate for Payer: BCBS MAPPO |
$155.32
|
| Rate for Payer: BCN Medicare Advantage |
$155.32
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cash Price |
$85.60
|
| Rate for Payer: Cofinity Commercial |
$223.66
|
| Rate for Payer: Cofinity Commercial |
$208.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$155.32
|
| Rate for Payer: Healthscope Commercial |
$186.38
|
| Rate for Payer: Healthscope Whirlpool |
$186.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$163.09
|
| Rate for Payer: Nomi Health Commercial |
$186.38
|
| Rate for Payer: PACE SWMI |
$155.32
|
| Rate for Payer: PHP Medicare Advantage |
$155.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.55
|
| Rate for Payer: Priority Health Medicare |
$155.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$155.32
|
| Rate for Payer: UHC Medicare Advantage |
$155.32
|
| Rate for Payer: UHCCP DNSP |
$155.32
|
|
|
CHG ASSAY OF LEAD
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 83655
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.23
|
| Rate for Payer: Aetna Medicare |
$12.11
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$17.44
|
| Rate for Payer: Cofinity Commercial |
$16.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$14.53
|
| Rate for Payer: Healthscope Whirlpool |
$14.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: Nomi Health Commercial |
$14.53
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.11
|
| Rate for Payer: UHC Medicare Advantage |
$12.11
|
| Rate for Payer: UHCCP DNSP |
$12.11
|
|
|
CHG ASSAY OF PHOSPHATASE ALKALINE
|
Professional
|
Both
|
$12.00
|
|
|
Service Code
|
HCPCS 84075
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$7.80 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$7.46
|
| Rate for Payer: Cofinity Commercial |
$6.94
|
| 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: Nomi Health Commercial |
$6.22
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP DNSP |
$5.18
|
|
|
CHG ASSAY OF PROGESTERONE
|
Professional
|
Both
|
$94.00
|
|
|
Service Code
|
HCPCS 84144
|
| Min. Negotiated Rate |
$20.86 |
| Max. Negotiated Rate |
$61.10 |
| Rate for Payer: Aetna Commercial |
$27.95
|
| Rate for Payer: Aetna Medicare |
$20.86
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS MAPPO |
$20.86
|
| Rate for Payer: BCN Medicare Advantage |
$20.86
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$30.04
|
| Rate for Payer: Cofinity Commercial |
$27.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$25.03
|
| Rate for Payer: Healthscope Whirlpool |
$25.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.90
|
| Rate for Payer: Nomi Health Commercial |
$25.03
|
| Rate for Payer: PACE SWMI |
$20.86
|
| Rate for Payer: PHP Medicare Advantage |
$20.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.86
|
| Rate for Payer: UHC Medicare Advantage |
$20.86
|
| Rate for Payer: UHCCP DNSP |
$20.86
|
|
|
CHG ASSAY OF PYRUVATE KINASE
|
Professional
|
Both
|
$95.00
|
|
|
Service Code
|
HCPCS 84220
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$61.75 |
| Rate for Payer: Aetna Commercial |
$12.65
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: BCBS Complete |
$38.00
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Commercial |
$13.59
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$11.33
|
| Rate for Payer: Healthscope Whirlpool |
$11.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Nomi Health Commercial |
$11.33
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.75
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.44
|
| Rate for Payer: UHC Medicare Advantage |
$9.44
|
| Rate for Payer: UHCCP DNSP |
$9.44
|
|
|
CHG ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE
|
Professional
|
Both
|
$80.00
|
|
|
Service Code
|
HCPCS 84588
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$52.00 |
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna Medicare |
$33.94
|
| Rate for Payer: BCBS Complete |
$32.00
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$48.87
|
| Rate for Payer: Cofinity Commercial |
$45.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Healthscope Commercial |
$40.73
|
| Rate for Payer: Healthscope Whirlpool |
$40.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Nomi Health Commercial |
$40.73
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.00
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.94
|
| Rate for Payer: UHC Medicare Advantage |
$33.94
|
| Rate for Payer: UHCCP DNSP |
$33.94
|
|
|
CHG BALLOON ANGIOPLASTY VISCERAL
|
Professional
|
Both
|
$160.00
|
|
|
Service Code
|
HCPCS 75966
|
| Min. Negotiated Rate |
$64.00 |
| Max. Negotiated Rate |
$104.00 |
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
|
|
CHG BALLOON ANGIO VENOUS
|
Professional
|
Both
|
$397.00
|
|
|
Service Code
|
HCPCS 75978
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$258.05 |
| Rate for Payer: Aetna Medicare |
$198.50
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: BCBS Complete |
$158.80
|
| Rate for Payer: BCBS Complete |
$20.40
|
| Rate for Payer: Cash Price |
$317.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$258.05
|
|
|
CHG BASIC RADIATION DOSIMETRY CALCULATION
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 77300
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$88.78 |
| Rate for Payer: Aetna Commercial |
$82.61
|
| Rate for Payer: Aetna Commercial |
$82.61
|
| Rate for Payer: Aetna Medicare |
$61.65
|
| Rate for Payer: Aetna Medicare |
$61.65
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS MAPPO |
$61.65
|
| Rate for Payer: BCBS MAPPO |
$61.65
|
| Rate for Payer: BCN Medicare Advantage |
$61.65
|
| Rate for Payer: BCN Medicare Advantage |
$61.65
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$82.61
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Cofinity Commercial |
$82.61
|
| Rate for Payer: Cofinity Commercial |
$88.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.65
|
| Rate for Payer: Healthscope Commercial |
$73.98
|
| Rate for Payer: Healthscope Commercial |
$73.98
|
| Rate for Payer: Healthscope Whirlpool |
$73.98
|
| Rate for Payer: Healthscope Whirlpool |
$73.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$64.73
|
| Rate for Payer: Nomi Health Commercial |
$73.98
|
| Rate for Payer: Nomi Health Commercial |
$73.98
|
| Rate for Payer: PACE SWMI |
$61.65
|
| Rate for Payer: PACE SWMI |
$61.65
|
| Rate for Payer: PHP Medicare Advantage |
$61.65
|
| Rate for Payer: PHP Medicare Advantage |
$61.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Medicare |
$61.65
|
| Rate for Payer: Priority Health Medicare |
$61.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.65
|
| Rate for Payer: UHC Medicare Advantage |
$61.65
|
| Rate for Payer: UHC Medicare Advantage |
$61.65
|
| Rate for Payer: UHCCP DNSP |
$61.65
|
| Rate for Payer: UHCCP DNSP |
$61.65
|
|
|
CHG BILIRUBIN TOTAL
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 82247
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Commercial |
$6.73
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$6.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$6.02
|
| Rate for Payer: Healthscope Whirlpool |
$6.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Nomi Health Commercial |
$6.02
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP DNSP |
$5.02
|
|
|
CHG BILIRUBIN TOTAL TRANSCUTANEOUS
|
Professional
|
Both
|
$13.00
|
|
|
Service Code
|
HCPCS 88720
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$8.45 |
| Rate for Payer: Aetna Commercial |
$6.73
|
| Rate for Payer: Aetna Medicare |
$5.02
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cash Price |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$6.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$6.02
|
| Rate for Payer: Healthscope Whirlpool |
$6.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Nomi Health Commercial |
$6.02
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.45
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP DNSP |
$5.02
|
|
|
CHG BLOOD COUNT HEMOGLOBIN
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 85018
|
| Min. Negotiated Rate |
$2.37 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Aetna Commercial |
$3.18
|
| Rate for Payer: Aetna Medicare |
$2.37
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$3.41
|
| Rate for Payer: Cofinity Commercial |
$3.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Healthscope Commercial |
$2.84
|
| Rate for Payer: Healthscope Whirlpool |
$2.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Nomi Health Commercial |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.37
|
| Rate for Payer: UHC Medicare Advantage |
$2.37
|
| Rate for Payer: UHCCP DNSP |
$2.37
|
|
|
CHG BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 82274
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$21.33
|
| Rate for Payer: Aetna Medicare |
$15.92
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$21.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Healthscope Whirlpool |
$19.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$19.10
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$15.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.92
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP DNSP |
$15.92
|
|
