|
CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC
|
Professional
|
Both
|
$10.00
|
|
|
Service Code
|
HCPCS 82272
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$6.50 |
| Rate for Payer: Aetna Commercial |
$5.67
|
| Rate for Payer: Aetna Medicare |
$4.23
|
| Rate for Payer: BCBS Complete |
$4.00
|
| Rate for Payer: BCBS MAPPO |
$4.23
|
| Rate for Payer: BCN Medicare Advantage |
$4.23
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cash Price |
$8.00
|
| Rate for Payer: Cofinity Commercial |
$6.09
|
| Rate for Payer: Cofinity Commercial |
$5.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.23
|
| Rate for Payer: Healthscope Commercial |
$5.08
|
| Rate for Payer: Healthscope Whirlpool |
$5.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.44
|
| Rate for Payer: Nomi Health Commercial |
$5.08
|
| Rate for Payer: PACE SWMI |
$4.23
|
| Rate for Payer: PHP Medicare Advantage |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.50
|
| Rate for Payer: Priority Health Medicare |
$4.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.23
|
| Rate for Payer: UHC Medicare Advantage |
$4.23
|
| Rate for Payer: UHCCP DNSP |
$4.23
|
|
|
CHG BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82270
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Aetna Commercial |
$5.87
|
| Rate for Payer: Aetna Medicare |
$4.38
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.38
|
| Rate for Payer: BCN Medicare Advantage |
$4.38
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.31
|
| Rate for Payer: Cofinity Commercial |
$5.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.38
|
| Rate for Payer: Healthscope Commercial |
$5.26
|
| Rate for Payer: Healthscope Whirlpool |
$5.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.60
|
| Rate for Payer: Nomi Health Commercial |
$5.26
|
| Rate for Payer: PACE SWMI |
$4.38
|
| Rate for Payer: PHP Medicare Advantage |
$4.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$4.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.38
|
| Rate for Payer: UHC Medicare Advantage |
$4.38
|
| Rate for Payer: UHCCP DNSP |
$4.38
|
|
|
CHG BONE AGE STUDIES
|
Professional
|
Both
|
$36.00
|
|
|
Service Code
|
HCPCS 77072
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$33.71 |
| Rate for Payer: Aetna Commercial |
$31.37
|
| Rate for Payer: Aetna Medicare |
$23.41
|
| Rate for Payer: BCBS Complete |
$14.40
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cofinity Commercial |
$33.71
|
| Rate for Payer: Cofinity Commercial |
$31.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Healthscope Whirlpool |
$28.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Nomi Health Commercial |
$28.09
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health Medicare |
$23.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.41
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP DNSP |
$23.41
|
|
|
CHG BONE LENGTH STUDIES
|
Professional
|
Both
|
$134.00
|
|
|
Service Code
|
HCPCS 77073
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$87.10 |
| Rate for Payer: Aetna Commercial |
$55.05
|
| Rate for Payer: Aetna Commercial |
$55.05
|
| Rate for Payer: Aetna Medicare |
$41.08
|
| Rate for Payer: Aetna Medicare |
$41.08
|
| Rate for Payer: BCBS Complete |
$53.60
|
| Rate for Payer: BCBS Complete |
$23.20
|
| Rate for Payer: BCBS MAPPO |
$41.08
|
| Rate for Payer: BCBS MAPPO |
$41.08
|
| Rate for Payer: BCN Medicare Advantage |
$41.08
|
| Rate for Payer: BCN Medicare Advantage |
$41.08
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Cofinity Commercial |
$59.16
|
| Rate for Payer: Cofinity Commercial |
$55.05
|
| Rate for Payer: Cofinity Commercial |
$59.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.08
|
| Rate for Payer: Healthscope Commercial |
$49.30
|
| Rate for Payer: Healthscope Commercial |
$49.30
|
| Rate for Payer: Healthscope Whirlpool |
$49.30
|
| Rate for Payer: Healthscope Whirlpool |
$49.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.13
|
| Rate for Payer: Nomi Health Commercial |
$49.30
|
| Rate for Payer: Nomi Health Commercial |
$49.30
|
| Rate for Payer: PACE SWMI |
$41.08
|
| Rate for Payer: PACE SWMI |
$41.08
|
| Rate for Payer: PHP Medicare Advantage |
$41.08
|
| Rate for Payer: PHP Medicare Advantage |
$41.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health Medicare |
$41.08
|
| Rate for Payer: Priority Health Medicare |
$41.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$41.08
|
| Rate for Payer: UHC Medicare Advantage |
$41.08
|
| Rate for Payer: UHCCP DNSP |
$41.08
|
| Rate for Payer: UHCCP DNSP |
$41.08
|
|
|
CHG BRACHYTHER DOSE PLAN COMPLX
|
Professional
|
Both
|
$526.00
|
|
|
Service Code
|
HCPCS 77328
|
| Min. Negotiated Rate |
$210.40 |
| Max. Negotiated Rate |
$341.90 |
| Rate for Payer: Aetna Medicare |
$263.00
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS Complete |
$210.40
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cash Price |
$420.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
|
|
CHG BRACHYTHER DOSE PLAN SIMPLE
|
Professional
|
Both
|
$279.00
|
|
|
Service Code
|
HCPCS 77326
|
| Min. Negotiated Rate |
$111.60 |
| Max. Negotiated Rate |
$181.35 |
| Rate for Payer: Aetna Medicare |
$139.50
|
| Rate for Payer: Aetna Medicare |
$92.00
|
| Rate for Payer: BCBS Complete |
$111.60
|
| Rate for Payer: BCBS Complete |
$73.60
|
| Rate for Payer: Cash Price |
$223.20
|
| Rate for Payer: Cash Price |
$147.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.35
|
|
|
CHG BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL
|
Professional
|
Both
|
$643.00
|
|
|
Service Code
|
HCPCS 77318
|
| Min. Negotiated Rate |
$257.20 |
| Max. Negotiated Rate |
$605.26 |
| Rate for Payer: Aetna Commercial |
$563.23
|
| Rate for Payer: Aetna Commercial |
$563.23
|
| Rate for Payer: Aetna Medicare |
$420.32
|
| Rate for Payer: Aetna Medicare |
$420.32
|
| Rate for Payer: BCBS Complete |
$283.60
|
| Rate for Payer: BCBS Complete |
$257.20
|
| Rate for Payer: BCBS MAPPO |
$420.32
|
| Rate for Payer: BCBS MAPPO |
$420.32
|
| Rate for Payer: BCN Medicare Advantage |
$420.32
|
| Rate for Payer: BCN Medicare Advantage |
$420.32
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$514.40
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cash Price |
$567.20
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Cofinity Commercial |
$605.26
|
| Rate for Payer: Cofinity Commercial |
$563.23
|
| Rate for Payer: Cofinity Commercial |
$563.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.32
|
| Rate for Payer: Healthscope Commercial |
$504.38
|
| Rate for Payer: Healthscope Commercial |
$504.38
|
| Rate for Payer: Healthscope Whirlpool |
$504.38
|
| Rate for Payer: Healthscope Whirlpool |
$504.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$441.34
|
| Rate for Payer: Nomi Health Commercial |
$504.38
|
| Rate for Payer: Nomi Health Commercial |
$504.38
|
| Rate for Payer: PACE SWMI |
$420.32
|
| Rate for Payer: PACE SWMI |
$420.32
|
| Rate for Payer: PHP Medicare Advantage |
$420.32
|
| Rate for Payer: PHP Medicare Advantage |
$420.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$417.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.85
|
| Rate for Payer: Priority Health Medicare |
$420.32
|
| Rate for Payer: Priority Health Medicare |
$420.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.32
|
| Rate for Payer: UHC Medicare Advantage |
$420.32
|
| Rate for Payer: UHC Medicare Advantage |
$420.32
|
| Rate for Payer: UHCCP DNSP |
$420.32
|
| Rate for Payer: UHCCP DNSP |
$420.32
|
|
|
CHG CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS
|
Professional
|
Both
|
$255.00
|
|
|
Service Code
|
HCPCS 78472
|
| Min. Negotiated Rate |
$102.00 |
| Max. Negotiated Rate |
$267.70 |
| Rate for Payer: Aetna Commercial |
$249.11
|
| Rate for Payer: Aetna Medicare |
$185.90
|
| Rate for Payer: BCBS Complete |
$102.00
|
| Rate for Payer: BCBS MAPPO |
$185.90
|
| Rate for Payer: BCN Medicare Advantage |
$185.90
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cash Price |
$204.00
|
| Rate for Payer: Cofinity Commercial |
$267.70
|
| Rate for Payer: Cofinity Commercial |
$249.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.90
|
| Rate for Payer: Healthscope Commercial |
$223.08
|
| Rate for Payer: Healthscope Whirlpool |
$223.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.19
|
| Rate for Payer: Nomi Health Commercial |
$223.08
|
| Rate for Payer: PACE SWMI |
$185.90
|
| Rate for Payer: PHP Medicare Advantage |
$185.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.75
|
| Rate for Payer: Priority Health Medicare |
$185.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.90
|
| Rate for Payer: UHC Medicare Advantage |
$185.90
|
| Rate for Payer: UHCCP DNSP |
$185.90
|
|
|
CHG CELL COUNT MISCELLANEOUS BODY FLUIDS
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 89050
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Aetna Commercial |
$6.32
|
| Rate for Payer: Aetna Medicare |
$4.72
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$4.72
|
| Rate for Payer: BCN Medicare Advantage |
$4.72
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cofinity Commercial |
$6.80
|
| Rate for Payer: Cofinity Commercial |
$6.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.72
|
| Rate for Payer: Healthscope Commercial |
$5.66
|
| Rate for Payer: Healthscope Whirlpool |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.96
|
| Rate for Payer: Nomi Health Commercial |
$5.66
|
| Rate for Payer: PACE SWMI |
$4.72
|
| Rate for Payer: PHP Medicare Advantage |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.15
|
| Rate for Payer: Priority Health Medicare |
$4.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.72
|
| Rate for Payer: UHC Medicare Advantage |
$4.72
|
| Rate for Payer: UHCCP DNSP |
$4.72
|
|
|
CHG CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY
|
Professional
|
Both
|
$658.00
|
|
|
Service Code
|
HCPCS 78630
|
| Min. Negotiated Rate |
$263.20 |
| Max. Negotiated Rate |
$427.70 |
| Rate for Payer: Aetna Commercial |
$360.49
|
| Rate for Payer: Aetna Medicare |
$269.02
|
| Rate for Payer: BCBS Complete |
$263.20
|
| Rate for Payer: BCBS MAPPO |
$269.02
|
| Rate for Payer: BCN Medicare Advantage |
$269.02
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cash Price |
$526.40
|
| Rate for Payer: Cofinity Commercial |
$387.39
|
| Rate for Payer: Cofinity Commercial |
$360.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$269.02
|
| Rate for Payer: Healthscope Commercial |
$322.82
|
| Rate for Payer: Healthscope Whirlpool |
$322.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$282.47
|
| Rate for Payer: Nomi Health Commercial |
$322.82
|
| Rate for Payer: PACE SWMI |
$269.02
|
| Rate for Payer: PHP Medicare Advantage |
$269.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.70
|
| Rate for Payer: Priority Health Medicare |
$269.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$269.02
|
| Rate for Payer: UHC Medicare Advantage |
$269.02
|
| Rate for Payer: UHCCP DNSP |
$269.02
|
|
|
CHG CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 75984
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$124.26 |
| Rate for Payer: Aetna Commercial |
$115.63
|
| Rate for Payer: Aetna Commercial |
$115.63
|
| Rate for Payer: Aetna Medicare |
$86.29
|
| Rate for Payer: Aetna Medicare |
$86.29
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS MAPPO |
$86.29
|
| Rate for Payer: BCBS MAPPO |
$86.29
|
| Rate for Payer: BCN Medicare Advantage |
$86.29
|
| Rate for Payer: BCN Medicare Advantage |
$86.29
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Cofinity Commercial |
$124.26
|
| Rate for Payer: Cofinity Commercial |
$115.63
|
| Rate for Payer: Cofinity Commercial |
$124.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.29
|
| Rate for Payer: Healthscope Commercial |
$103.55
|
| Rate for Payer: Healthscope Commercial |
$103.55
|
| Rate for Payer: Healthscope Whirlpool |
$103.55
|
| Rate for Payer: Healthscope Whirlpool |
$103.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.60
|
| Rate for Payer: Nomi Health Commercial |
$103.55
|
| Rate for Payer: Nomi Health Commercial |
$103.55
|
| Rate for Payer: PACE SWMI |
$86.29
|
| Rate for Payer: PACE SWMI |
$86.29
|
| Rate for Payer: PHP Medicare Advantage |
$86.29
|
| Rate for Payer: PHP Medicare Advantage |
$86.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.00
|
| Rate for Payer: Priority Health Medicare |
$86.29
|
| Rate for Payer: Priority Health Medicare |
$86.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.29
|
| Rate for Payer: UHC Medicare Advantage |
$86.29
|
| Rate for Payer: UHC Medicare Advantage |
$86.29
|
| Rate for Payer: UHCCP DNSP |
$86.29
|
| Rate for Payer: UHCCP DNSP |
$86.29
|
|
|
CHG CHEST X-RAY 1 VW
|
Professional
|
Both
|
$73.00
|
|
|
Service Code
|
HCPCS 71010
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$47.45 |
| Rate for Payer: Aetna Medicare |
$36.50
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
|
|
CHG CHEST X-RAY 2 VW
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 71020
|
| Min. Negotiated Rate |
$17.60 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Medicare |
$22.00
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: BCBS Complete |
$15.60
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
|
|
CHG CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 74300
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$18.20 |
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: BCBS Complete |
$11.20
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
|
|
CHG CHOLESTEROL SERUM/WHOLE BLOOD TOTAL
|
Professional
|
Both
|
$14.00
|
|
|
Service Code
|
HCPCS 82465
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$9.10 |
| Rate for Payer: Aetna Commercial |
$5.83
|
| Rate for Payer: Aetna Medicare |
$4.35
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cash Price |
$11.20
|
| Rate for Payer: Cofinity Commercial |
$6.26
|
| Rate for Payer: Cofinity Commercial |
$5.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$5.22
|
| Rate for Payer: Healthscope Whirlpool |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Nomi Health Commercial |
$5.22
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.10
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.35
|
| Rate for Payer: UHC Medicare Advantage |
$4.35
|
| Rate for Payer: UHCCP DNSP |
$4.35
|
|
|
CHG COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 71271
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$183.12 |
| Rate for Payer: Aetna Commercial |
$170.41
|
| Rate for Payer: Aetna Medicare |
$127.17
|
| Rate for Payer: BCBS Complete |
$44.80
|
| Rate for Payer: BCBS MAPPO |
$127.17
|
| Rate for Payer: BCN Medicare Advantage |
$127.17
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cofinity Commercial |
$183.12
|
| Rate for Payer: Cofinity Commercial |
$170.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$127.17
|
| Rate for Payer: Healthscope Commercial |
$152.60
|
| Rate for Payer: Healthscope Whirlpool |
$152.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$133.53
|
| Rate for Payer: Nomi Health Commercial |
$152.60
|
| Rate for Payer: PACE SWMI |
$127.17
|
| Rate for Payer: PHP Medicare Advantage |
$127.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health Medicare |
$127.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$127.17
|
| Rate for Payer: UHC Medicare Advantage |
$127.17
|
| Rate for Payer: UHCCP DNSP |
$127.17
|
|
|
CHG CONTINUING MEDICAL PHYSICS CONSLTJ PR WK
|
Professional
|
Both
|
$154.00
|
|
|
Service Code
|
HCPCS 77336
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$117.12 |
| Rate for Payer: Aetna Commercial |
$108.98
|
| Rate for Payer: Aetna Medicare |
$81.33
|
| Rate for Payer: BCBS Complete |
$61.60
|
| Rate for Payer: BCBS MAPPO |
$81.33
|
| Rate for Payer: BCN Medicare Advantage |
$81.33
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cash Price |
$123.20
|
| Rate for Payer: Cofinity Commercial |
$117.12
|
| Rate for Payer: Cofinity Commercial |
$108.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$97.60
|
| Rate for Payer: Healthscope Whirlpool |
$97.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.40
|
| Rate for Payer: Nomi Health Commercial |
$97.60
|
| Rate for Payer: PACE SWMI |
$81.33
|
| Rate for Payer: PHP Medicare Advantage |
$81.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.10
|
| Rate for Payer: Priority Health Medicare |
$81.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.33
|
| Rate for Payer: UHC Medicare Advantage |
$81.33
|
| Rate for Payer: UHCCP DNSP |
$81.33
|
|
|
CHG CREATININE OTHER SOURCE
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 82570
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$7.46 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$8.80
|
| Rate for Payer: Cash Price |
$8.80
|
| 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 |
$7.15
|
| 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 CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID
|
Professional
|
Both
|
$56.00
|
|
|
Service Code
|
HCPCS 89060
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$36.40 |
| Rate for Payer: Aetna Commercial |
$9.82
|
| Rate for Payer: Aetna Medicare |
$7.33
|
| Rate for Payer: BCBS Complete |
$22.40
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cash Price |
$44.80
|
| Rate for Payer: Cofinity Commercial |
$9.82
|
| Rate for Payer: Cofinity Commercial |
$10.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$8.80
|
| Rate for Payer: Healthscope Whirlpool |
$8.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: Nomi Health Commercial |
$8.80
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.40
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.33
|
| Rate for Payer: UHCCP DNSP |
$7.33
|
|
|
CHG CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP
|
Professional
|
Both
|
$306.00
|
|
|
Service Code
|
HCPCS 75635
|
| Min. Negotiated Rate |
$122.40 |
| Max. Negotiated Rate |
$542.87 |
| Rate for Payer: Aetna Commercial |
$505.17
|
| Rate for Payer: Aetna Medicare |
$376.99
|
| Rate for Payer: BCBS Complete |
$122.40
|
| Rate for Payer: BCBS MAPPO |
$376.99
|
| Rate for Payer: BCN Medicare Advantage |
$376.99
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$542.87
|
| Rate for Payer: Cofinity Commercial |
$505.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$376.99
|
| Rate for Payer: Healthscope Commercial |
$452.39
|
| Rate for Payer: Healthscope Whirlpool |
$452.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$395.84
|
| Rate for Payer: Nomi Health Commercial |
$452.39
|
| Rate for Payer: PACE SWMI |
$376.99
|
| Rate for Payer: PHP Medicare Advantage |
$376.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$198.90
|
| Rate for Payer: Priority Health Medicare |
$376.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$376.99
|
| Rate for Payer: UHC Medicare Advantage |
$376.99
|
| Rate for Payer: UHCCP DNSP |
$376.99
|
|
|
CHG CTA ABDOMEN W/CONTRAST&IMG POSTPROCESSING
|
Professional
|
Both
|
$187.00
|
|
|
Service Code
|
HCPCS 74175
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$404.19 |
| Rate for Payer: Aetna Commercial |
$376.12
|
| Rate for Payer: Aetna Medicare |
$280.69
|
| Rate for Payer: BCBS Complete |
$74.80
|
| Rate for Payer: BCBS MAPPO |
$280.69
|
| Rate for Payer: BCN Medicare Advantage |
$280.69
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$404.19
|
| Rate for Payer: Cofinity Commercial |
$376.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$280.69
|
| Rate for Payer: Healthscope Commercial |
$336.83
|
| Rate for Payer: Healthscope Whirlpool |
$336.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$294.72
|
| Rate for Payer: Nomi Health Commercial |
$336.83
|
| Rate for Payer: PACE SWMI |
$280.69
|
| Rate for Payer: PHP Medicare Advantage |
$280.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.55
|
| Rate for Payer: Priority Health Medicare |
$280.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$280.69
|
| Rate for Payer: UHC Medicare Advantage |
$280.69
|
| Rate for Payer: UHCCP DNSP |
$280.69
|
|
|
CHG CTA ABD&PLVS W/CNTRST & IMG POSTPROCESSING
|
Professional
|
Both
|
$225.00
|
|
|
Service Code
|
HCPCS 74174
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$502.16 |
| Rate for Payer: Aetna Commercial |
$467.28
|
| Rate for Payer: Aetna Medicare |
$348.72
|
| Rate for Payer: BCBS Complete |
$90.00
|
| Rate for Payer: BCBS MAPPO |
$348.72
|
| Rate for Payer: BCN Medicare Advantage |
$348.72
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$502.16
|
| Rate for Payer: Cofinity Commercial |
$467.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.72
|
| Rate for Payer: Healthscope Commercial |
$418.46
|
| Rate for Payer: Healthscope Whirlpool |
$418.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$366.16
|
| Rate for Payer: Nomi Health Commercial |
$418.46
|
| Rate for Payer: PACE SWMI |
$348.72
|
| Rate for Payer: PHP Medicare Advantage |
$348.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.25
|
| Rate for Payer: Priority Health Medicare |
$348.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.72
|
| Rate for Payer: UHC Medicare Advantage |
$348.72
|
| Rate for Payer: UHCCP DNSP |
$348.72
|
|
|
CHG CT ABDOMEN & PELVIS W/CONTRAST MATERIAL
|
Professional
|
Both
|
$188.00
|
|
|
Service Code
|
HCPCS 74177
|
| Min. Negotiated Rate |
$75.20 |
| Max. Negotiated Rate |
$398.97 |
| Rate for Payer: Aetna Commercial |
$371.26
|
| Rate for Payer: Aetna Medicare |
$277.06
|
| Rate for Payer: BCBS Complete |
$75.20
|
| Rate for Payer: BCBS MAPPO |
$277.06
|
| Rate for Payer: BCN Medicare Advantage |
$277.06
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cash Price |
$150.40
|
| Rate for Payer: Cofinity Commercial |
$398.97
|
| Rate for Payer: Cofinity Commercial |
$371.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$277.06
|
| Rate for Payer: Healthscope Commercial |
$332.47
|
| Rate for Payer: Healthscope Whirlpool |
$332.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$290.91
|
| Rate for Payer: Nomi Health Commercial |
$332.47
|
| Rate for Payer: PACE SWMI |
$277.06
|
| Rate for Payer: PHP Medicare Advantage |
$277.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.20
|
| Rate for Payer: Priority Health Medicare |
$277.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$277.06
|
| Rate for Payer: UHC Medicare Advantage |
$277.06
|
| Rate for Payer: UHCCP DNSP |
$277.06
|
|
|
CHG CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$180.00
|
|
|
Service Code
|
HCPCS 74176
|
| Min. Negotiated Rate |
$72.00 |
| Max. Negotiated Rate |
$245.64 |
| Rate for Payer: Aetna Commercial |
$228.58
|
| Rate for Payer: Aetna Medicare |
$170.58
|
| Rate for Payer: BCBS Complete |
$72.00
|
| Rate for Payer: BCBS MAPPO |
$170.58
|
| Rate for Payer: BCN Medicare Advantage |
$170.58
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cofinity Commercial |
$245.64
|
| Rate for Payer: Cofinity Commercial |
$228.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$170.58
|
| Rate for Payer: Healthscope Commercial |
$204.70
|
| Rate for Payer: Healthscope Whirlpool |
$204.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$179.11
|
| Rate for Payer: Nomi Health Commercial |
$204.70
|
| Rate for Payer: PACE SWMI |
$170.58
|
| Rate for Payer: PHP Medicare Advantage |
$170.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.00
|
| Rate for Payer: Priority Health Medicare |
$170.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$170.58
|
| Rate for Payer: UHC Medicare Advantage |
$170.58
|
| Rate for Payer: UHCCP DNSP |
$170.58
|
|
|
CHG CT ABDOMEN W/CONTRAST MATERIAL
|
Professional
|
Both
|
$131.00
|
|
|
Service Code
|
HCPCS 74160
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$304.13 |
| Rate for Payer: Aetna Commercial |
$283.01
|
| Rate for Payer: Aetna Commercial |
$283.01
|
| Rate for Payer: Aetna Medicare |
$211.20
|
| Rate for Payer: Aetna Medicare |
$211.20
|
| Rate for Payer: BCBS Complete |
$52.40
|
| Rate for Payer: BCBS Complete |
$52.80
|
| Rate for Payer: BCBS MAPPO |
$211.20
|
| Rate for Payer: BCBS MAPPO |
$211.20
|
| Rate for Payer: BCN Medicare Advantage |
$211.20
|
| Rate for Payer: BCN Medicare Advantage |
$211.20
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$104.80
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cofinity Commercial |
$283.01
|
| Rate for Payer: Cofinity Commercial |
$304.13
|
| Rate for Payer: Cofinity Commercial |
$283.01
|
| Rate for Payer: Cofinity Commercial |
$304.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$211.20
|
| Rate for Payer: Healthscope Commercial |
$253.44
|
| Rate for Payer: Healthscope Commercial |
$253.44
|
| Rate for Payer: Healthscope Whirlpool |
$253.44
|
| Rate for Payer: Healthscope Whirlpool |
$253.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$221.76
|
| Rate for Payer: Nomi Health Commercial |
$253.44
|
| Rate for Payer: Nomi Health Commercial |
$253.44
|
| Rate for Payer: PACE SWMI |
$211.20
|
| Rate for Payer: PACE SWMI |
$211.20
|
| Rate for Payer: PHP Medicare Advantage |
$211.20
|
| Rate for Payer: PHP Medicare Advantage |
$211.20
|
| 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 Medicare |
$211.20
|
| Rate for Payer: Priority Health Medicare |
$211.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$211.20
|
| Rate for Payer: UHC Medicare Advantage |
$211.20
|
| Rate for Payer: UHC Medicare Advantage |
$211.20
|
| Rate for Payer: UHCCP DNSP |
$211.20
|
| Rate for Payer: UHCCP DNSP |
$211.20
|
|
