|
CHG HEMOGLOBIN GLYCOSYLATED A1C
|
Professional
|
Both
|
$23.00
|
|
|
Service Code
|
HCPCS 83036
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$14.95 |
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$9.71
|
| Rate for Payer: BCN Medicare Advantage |
$9.71
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cash Price |
$18.40
|
| Rate for Payer: Cofinity Commercial |
$13.98
|
| Rate for Payer: Cofinity Commercial |
$13.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.71
|
| Rate for Payer: Healthscope Commercial |
$11.65
|
| Rate for Payer: Healthscope Whirlpool |
$11.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.20
|
| Rate for Payer: Nomi Health Commercial |
$11.65
|
| Rate for Payer: PACE SWMI |
$9.71
|
| Rate for Payer: PHP Medicare Advantage |
$9.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.95
|
| Rate for Payer: Priority Health Medicare |
$9.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.71
|
| Rate for Payer: UHC Medicare Advantage |
$9.71
|
| Rate for Payer: UHCCP DNSP |
$9.71
|
|
|
CHG HETEROPHILE ANTIBODIES SCREEN
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 86308
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$9.75 |
| Rate for Payer: Aetna Commercial |
$6.94
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| 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 |
$9.75
|
| 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 HYSTEROSALPINGOGRAPHY RS&I
|
Professional
|
Both
|
$153.00
|
|
|
Service Code
|
HCPCS 74740
|
| Min. Negotiated Rate |
$61.20 |
| Max. Negotiated Rate |
$116.94 |
| Rate for Payer: Aetna Commercial |
$108.82
|
| Rate for Payer: Aetna Medicare |
$81.21
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: BCBS MAPPO |
$81.21
|
| Rate for Payer: BCN Medicare Advantage |
$81.21
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$116.94
|
| Rate for Payer: Cofinity Commercial |
$108.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.21
|
| Rate for Payer: Healthscope Commercial |
$97.45
|
| Rate for Payer: Healthscope Whirlpool |
$97.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.27
|
| Rate for Payer: Nomi Health Commercial |
$97.45
|
| Rate for Payer: PACE SWMI |
$81.21
|
| Rate for Payer: PHP Medicare Advantage |
$81.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health Medicare |
$81.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$81.21
|
| Rate for Payer: UHC Medicare Advantage |
$81.21
|
| Rate for Payer: UHCCP DNSP |
$81.21
|
|
|
CHG IAADIADOO INFLUENZA
|
Professional
|
Both
|
$30.00
|
|
|
Service Code
|
HCPCS 87804
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$23.83 |
| Rate for Payer: Aetna Commercial |
$22.18
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$23.83
|
| Rate for Payer: Cofinity Commercial |
$22.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Healthscope Whirlpool |
$19.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.38
|
| Rate for Payer: Nomi Health Commercial |
$19.86
|
| Rate for Payer: PACE SWMI |
$16.55
|
| Rate for Payer: PHP Medicare Advantage |
$16.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.55
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UHCCP DNSP |
$16.55
|
|
|
CHG IAADIADOO RESPIRATORY SYNCTIAL VIRUS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 87807
|
| Min. Negotiated Rate |
$7.20 |
| Max. Negotiated Rate |
$18.86 |
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cofinity Commercial |
$18.86
|
| Rate for Payer: Cofinity Commercial |
$17.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$15.72
|
| Rate for Payer: Healthscope Whirlpool |
$15.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Nomi Health Commercial |
$15.72
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$13.10
|
| Rate for Payer: UHCCP DNSP |
$13.10
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 87880
|
| Min. Negotiated Rate |
$11.60 |
| Max. Negotiated Rate |
$23.80 |
| Rate for Payer: Aetna Commercial |
$22.15
|
| Rate for Payer: Aetna Medicare |
$16.53
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS MAPPO |
$16.53
|
| Rate for Payer: BCN Medicare Advantage |
$16.53
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cofinity Commercial |
$23.80
|
| Rate for Payer: Cofinity Commercial |
$22.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.53
|
| Rate for Payer: Healthscope Commercial |
$19.84
|
| Rate for Payer: Healthscope Whirlpool |
$19.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.36
|
| Rate for Payer: Nomi Health Commercial |
$19.84
|
| Rate for Payer: PACE SWMI |
$16.53
|
| Rate for Payer: PHP Medicare Advantage |
$16.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health Medicare |
$16.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.53
|
| Rate for Payer: UHC Medicare Advantage |
$16.53
|
| Rate for Payer: UHCCP DNSP |
$16.53
|
|
|
CHG IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 87426
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$50.88 |
| Rate for Payer: Aetna Commercial |
$47.34
|
| Rate for Payer: Aetna Medicare |
$35.33
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: BCBS MAPPO |
$35.33
|
| Rate for Payer: BCN Medicare Advantage |
$35.33
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$50.88
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.33
|
| Rate for Payer: Healthscope Commercial |
$42.40
|
| Rate for Payer: Healthscope Whirlpool |
$42.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.10
|
| Rate for Payer: Nomi Health Commercial |
$42.40
|
| Rate for Payer: PACE SWMI |
$35.33
|
| Rate for Payer: PHP Medicare Advantage |
$35.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Medicare |
$35.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.33
|
| Rate for Payer: UHC Medicare Advantage |
$35.33
|
| Rate for Payer: UHCCP DNSP |
$35.33
|
|
|
CHG IAADI BORDETELLA PRTUSSIS/PARAPRTUSSIS
|
Professional
|
Both
|
$44.00
|
|
|
Service Code
|
HCPCS 87265
|
| Min. Negotiated Rate |
$11.98 |
| Max. Negotiated Rate |
$28.60 |
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare |
$11.98
|
| Rate for Payer: BCBS Complete |
$17.60
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Commercial |
$17.25
|
| Rate for Payer: Cofinity Commercial |
$16.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$14.38
|
| Rate for Payer: Healthscope Whirlpool |
$14.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Nomi Health Commercial |
$14.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.60
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP DNSP |
$11.98
|
|
|
CHG IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 87491
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$50.53 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$50.53
|
| Rate for Payer: Cofinity Commercial |
$47.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$42.11
|
| Rate for Payer: Healthscope Whirlpool |
$42.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Nomi Health Commercial |
$42.11
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
|
|
CHG IADNA MULTIPLE ORGANISMS DIRECT PROBE TQ
|
Professional
|
Both
|
$83.00
|
|
|
Service Code
|
HCPCS 87800
|
| Min. Negotiated Rate |
$33.20 |
| Max. Negotiated Rate |
$62.88 |
| Rate for Payer: Aetna Commercial |
$58.52
|
| Rate for Payer: Aetna Medicare |
$43.67
|
| Rate for Payer: BCBS Complete |
$33.20
|
| Rate for Payer: BCBS MAPPO |
$43.67
|
| Rate for Payer: BCN Medicare Advantage |
$43.67
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cash Price |
$66.40
|
| Rate for Payer: Cofinity Commercial |
$62.88
|
| Rate for Payer: Cofinity Commercial |
$58.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.67
|
| Rate for Payer: Healthscope Commercial |
$52.40
|
| Rate for Payer: Healthscope Whirlpool |
$52.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.85
|
| Rate for Payer: Nomi Health Commercial |
$52.40
|
| Rate for Payer: PACE SWMI |
$43.67
|
| Rate for Payer: PHP Medicare Advantage |
$43.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.95
|
| Rate for Payer: Priority Health Medicare |
$43.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$43.67
|
| Rate for Payer: UHC Medicare Advantage |
$43.67
|
| Rate for Payer: UHCCP DNSP |
$43.67
|
|
|
CHG IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$77.00
|
|
|
Service Code
|
HCPCS 87591
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$50.53 |
| Rate for Payer: Aetna Commercial |
$47.02
|
| Rate for Payer: Aetna Medicare |
$35.09
|
| Rate for Payer: BCBS Complete |
$30.80
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cash Price |
$61.60
|
| Rate for Payer: Cofinity Commercial |
$50.53
|
| Rate for Payer: Cofinity Commercial |
$47.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$42.11
|
| Rate for Payer: Healthscope Whirlpool |
$42.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Nomi Health Commercial |
$42.11
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.05
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP DNSP |
$35.09
|
|
|
CHG IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ
|
Professional
|
Both
|
$148.00
|
|
|
Service Code
|
HCPCS 87635
|
| Min. Negotiated Rate |
$51.31 |
| Max. Negotiated Rate |
$96.20 |
| Rate for Payer: Aetna Commercial |
$68.76
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: BCBS Complete |
$59.20
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$73.89
|
| Rate for Payer: Cofinity Commercial |
$68.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$61.57
|
| Rate for Payer: Healthscope Whirlpool |
$61.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Nomi Health Commercial |
$61.57
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.20
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP DNSP |
$51.31
|
|
|
CHG IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 86318
|
| Min. Negotiated Rate |
$18.09 |
| Max. Negotiated Rate |
$30.55 |
| Rate for Payer: Aetna Commercial |
$24.24
|
| Rate for Payer: Aetna Medicare |
$18.09
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS MAPPO |
$18.09
|
| Rate for Payer: BCN Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cofinity Commercial |
$26.05
|
| Rate for Payer: Cofinity Commercial |
$24.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.09
|
| Rate for Payer: Healthscope Commercial |
$21.71
|
| Rate for Payer: Healthscope Whirlpool |
$21.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.99
|
| Rate for Payer: Nomi Health Commercial |
$21.71
|
| Rate for Payer: PACE SWMI |
$18.09
|
| Rate for Payer: PHP Medicare Advantage |
$18.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health Medicare |
$18.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.09
|
| Rate for Payer: UHC Medicare Advantage |
$18.09
|
| Rate for Payer: UHCCP DNSP |
$18.09
|
|
|
CHG IMMUNOASSAY TUMOR ANTIGEN QUAL/SEMIQUANTITATIVE
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 86294
|
| Min. Negotiated Rate |
$16.00 |
| Max. Negotiated Rate |
$36.82 |
| Rate for Payer: Aetna Commercial |
$34.26
|
| Rate for Payer: Aetna Medicare |
$25.57
|
| Rate for Payer: BCBS Complete |
$16.00
|
| Rate for Payer: BCBS MAPPO |
$25.57
|
| Rate for Payer: BCN Medicare Advantage |
$25.57
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cofinity Commercial |
$36.82
|
| Rate for Payer: Cofinity Commercial |
$34.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.57
|
| Rate for Payer: Healthscope Commercial |
$30.68
|
| Rate for Payer: Healthscope Whirlpool |
$30.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.85
|
| Rate for Payer: Nomi Health Commercial |
$30.68
|
| Rate for Payer: PACE SWMI |
$25.57
|
| Rate for Payer: PHP Medicare Advantage |
$25.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Medicare |
$25.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.57
|
| Rate for Payer: UHC Medicare Advantage |
$25.57
|
| Rate for Payer: UHCCP DNSP |
$25.57
|
|
|
CHG INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Professional
|
Both
|
$147.00
|
|
|
Service Code
|
HCPCS 87502
|
| Min. Negotiated Rate |
$58.80 |
| Max. Negotiated Rate |
$137.95 |
| Rate for Payer: Aetna Commercial |
$128.37
|
| Rate for Payer: Aetna Medicare |
$95.80
|
| Rate for Payer: BCBS Complete |
$58.80
|
| Rate for Payer: BCBS MAPPO |
$95.80
|
| Rate for Payer: BCN Medicare Advantage |
$95.80
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$137.95
|
| Rate for Payer: Cofinity Commercial |
$128.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.80
|
| Rate for Payer: Healthscope Commercial |
$114.96
|
| Rate for Payer: Healthscope Whirlpool |
$114.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.59
|
| Rate for Payer: Nomi Health Commercial |
$114.96
|
| Rate for Payer: PACE SWMI |
$95.80
|
| Rate for Payer: PHP Medicare Advantage |
$95.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.55
|
| Rate for Payer: Priority Health Medicare |
$95.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.80
|
| Rate for Payer: UHC Medicare Advantage |
$95.80
|
| Rate for Payer: UHCCP DNSP |
$95.80
|
|
|
CHG INTEN MOD RADIOTHER PLAN, SIN/MULT FIELD
|
Professional
|
Both
|
$940.00
|
|
|
Service Code
|
HCPCS 77418
|
| Min. Negotiated Rate |
$376.00 |
| Max. Negotiated Rate |
$611.00 |
| Rate for Payer: Aetna Medicare |
$470.00
|
| Rate for Payer: BCBS Complete |
$376.00
|
| Rate for Payer: Cash Price |
$752.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$611.00
|
|
|
CHG INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX
|
Professional
|
Both
|
$1,709.00
|
|
|
Service Code
|
HCPCS 77778
|
| Min. Negotiated Rate |
$683.60 |
| Max. Negotiated Rate |
$1,233.68 |
| Rate for Payer: Aetna Commercial |
$1,148.00
|
| Rate for Payer: Aetna Commercial |
$1,148.00
|
| Rate for Payer: Aetna Medicare |
$856.72
|
| Rate for Payer: Aetna Medicare |
$856.72
|
| Rate for Payer: BCBS Complete |
$212.80
|
| Rate for Payer: BCBS Complete |
$683.60
|
| Rate for Payer: BCBS MAPPO |
$856.72
|
| Rate for Payer: BCBS MAPPO |
$856.72
|
| Rate for Payer: BCN Medicare Advantage |
$856.72
|
| Rate for Payer: BCN Medicare Advantage |
$856.72
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$1,367.20
|
| Rate for Payer: Cash Price |
$425.60
|
| Rate for Payer: Cofinity Commercial |
$1,233.68
|
| Rate for Payer: Cofinity Commercial |
$1,148.00
|
| Rate for Payer: Cofinity Commercial |
$1,233.68
|
| Rate for Payer: Cofinity Commercial |
$1,148.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$856.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$856.72
|
| Rate for Payer: Healthscope Commercial |
$1,028.06
|
| Rate for Payer: Healthscope Commercial |
$1,028.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,028.06
|
| Rate for Payer: Healthscope Whirlpool |
$1,028.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$899.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$899.56
|
| Rate for Payer: Nomi Health Commercial |
$1,028.06
|
| Rate for Payer: Nomi Health Commercial |
$1,028.06
|
| Rate for Payer: PACE SWMI |
$856.72
|
| Rate for Payer: PACE SWMI |
$856.72
|
| Rate for Payer: PHP Medicare Advantage |
$856.72
|
| Rate for Payer: PHP Medicare Advantage |
$856.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,110.85
|
| Rate for Payer: Priority Health Medicare |
$856.72
|
| Rate for Payer: Priority Health Medicare |
$856.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$856.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$856.72
|
| Rate for Payer: UHC Medicare Advantage |
$856.72
|
| Rate for Payer: UHC Medicare Advantage |
$856.72
|
| Rate for Payer: UHCCP DNSP |
$856.72
|
| Rate for Payer: UHCCP DNSP |
$856.72
|
|
|
CHG INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE
|
Professional
|
Both
|
$465.00
|
|
|
Service Code
|
HCPCS 77761
|
| Min. Negotiated Rate |
$186.00 |
| Max. Negotiated Rate |
$562.33 |
| Rate for Payer: Aetna Commercial |
$523.28
|
| Rate for Payer: Aetna Medicare |
$390.51
|
| Rate for Payer: BCBS Complete |
$186.00
|
| Rate for Payer: BCBS MAPPO |
$390.51
|
| Rate for Payer: BCN Medicare Advantage |
$390.51
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cash Price |
$372.00
|
| Rate for Payer: Cofinity Commercial |
$562.33
|
| Rate for Payer: Cofinity Commercial |
$523.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.51
|
| Rate for Payer: Healthscope Commercial |
$468.61
|
| Rate for Payer: Healthscope Whirlpool |
$468.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.04
|
| Rate for Payer: Nomi Health Commercial |
$468.61
|
| Rate for Payer: PACE SWMI |
$390.51
|
| Rate for Payer: PHP Medicare Advantage |
$390.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$302.25
|
| Rate for Payer: Priority Health Medicare |
$390.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.51
|
| Rate for Payer: UHC Medicare Advantage |
$390.51
|
| Rate for Payer: UHCCP DNSP |
$390.51
|
|
|
CHG INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I
|
Professional
|
Both
|
$91.00
|
|
|
Service Code
|
HCPCS 74360
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$59.15 |
| Rate for Payer: Aetna Medicare |
$45.50
|
| Rate for Payer: BCBS Complete |
$36.40
|
| Rate for Payer: Cash Price |
$72.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.15
|
|
|
CHG INTRAVASC ULTRASOUND,1ST VESSEL
|
Professional
|
Both
|
$224.00
|
|
|
Service Code
|
HCPCS 75945
|
| Min. Negotiated Rate |
$89.60 |
| Max. Negotiated Rate |
$145.60 |
| Rate for Payer: Aetna Medicare |
$112.00
|
| Rate for Payer: Aetna Medicare |
$42.50
|
| Rate for Payer: BCBS Complete |
$89.60
|
| Rate for Payer: BCBS Complete |
$34.00
|
| Rate for Payer: Cash Price |
$179.20
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.60
|
|
|
CHG INTRAVASC US, RAD SUPERISE/ INTERP, EA ADDN VESSEL
|
Professional
|
Both
|
$156.00
|
|
|
Service Code
|
HCPCS 75946
|
| Min. Negotiated Rate |
$62.40 |
| Max. Negotiated Rate |
$101.40 |
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$62.40
|
| Rate for Payer: BCBS Complete |
$18.40
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.40
|
|
|
CHG INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I
|
Professional
|
Both
|
$210.00
|
|
|
Service Code
|
HCPCS 74340
|
| Min. Negotiated Rate |
$84.00 |
| Max. Negotiated Rate |
$136.50 |
| Rate for Payer: Aetna Medicare |
$105.00
|
| Rate for Payer: BCBS Complete |
$84.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.50
|
|
|
CHG JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 77077
|
| Min. Negotiated Rate |
$42.16 |
| Max. Negotiated Rate |
$89.70 |
| Rate for Payer: Aetna Commercial |
$56.49
|
| Rate for Payer: Aetna Commercial |
$56.49
|
| Rate for Payer: Aetna Medicare |
$42.16
|
| Rate for Payer: Aetna Medicare |
$42.16
|
| Rate for Payer: BCBS Complete |
$24.40
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS MAPPO |
$42.16
|
| Rate for Payer: BCBS MAPPO |
$42.16
|
| Rate for Payer: BCN Medicare Advantage |
$42.16
|
| Rate for Payer: BCN Medicare Advantage |
$42.16
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cofinity Commercial |
$56.49
|
| Rate for Payer: Cofinity Commercial |
$56.49
|
| Rate for Payer: Cofinity Commercial |
$60.71
|
| Rate for Payer: Cofinity Commercial |
$60.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.16
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$50.59
|
| Rate for Payer: Healthscope Whirlpool |
$50.59
|
| Rate for Payer: Healthscope Whirlpool |
$50.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.27
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: Nomi Health Commercial |
$50.59
|
| Rate for Payer: PACE SWMI |
$42.16
|
| Rate for Payer: PACE SWMI |
$42.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Medicare |
$42.16
|
| Rate for Payer: Priority Health Medicare |
$42.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.16
|
| Rate for Payer: UHC Medicare Advantage |
$42.16
|
| Rate for Payer: UHC Medicare Advantage |
$42.16
|
| Rate for Payer: UHCCP DNSP |
$42.16
|
| Rate for Payer: UHCCP DNSP |
$42.16
|
|
|
CHG LIPID PANEL
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 80061
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$29.25 |
| Rate for Payer: Aetna Commercial |
$17.94
|
| Rate for Payer: Aetna Medicare |
$13.39
|
| Rate for Payer: BCBS Complete |
$18.00
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cofinity Commercial |
$19.28
|
| Rate for Payer: Cofinity Commercial |
$17.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$16.07
|
| Rate for Payer: Healthscope Whirlpool |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Nomi Health Commercial |
$16.07
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.39
|
| Rate for Payer: UHCCP DNSP |
$13.39
|
|
|
CHG MANUAL APPL STRESS PHYS/QHP JOINT RADIOGRAPHY
|
Professional
|
Both
|
$89.00
|
|
|
Service Code
|
HCPCS 77071
|
| Min. Negotiated Rate |
$35.60 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna Commercial |
$66.62
|
| Rate for Payer: Aetna Commercial |
$66.62
|
| Rate for Payer: Aetna Medicare |
$49.72
|
| Rate for Payer: Aetna Medicare |
$49.72
|
| Rate for Payer: BCBS Complete |
$35.60
|
| Rate for Payer: BCBS Complete |
$37.60
|
| Rate for Payer: BCBS MAPPO |
$49.72
|
| Rate for Payer: BCBS MAPPO |
$49.72
|
| Rate for Payer: BCN Medicare Advantage |
$49.72
|
| Rate for Payer: BCN Medicare Advantage |
$49.72
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Cofinity Commercial |
$71.60
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Cofinity Commercial |
$71.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.72
|
| Rate for Payer: Healthscope Commercial |
$59.66
|
| Rate for Payer: Healthscope Commercial |
$59.66
|
| Rate for Payer: Healthscope Whirlpool |
$59.66
|
| Rate for Payer: Healthscope Whirlpool |
$59.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.21
|
| Rate for Payer: Nomi Health Commercial |
$59.66
|
| Rate for Payer: Nomi Health Commercial |
$59.66
|
| Rate for Payer: PACE SWMI |
$49.72
|
| Rate for Payer: PACE SWMI |
$49.72
|
| Rate for Payer: PHP Medicare Advantage |
$49.72
|
| Rate for Payer: PHP Medicare Advantage |
$49.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health Medicare |
$49.72
|
| Rate for Payer: Priority Health Medicare |
$49.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$49.72
|
| Rate for Payer: UHC Medicare Advantage |
$49.72
|
| Rate for Payer: UHCCP DNSP |
$49.72
|
| Rate for Payer: UHCCP DNSP |
$49.72
|
|
