|
CHG CONTINUING MEDICAL PHYSICS CONSLTJ PR WK
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 77336
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$2,156.52 |
| Rate for Payer: Aetna Commercial |
$90.57
|
| Rate for Payer: Aetna Medicare |
$77.00
|
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,156.52
|
| Rate for Payer: BCN Commercial |
$126.08
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$137.04
|
| Rate for Payer: Priority Health Narrow Network |
$137.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.93
|
| Rate for Payer: UHC Exchange |
$70.93
|
|
|
CHG CREATININE OTHER SOURCE
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 82570
|
| Min. Negotiated Rate |
$3.89 |
| Max. Negotiated Rate |
$2,406.93 |
| Rate for Payer: Aetna Commercial |
$4.92
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,406.93
|
| Rate for Payer: BCN Commercial |
$3.89
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.33
|
| Rate for Payer: Priority Health Narrow Network |
$5.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.00
|
| Rate for Payer: UHC Exchange |
$4.00
|
|
|
CHG CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 89060
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$2,750.86 |
| Rate for Payer: Aetna Commercial |
$6.96
|
| Rate for Payer: Aetna Medicare |
$28.00
|
| Rate for Payer: BCBS Complete |
$11.85
|
| Rate for Payer: BCBS Trust/PPO |
$2,750.86
|
| Rate for Payer: BCN Commercial |
$30.50
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Meridian Medicaid |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.82
|
| Rate for Payer: Priority Health Narrow Network |
$26.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.23
|
| Rate for Payer: UHC Exchange |
$3.23
|
| Rate for Payer: UHCCP Medicaid |
$11.29
|
|
|
CHG CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 75635
|
| Min. Negotiated Rate |
$71.14 |
| Max. Negotiated Rate |
$622.09 |
| Rate for Payer: Aetna Commercial |
$351.85
|
| Rate for Payer: Aetna Medicare |
$153.00
|
| Rate for Payer: BCBS Complete |
$74.70
|
| Rate for Payer: BCBS Trust/PPO |
$164.30
|
| Rate for Payer: BCN Commercial |
$622.09
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Meridian Medicaid |
$74.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.40
|
| Rate for Payer: Priority Health Narrow Network |
$170.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$590.66
|
| Rate for Payer: UHC Exchange |
$590.66
|
| Rate for Payer: UHCCP Medicaid |
$71.14
|
|
|
CHG CTA ABDOMEN W/CONTRAST&IMG POSTPROCESSING
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 74175
|
| Min. Negotiated Rate |
$54.53 |
| Max. Negotiated Rate |
$526.56 |
| Rate for Payer: Aetna Commercial |
$316.72
|
| Rate for Payer: Aetna Medicare |
$93.50
|
| Rate for Payer: BCBS Complete |
$57.26
|
| Rate for Payer: BCN Commercial |
$467.17
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Meridian Medicaid |
$57.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.37
|
| Rate for Payer: Priority Health Narrow Network |
$130.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$526.56
|
| Rate for Payer: UHC Exchange |
$526.56
|
| Rate for Payer: UHCCP Medicaid |
$54.53
|
|
|
CHG CTA ABD&PLVS W/CNTRST & IMG POSTPROCESSING
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 74174
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$619.23 |
| Rate for Payer: Aetna Commercial |
$493.17
|
| Rate for Payer: Aetna Medicare |
$112.50
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCN Commercial |
$579.57
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$157.57
|
| Rate for Payer: Priority Health Narrow Network |
$157.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$619.23
|
| Rate for Payer: UHC Exchange |
$619.23
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
|
|
CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 74177
|
| Min. Negotiated Rate |
$54.95 |
| Max. Negotiated Rate |
$465.22 |
| Rate for Payer: Aetna Commercial |
$399.91
|
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$57.70
|
| Rate for Payer: BCN Commercial |
$465.22
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Meridian Medicaid |
$57.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.88
|
| Rate for Payer: Priority Health Narrow Network |
$130.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$376.02
|
| Rate for Payer: UHC Exchange |
$376.02
|
| Rate for Payer: UHCCP Medicaid |
$54.95
|
|
|
CHG CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 74176
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$277.56 |
| Rate for Payer: Aetna Commercial |
$239.29
|
| Rate for Payer: Aetna Medicare |
$90.00
|
| Rate for Payer: BCBS Complete |
$54.80
|
| Rate for Payer: BCN Commercial |
$277.56
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Meridian Medicaid |
$54.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.23
|
| Rate for Payer: Priority Health Narrow Network |
$125.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$240.32
|
| Rate for Payer: UHC Exchange |
$240.32
|
| Rate for Payer: UHCCP Medicaid |
$52.19
|
|
|
CHG CT ABDOMEN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 74160
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$2,524.22 |
| Rate for Payer: Aetna Commercial |
$283.74
|
| Rate for Payer: Aetna Commercial |
$283.74
|
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: Aetna Medicare |
$65.50
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,524.22
|
| Rate for Payer: BCBS Trust/PPO |
$2,524.22
|
| Rate for Payer: BCN Commercial |
$357.72
|
| Rate for Payer: BCN Commercial |
$357.72
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.87
|
| Rate for Payer: Priority Health Narrow Network |
$91.87
|
| Rate for Payer: Priority Health Narrow Network |
$91.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$335.50
|
| Rate for Payer: UHC Exchange |
$335.50
|
| Rate for Payer: UHC Exchange |
$335.50
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
CHG CT ABDOMEN W/O CONTRAST FLWD BY CONTRAST MATRL
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 74170
|
| Min. Negotiated Rate |
$41.75 |
| Max. Negotiated Rate |
$440.77 |
| Rate for Payer: Aetna Commercial |
$291.58
|
| Rate for Payer: Aetna Medicare |
$72.00
|
| Rate for Payer: BCBS Complete |
$43.84
|
| Rate for Payer: BCN Commercial |
$401.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Meridian Medicaid |
$43.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.59
|
| Rate for Payer: Priority Health Narrow Network |
$100.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$440.77
|
| Rate for Payer: UHC Exchange |
$440.77
|
| Rate for Payer: UHCCP Medicaid |
$41.75
|
|
|
CHG CT ABDOMEN W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$122.00
|
|
|
Service Code
|
HCPCS 74150
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$251.58 |
| Rate for Payer: Aetna Commercial |
$178.47
|
| Rate for Payer: Aetna Medicare |
$61.00
|
| Rate for Payer: BCBS Complete |
$37.35
|
| Rate for Payer: BCN Commercial |
$207.20
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Cash Price |
$97.60
|
| Rate for Payer: Meridian Medicaid |
$37.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.71
|
| Rate for Payer: Priority Health Narrow Network |
$85.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.58
|
| Rate for Payer: UHC Exchange |
$251.58
|
| Rate for Payer: UHCCP Medicaid |
$35.57
|
|
|
CHG CT ABD&PLV W/O CNTRST 1/BTH FLWD CNTRST 1/BTH
|
Professional
|
Both
|
$206.00
|
|
|
Service Code
|
HCPCS 74178
|
| Min. Negotiated Rate |
$60.28 |
| Max. Negotiated Rate |
$520.93 |
| Rate for Payer: Aetna Commercial |
$448.29
|
| Rate for Payer: Aetna Medicare |
$103.00
|
| Rate for Payer: BCBS Complete |
$63.29
|
| Rate for Payer: BCN Commercial |
$520.93
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Meridian Medicaid |
$63.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$144.23
|
| Rate for Payer: Priority Health Narrow Network |
$144.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$475.46
|
| Rate for Payer: UHC Exchange |
$475.46
|
| Rate for Payer: UHCCP Medicaid |
$60.28
|
|
|
CHG CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST
|
Professional
|
Both
|
$246.00
|
|
|
Service Code
|
HCPCS 75574
|
| Min. Negotiated Rate |
$71.78 |
| Max. Negotiated Rate |
$705.19 |
| Rate for Payer: Aetna Commercial |
$351.36
|
| Rate for Payer: Aetna Medicare |
$123.00
|
| Rate for Payer: BCBS Complete |
$75.37
|
| Rate for Payer: BCN Commercial |
$485.26
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Cash Price |
$196.80
|
| Rate for Payer: Meridian Medicaid |
$75.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.43
|
| Rate for Payer: Priority Health Narrow Network |
$171.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$705.19
|
| Rate for Payer: UHC Exchange |
$705.19
|
| Rate for Payer: UHCCP Medicaid |
$71.78
|
|
|
CHG CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 71275
|
| Min. Negotiated Rate |
$54.74 |
| Max. Negotiated Rate |
$514.25 |
| Rate for Payer: Aetna Commercial |
$317.55
|
| Rate for Payer: Aetna Medicare |
$94.00
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: BCN Commercial |
$427.59
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Meridian Medicaid |
$57.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.88
|
| Rate for Payer: Priority Health Narrow Network |
$130.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$514.25
|
| Rate for Payer: UHC Exchange |
$514.25
|
| Rate for Payer: UHCCP Medicaid |
$54.74
|
|
|
CHG CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 70496
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$651.39 |
| Rate for Payer: Aetna Commercial |
$313.24
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCN Commercial |
$419.77
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.74
|
| Rate for Payer: Priority Health Narrow Network |
$125.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$651.39
|
| Rate for Payer: UHC Exchange |
$651.39
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
CHG CT ANGIOGRAPHY LOWER EXTREMITY
|
Professional
|
Both
|
$194.00
|
|
|
Service Code
|
HCPCS 73706
|
| Min. Negotiated Rate |
$56.66 |
| Max. Negotiated Rate |
$517.94 |
| Rate for Payer: Aetna Commercial |
$321.13
|
| Rate for Payer: Aetna Medicare |
$97.00
|
| Rate for Payer: BCBS Complete |
$59.49
|
| Rate for Payer: BCN Commercial |
$492.59
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Meridian Medicaid |
$59.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$56.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.50
|
| Rate for Payer: Priority Health Narrow Network |
$135.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$517.94
|
| Rate for Payer: UHC Exchange |
$517.94
|
| Rate for Payer: UHCCP Medicaid |
$56.66
|
|
|
CHG CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$181.00
|
|
|
Service Code
|
HCPCS 70498
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$652.13 |
| Rate for Payer: Aetna Commercial |
$313.24
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: BCBS Complete |
$55.02
|
| Rate for Payer: BCN Commercial |
$419.28
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Meridian Medicaid |
$55.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.74
|
| Rate for Payer: Priority Health Narrow Network |
$125.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$652.13
|
| Rate for Payer: UHC Exchange |
$652.13
|
| Rate for Payer: UHCCP Medicaid |
$52.40
|
|
|
CHG CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 72191
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$495.88 |
| Rate for Payer: Aetna Commercial |
$315.87
|
| Rate for Payer: Aetna Medicare |
$92.50
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCN Commercial |
$464.73
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.83
|
| Rate for Payer: Priority Health Narrow Network |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$495.88
|
| Rate for Payer: UHC Exchange |
$495.88
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG CT ANGIOGRAPHY UPPER EXTREMITY
|
Professional
|
Both
|
$185.00
|
|
|
Service Code
|
HCPCS 73206
|
| Min. Negotiated Rate |
$53.89 |
| Max. Negotiated Rate |
$473.03 |
| Rate for Payer: Aetna Commercial |
$315.93
|
| Rate for Payer: Aetna Medicare |
$92.50
|
| Rate for Payer: BCBS Complete |
$56.58
|
| Rate for Payer: BCN Commercial |
$453.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Meridian Medicaid |
$56.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$120.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.83
|
| Rate for Payer: Priority Health Narrow Network |
$128.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$473.03
|
| Rate for Payer: UHC Exchange |
$473.03
|
| Rate for Payer: UHCCP Medicaid |
$53.89
|
|
|
CHG CT CERVICAL SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 72126
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$313.82 |
| Rate for Payer: Aetna Commercial |
$220.57
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: BCBS Complete |
$38.24
|
| Rate for Payer: BCN Commercial |
$256.07
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Meridian Medicaid |
$38.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.76
|
| Rate for Payer: Priority Health Narrow Network |
$87.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.82
|
| Rate for Payer: UHC Exchange |
$313.82
|
| Rate for Payer: UHCCP Medicaid |
$36.42
|
|
|
CHG CT CERVICAL SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72125
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$263.08 |
| Rate for Payer: Aetna Commercial |
$169.64
|
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Meridian Medicaid |
$31.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.85
|
| Rate for Payer: Priority Health Narrow Network |
$71.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$263.08
|
| Rate for Payer: UHC Exchange |
$263.08
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 72127
|
| Min. Negotiated Rate |
$37.91 |
| Max. Negotiated Rate |
$379.82 |
| Rate for Payer: Aetna Commercial |
$258.31
|
| Rate for Payer: Aetna Medicare |
$65.50
|
| Rate for Payer: BCBS Complete |
$39.81
|
| Rate for Payer: BCN Commercial |
$300.05
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Meridian Medicaid |
$39.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$91.36
|
| Rate for Payer: Priority Health Narrow Network |
$91.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$379.82
|
| Rate for Payer: UHC Exchange |
$379.82
|
| Rate for Payer: UHCCP Medicaid |
$37.91
|
|
|
CHG CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING
|
Professional
|
Both
|
$235.00
|
|
|
Service Code
|
HCPCS 74263
|
| Min. Negotiated Rate |
$71.57 |
| Max. Negotiated Rate |
$1,004.72 |
| Rate for Payer: Aetna Commercial |
$905.57
|
| Rate for Payer: Aetna Medicare |
$117.50
|
| Rate for Payer: BCBS Complete |
$75.15
|
| Rate for Payer: BCN Commercial |
$1,004.72
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Cash Price |
$188.00
|
| Rate for Payer: Meridian Medicaid |
$75.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.75
|
| Rate for Payer: Priority Health Narrow Network |
$164.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$727.13
|
| Rate for Payer: UHC Exchange |
$727.13
|
| Rate for Payer: UHCCP Medicaid |
$71.57
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST
|
Professional
|
Both
|
$258.00
|
|
|
Service Code
|
HCPCS 74262
|
| Min. Negotiated Rate |
$75.40 |
| Max. Negotiated Rate |
$718.36 |
| Rate for Payer: Aetna Commercial |
$358.62
|
| Rate for Payer: Aetna Medicare |
$129.00
|
| Rate for Payer: BCBS Complete |
$79.17
|
| Rate for Payer: BCN Commercial |
$718.36
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Cash Price |
$206.40
|
| Rate for Payer: Meridian Medicaid |
$79.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$180.16
|
| Rate for Payer: Priority Health Narrow Network |
$180.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$476.09
|
| Rate for Payer: UHC Exchange |
$476.09
|
| Rate for Payer: UHCCP Medicaid |
$75.40
|
|
|
CHG CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST
|
Professional
|
Both
|
$918.00
|
|
|
Service Code
|
HCPCS 74261
|
| Min. Negotiated Rate |
$72.42 |
| Max. Negotiated Rate |
$4,266.02 |
| Rate for Payer: Aetna Commercial |
$272.64
|
| Rate for Payer: Aetna Commercial |
$272.64
|
| Rate for Payer: Aetna Medicare |
$459.00
|
| Rate for Payer: Aetna Medicare |
$123.50
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Complete |
$76.04
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCBS Trust/PPO |
$4,266.02
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: BCN Commercial |
$637.72
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Cash Price |
$197.60
|
| Rate for Payer: Cash Price |
$734.40
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Meridian Medicaid |
$76.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$596.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$172.46
|
| Rate for Payer: Priority Health Narrow Network |
$172.46
|
| Rate for Payer: Priority Health Narrow Network |
$172.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$423.95
|
| Rate for Payer: UHC Exchange |
$423.95
|
| Rate for Payer: UHC Exchange |
$423.95
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
| Rate for Payer: UHCCP Medicaid |
$72.42
|
|
