|
CHG CT SOFT TISSUE NECK W/CONTRAST MATERIAL
|
Professional
|
Both
|
$143.00
|
|
|
Service Code
|
HCPCS 70491
|
| Min. Negotiated Rate |
$41.32 |
| Max. Negotiated Rate |
$311.07 |
| Rate for Payer: Aetna Commercial |
$241.79
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: BCBS Complete |
$43.39
|
| Rate for Payer: BCN Commercial |
$280.50
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Cash Price |
$114.40
|
| Rate for Payer: Meridian Medicaid |
$43.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$99.58
|
| Rate for Payer: Priority Health Narrow Network |
$99.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$311.07
|
| Rate for Payer: UHC Exchange |
$311.07
|
| Rate for Payer: UHCCP Medicaid |
$41.32
|
|
|
CHG CT SOFT TISSUE NECK W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$133.00
|
|
|
Service Code
|
HCPCS 70490
|
| Min. Negotiated Rate |
$38.55 |
| Max. Negotiated Rate |
$259.91 |
| Rate for Payer: Aetna Commercial |
$195.78
|
| Rate for Payer: Aetna Medicare |
$66.50
|
| Rate for Payer: BCBS Complete |
$40.48
|
| Rate for Payer: BCN Commercial |
$227.73
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Cash Price |
$106.40
|
| Rate for Payer: Meridian Medicaid |
$40.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.39
|
| Rate for Payer: Priority Health Narrow Network |
$92.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$259.91
|
| Rate for Payer: UHC Exchange |
$259.91
|
| Rate for Payer: UHCCP Medicaid |
$38.55
|
|
|
CHG CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$166.00
|
|
|
Service Code
|
HCPCS 70492
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$376.04 |
| Rate for Payer: Aetna Commercial |
$292.92
|
| Rate for Payer: Aetna Medicare |
$83.00
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCN Commercial |
$337.19
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Cash Price |
$132.80
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.00
|
| Rate for Payer: Priority Health Narrow Network |
$116.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$376.04
|
| Rate for Payer: UHC Exchange |
$376.04
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
|
|
CHG CT THORACIC SPINE W/CONTRAST MATERIAL
|
Professional
|
Both
|
$126.00
|
|
|
Service Code
|
HCPCS 72129
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$313.82 |
| Rate for Payer: Aetna Commercial |
$221.78
|
| Rate for Payer: Aetna Medicare |
$63.00
|
| Rate for Payer: BCBS Complete |
$38.47
|
| Rate for Payer: BCN Commercial |
$258.02
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Meridian Medicaid |
$38.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.27
|
| Rate for Payer: Priority Health Narrow Network |
$88.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$313.82
|
| Rate for Payer: UHC Exchange |
$313.82
|
| Rate for Payer: UHCCP Medicaid |
$36.64
|
|
|
CHG CT THORACIC SPINE W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 72128
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$262.33 |
| Rate for Payer: Aetna Commercial |
$169.24
|
| 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 |
$262.33
|
| Rate for Payer: UHC Exchange |
$262.33
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT THORACIC SPINE W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$132.00
|
|
|
Service Code
|
HCPCS 72130
|
| Min. Negotiated Rate |
$38.13 |
| Max. Negotiated Rate |
$381.31 |
| Rate for Payer: Aetna Commercial |
$259.52
|
| Rate for Payer: Aetna Medicare |
$66.00
|
| Rate for Payer: BCBS Complete |
$40.04
|
| Rate for Payer: BCN Commercial |
$302.98
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Cash Price |
$105.60
|
| Rate for Payer: Meridian Medicaid |
$40.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.13
|
| 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 Narrow Network |
$91.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$381.31
|
| Rate for Payer: UHC Exchange |
$381.31
|
| Rate for Payer: UHCCP Medicaid |
$38.13
|
|
|
CHG CT UPPER EXTREMITY W/CONTRAST MATERIAL
|
Professional
|
Both
|
$119.00
|
|
|
Service Code
|
HCPCS 73201
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$306.89 |
| Rate for Payer: Aetna Commercial |
$265.95
|
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: BCBS Complete |
$36.46
|
| Rate for Payer: BCN Commercial |
$306.89
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Meridian Medicaid |
$36.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.66
|
| Rate for Payer: Priority Health Narrow Network |
$83.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$300.32
|
| Rate for Payer: UHC Exchange |
$300.32
|
| Rate for Payer: UHCCP Medicaid |
$34.72
|
|
|
CHG CT UPPER EXTREMITY W/O CONTRAST MATERIAL
|
Professional
|
Both
|
$103.00
|
|
|
Service Code
|
HCPCS 73200
|
| Min. Negotiated Rate |
$29.82 |
| Max. Negotiated Rate |
$251.06 |
| Rate for Payer: Aetna Commercial |
$187.00
|
| Rate for Payer: Aetna Medicare |
$51.50
|
| Rate for Payer: BCBS Complete |
$31.31
|
| Rate for Payer: BCN Commercial |
$245.80
|
| 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 |
$251.06
|
| Rate for Payer: UHC Exchange |
$251.06
|
| Rate for Payer: UHCCP Medicaid |
$29.82
|
|
|
CHG CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 73202
|
| Min. Negotiated Rate |
$36.21 |
| Max. Negotiated Rate |
$383.47 |
| Rate for Payer: Aetna Commercial |
$280.75
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: BCBS Complete |
$38.02
|
| Rate for Payer: BCN Commercial |
$380.68
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Meridian Medicaid |
$38.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.26
|
| Rate for Payer: Priority Health Narrow Network |
$87.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$383.47
|
| Rate for Payer: UHC Exchange |
$383.47
|
| Rate for Payer: UHCCP Medicaid |
$36.21
|
|
|
CHG CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 87070
|
| Min. Negotiated Rate |
$6.47 |
| Max. Negotiated Rate |
$2,125.88 |
| Rate for Payer: Aetna Commercial |
$8.19
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$14.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,125.88
|
| Rate for Payer: BCN Commercial |
$6.47
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.65
|
| Rate for Payer: Priority Health Narrow Network |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$7.40
|
| Rate for Payer: UHC Exchange |
$7.40
|
|
|
CHG CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 87081
|
| Min. Negotiated Rate |
$4.16 |
| Max. Negotiated Rate |
$2,824.29 |
| Rate for Payer: Aetna Commercial |
$6.30
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,824.29
|
| Rate for Payer: BCN Commercial |
$4.97
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Cash Price |
$16.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.66
|
| Rate for Payer: Priority Health Narrow Network |
$6.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$4.16
|
| Rate for Payer: UHC Exchange |
$4.16
|
|
|
CHG CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 87086
|
| Min. Negotiated Rate |
$6.05 |
| Max. Negotiated Rate |
$2,635.16 |
| Rate for Payer: Aetna Commercial |
$7.67
|
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,635.16
|
| Rate for Payer: BCN Commercial |
$6.05
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.99
|
| Rate for Payer: Priority Health Narrow Network |
$7.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.94
|
| Rate for Payer: UHC Exchange |
$6.94
|
|
|
CHG CYSTOGRAPHY MINIMUM 3 VIEWS RS&I
|
Professional
|
Both
|
$104.00
|
|
|
Service Code
|
HCPCS 74430
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$1,300.67 |
| Rate for Payer: Aetna Commercial |
$46.64
|
| Rate for Payer: Aetna Medicare |
$52.00
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,300.67
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.10
|
| Rate for Payer: Priority Health Narrow Network |
$23.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$82.53
|
| Rate for Payer: UHC Exchange |
$82.53
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
|
|
CHG CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN
|
Professional
|
Both
|
$64.00
|
|
|
Service Code
|
HCPCS 88141
|
| Min. Negotiated Rate |
$15.98 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial |
$19.81
|
| Rate for Payer: Aetna Medicare |
$32.00
|
| Rate for Payer: BCBS Complete |
$16.78
|
| Rate for Payer: BCBS Trust/PPO |
$168.00
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Meridian Medicaid |
$16.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.14
|
| Rate for Payer: Priority Health Narrow Network |
$37.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$27.64
|
| Rate for Payer: UHC Exchange |
$27.64
|
| Rate for Payer: UHCCP Medicaid |
$15.98
|
|
|
CHG CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 88142
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$129.43 |
| Rate for Payer: Aetna Commercial |
$19.25
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$129.43
|
| Rate for Payer: BCN Commercial |
$15.20
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.47
|
| Rate for Payer: Priority Health Narrow Network |
$31.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.02
|
| Rate for Payer: UHC Exchange |
$29.02
|
|
|
CHG DEXA,BONE DENSITY,VERTEB FRACT
|
Professional
|
Both
|
$19.00
|
|
|
Service Code
|
HCPCS 77082
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$12.35 |
| Rate for Payer: Aetna Medicare |
$9.50
|
| Rate for Payer: BCBS Complete |
$7.60
|
| Rate for Payer: Cash Price |
$15.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.35
|
|
|
CHG DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+
|
Professional
|
Both
|
$129.00
|
|
|
Service Code
|
HCPCS 71270
|
| Min. Negotiated Rate |
$37.49 |
| Max. Negotiated Rate |
$386.31 |
| Rate for Payer: Aetna Commercial |
$258.23
|
| Rate for Payer: Aetna Medicare |
$64.50
|
| Rate for Payer: BCBS Complete |
$39.36
|
| Rate for Payer: BCN Commercial |
$298.58
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Meridian Medicaid |
$39.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$89.82
|
| Rate for Payer: Priority Health Narrow Network |
$89.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$386.31
|
| Rate for Payer: UHC Exchange |
$386.31
|
| Rate for Payer: UHCCP Medicaid |
$37.49
|
|
|
CHG DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST
|
Professional
|
Both
|
$120.00
|
|
|
Service Code
|
HCPCS 71260
|
| Min. Negotiated Rate |
$34.93 |
| Max. Negotiated Rate |
$314.22 |
| Rate for Payer: Aetna Commercial |
$218.31
|
| Rate for Payer: Aetna Medicare |
$60.00
|
| Rate for Payer: BCBS Complete |
$36.68
|
| Rate for Payer: BCN Commercial |
$253.14
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Cash Price |
$96.00
|
| Rate for Payer: Meridian Medicaid |
$36.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$84.17
|
| Rate for Payer: Priority Health Narrow Network |
$84.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$314.22
|
| Rate for Payer: UHC Exchange |
$314.22
|
| Rate for Payer: UHCCP Medicaid |
$34.93
|
|
|
CHG DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST
|
Professional
|
Both
|
$112.00
|
|
|
Service Code
|
HCPCS 71250
|
| Min. Negotiated Rate |
$32.38 |
| Max. Negotiated Rate |
$262.33 |
| Rate for Payer: Aetna Commercial |
$173.19
|
| Rate for Payer: Aetna Medicare |
$56.00
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: BCN Commercial |
$201.83
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Cash Price |
$89.60
|
| Rate for Payer: Meridian Medicaid |
$34.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.02
|
| Rate for Payer: Priority Health Narrow Network |
$78.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$262.33
|
| Rate for Payer: UHC Exchange |
$262.33
|
| Rate for Payer: UHCCP Medicaid |
$32.38
|
|
|
CHG DIGITAL BREAST TOMOSYNTHESIS UNILATERAL
|
Professional
|
Both
|
$66.00
|
|
|
Service Code
|
HCPCS 77061
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$203.73 |
| Rate for Payer: Aetna Commercial |
$146.59
|
| Rate for Payer: Aetna Medicare |
$33.00
|
| Rate for Payer: BCBS Complete |
$26.40
|
| Rate for Payer: BCN Commercial |
$84.16
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.52
|
| Rate for Payer: Priority Health Narrow Network |
$58.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$203.73
|
| Rate for Payer: UHC Exchange |
$203.73
|
|
|
CHG DISKOGRAPY LUMBAR RS&I
|
Professional
|
Both
|
$105.00
|
|
|
Service Code
|
HCPCS 72295
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$2,771.99 |
| Rate for Payer: Aetna Commercial |
$128.76
|
| Rate for Payer: Aetna Medicare |
$52.50
|
| Rate for Payer: BCBS Complete |
$26.39
|
| Rate for Payer: BCBS Trust/PPO |
$2,771.99
|
| Rate for Payer: BCN Commercial |
$162.73
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Meridian Medicaid |
$26.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$60.06
|
| Rate for Payer: Priority Health Narrow Network |
$60.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$145.45
|
| Rate for Payer: UHC Exchange |
$145.45
|
| Rate for Payer: UHCCP Medicaid |
$25.13
|
|
|
CHG DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT
|
Professional
|
Both
|
$145.00
|
|
|
Service Code
|
HCPCS 76828
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$563.70 |
| Rate for Payer: Aetna Commercial |
$59.77
|
| Rate for Payer: Aetna Medicare |
$72.50
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS Trust/PPO |
$563.70
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Cash Price |
$116.00
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.03
|
| Rate for Payer: Priority Health Narrow Network |
$40.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$53.64
|
| Rate for Payer: UHC Exchange |
$53.64
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
CHG DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 76827
|
| Min. Negotiated Rate |
$17.47 |
| Max. Negotiated Rate |
$506.11 |
| Rate for Payer: Aetna Commercial |
$84.26
|
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: BCBS Complete |
$18.34
|
| Rate for Payer: BCBS Trust/PPO |
$506.11
|
| Rate for Payer: BCN Commercial |
$102.13
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Meridian Medicaid |
$18.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42.09
|
| Rate for Payer: Priority Health Narrow Network |
$42.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$72.40
|
| Rate for Payer: UHC Exchange |
$72.40
|
| Rate for Payer: UHCCP Medicaid |
$17.47
|
|
|
CHG DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART
|
Professional
|
Both
|
$144.00
|
|
|
Service Code
|
HCPCS 76821
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$192.30 |
| Rate for Payer: Aetna Commercial |
$104.92
|
| Rate for Payer: Aetna Medicare |
$72.00
|
| Rate for Payer: BCBS Complete |
$22.14
|
| Rate for Payer: BCBS Trust/PPO |
$192.30
|
| Rate for Payer: BCN Commercial |
$129.99
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Meridian Medicaid |
$22.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.81
|
| Rate for Payer: Priority Health Narrow Network |
$50.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$101.51
|
| Rate for Payer: UHC Exchange |
$101.51
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
|
|
CHG DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY
|
Professional
|
Both
|
$249.00
|
|
|
Service Code
|
HCPCS 76820
|
| Min. Negotiated Rate |
$14.91 |
| Max. Negotiated Rate |
$536.22 |
| Rate for Payer: Aetna Commercial |
$53.83
|
| Rate for Payer: Aetna Medicare |
$124.50
|
| Rate for Payer: BCBS Complete |
$15.66
|
| Rate for Payer: BCBS Trust/PPO |
$536.22
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Cash Price |
$199.20
|
| Rate for Payer: Meridian Medicaid |
$15.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.93
|
| Rate for Payer: Priority Health Narrow Network |
$35.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$52.37
|
| Rate for Payer: UHC Exchange |
$52.37
|
| Rate for Payer: UHCCP Medicaid |
$14.91
|
|
