|
CHG PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 86403
|
| Min. Negotiated Rate |
$6.53 |
| Max. Negotiated Rate |
$1,738.64 |
| Rate for Payer: Aetna Commercial |
$10.96
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,738.64
|
| Rate for Payer: BCN Commercial |
$8.66
|
| 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 |
$11.65
|
| Rate for Payer: Priority Health Narrow Network |
$11.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.53
|
| Rate for Payer: UHC Exchange |
$6.53
|
|
|
CHG PERCUTANEOUS VERTEBROPLASTY, CT GUIDE
|
Professional
|
Both
|
$267.00
|
|
|
Service Code
|
HCPCS 72292
|
| Min. Negotiated Rate |
$106.80 |
| Max. Negotiated Rate |
$173.55 |
| Rate for Payer: Aetna Medicare |
$133.50
|
| Rate for Payer: BCBS Complete |
$106.80
|
| Rate for Payer: Cash Price |
$213.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$173.55
|
|
|
CHG PERCUTANEOUS VERTEBROPLASTY, FLUOR GUIDE
|
Professional
|
Both
|
$242.00
|
|
|
Service Code
|
HCPCS 72291
|
| Min. Negotiated Rate |
$96.80 |
| Max. Negotiated Rate |
$157.30 |
| Rate for Payer: Aetna Medicare |
$121.00
|
| Rate for Payer: BCBS Complete |
$96.80
|
| Rate for Payer: Cash Price |
$193.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.30
|
|
|
CHG PERITONEOGRAM RS&I
|
Professional
|
Both
|
$46.00
|
|
|
Service Code
|
HCPCS 74190
|
| Min. Negotiated Rate |
$13.85 |
| Max. Negotiated Rate |
$2,754.03 |
| Rate for Payer: Aetna Commercial |
$534.94
|
| Rate for Payer: Aetna Medicare |
$23.00
|
| Rate for Payer: BCBS Complete |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$2,754.03
|
| Rate for Payer: BCN Commercial |
$497.65
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Meridian Medicaid |
$14.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$33.37
|
| Rate for Payer: Priority Health Narrow Network |
$33.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$85.31
|
| Rate for Payer: UHC Exchange |
$85.31
|
| Rate for Payer: UHCCP Medicaid |
$13.85
|
|
|
CHG PH BODY FLUID NOT ELSEWHERE SPECIFIED
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 83986
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$4,440.36 |
| Rate for Payer: Aetna Commercial |
$3.40
|
| Rate for Payer: Aetna Medicare |
$7.50
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,440.36
|
| Rate for Payer: BCN Commercial |
$2.69
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.66
|
| Rate for Payer: Priority Health Narrow Network |
$3.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3.46
|
| Rate for Payer: UHC Exchange |
$3.46
|
|
|
CHG PLACEMNT,PROX/DIST EXT PROS, INFRARENAL
|
Professional
|
Both
|
$455.00
|
|
|
Service Code
|
HCPCS 75953
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$295.75 |
| Rate for Payer: Aetna Medicare |
$227.50
|
| Rate for Payer: BCBS Complete |
$182.00
|
| Rate for Payer: Cash Price |
$364.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$295.75
|
|
|
CHG PLMT PROX XTN PRSTH EVASC DESC THORAC AORTA RS&I
|
Professional
|
Both
|
$379.00
|
|
|
Service Code
|
HCPCS 75958
|
| Min. Negotiated Rate |
$118.64 |
| Max. Negotiated Rate |
$2,266.53 |
| Rate for Payer: Aetna Commercial |
$229.01
|
| Rate for Payer: Aetna Medicare |
$189.50
|
| Rate for Payer: BCBS Complete |
$124.57
|
| Rate for Payer: BCBS Trust/PPO |
$471.24
|
| Rate for Payer: BCN Commercial |
$339.14
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Cash Price |
$303.20
|
| Rate for Payer: Meridian Medicaid |
$124.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$282.80
|
| Rate for Payer: Priority Health Narrow Network |
$282.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$2,266.53
|
| Rate for Payer: UHC Exchange |
$2,266.53
|
| Rate for Payer: UHCCP Medicaid |
$118.64
|
|
|
CHG PROTHROMBIN TIME
|
Professional
|
Both
|
$11.00
|
|
|
Service Code
|
HCPCS 85610
|
| Min. Negotiated Rate |
$4.08 |
| Max. Negotiated Rate |
$4,563.98 |
| Rate for Payer: Aetna Commercial |
$4.08
|
| Rate for Payer: Aetna Medicare |
$5.50
|
| Rate for Payer: BCBS Complete |
$4.40
|
| Rate for Payer: BCBS Trust/PPO |
$4,563.98
|
| Rate for Payer: BCN Commercial |
$4.29
|
| 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 |
$4.33
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.62
|
| Rate for Payer: UHC Exchange |
$5.62
|
|
|
CHG RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ
|
Professional
|
Both
|
$71.00
|
|
|
Service Code
|
HCPCS 73050
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$992.68 |
| Rate for Payer: Aetna Commercial |
$32.39
|
| Rate for Payer: Aetna Commercial |
$32.39
|
| Rate for Payer: Aetna Commercial |
$32.39
|
| Rate for Payer: Aetna Medicare |
$35.50
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS Trust/PPO |
$992.68
|
| Rate for Payer: BCBS Trust/PPO |
$992.68
|
| Rate for Payer: BCBS Trust/PPO |
$992.68
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$56.80
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.86
|
| Rate for Payer: Priority Health Narrow Network |
$13.86
|
| Rate for Payer: Priority Health Narrow Network |
$13.86
|
| Rate for Payer: Priority Health Narrow Network |
$13.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$38.70
|
| Rate for Payer: UHC Exchange |
$38.70
|
| Rate for Payer: UHC Exchange |
$38.70
|
| Rate for Payer: UHC Exchange |
$38.70
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
|
|
CHG RADEX ANKLE COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 73610
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$1,014.86 |
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Commercial |
$41.51
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: Aetna Medicare |
$44.50
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,014.86
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: BCN Commercial |
$54.24
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.13
|
| Rate for Payer: UHC Exchange |
$33.13
|
| Rate for Payer: UHC Exchange |
$33.13
|
| Rate for Payer: UHC Exchange |
$33.13
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADEX CALCANEUS MINIMUM 2 VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 73650
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$2,853.88 |
| Rate for Payer: Aetna Commercial |
$32.70
|
| Rate for Payer: Aetna Commercial |
$32.70
|
| Rate for Payer: Aetna Commercial |
$32.70
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Trust/PPO |
$2,853.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,853.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,853.88
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: BCN Commercial |
$42.02
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow Network |
$11.81
|
| Rate for Payer: Priority Health Narrow Network |
$11.81
|
| Rate for Payer: Priority Health Narrow Network |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.44
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADEX CLAVICLE COMPLETE
|
Professional
|
Both
|
$41.00
|
|
|
Service Code
|
HCPCS 73000
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$3,301.35 |
| Rate for Payer: Aetna Commercial |
$36.51
|
| Rate for Payer: Aetna Commercial |
$36.51
|
| Rate for Payer: Aetna Commercial |
$36.51
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: Aetna Medicare |
$20.50
|
| Rate for Payer: Aetna Medicare |
$47.00
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.35
|
| Rate for Payer: BCBS Trust/PPO |
$3,301.35
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$75.20
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$29.22
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADEX ELBOW 2 VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 73070
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$316.45 |
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Aetna Medicare |
$44.00
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$316.45
|
| Rate for Payer: BCBS Trust/PPO |
$316.45
|
| Rate for Payer: BCBS Trust/PPO |
$316.45
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.81
|
| Rate for Payer: UHC Exchange |
$28.81
|
| Rate for Payer: UHC Exchange |
$28.81
|
| Rate for Payer: UHC Exchange |
$28.81
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADEX ELBOW ARTHROGRAPHY RS&I
|
Professional
|
Both
|
$86.00
|
|
|
Service Code
|
HCPCS 73085
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$296.90 |
| Rate for Payer: Aetna Commercial |
$133.37
|
| Rate for Payer: Aetna Medicare |
$43.00
|
| Rate for Payer: BCBS Complete |
$17.22
|
| Rate for Payer: BCBS Trust/PPO |
$296.90
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Cash Price |
$68.80
|
| Rate for Payer: Meridian Medicaid |
$17.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.01
|
| Rate for Payer: Priority Health Narrow Network |
$39.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$99.69
|
| Rate for Payer: UHC Exchange |
$99.69
|
| Rate for Payer: UHCCP Medicaid |
$16.40
|
|
|
CHG RADEX ELBOW COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$101.00
|
|
|
Service Code
|
HCPCS 73080
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$379.85 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Medicare |
$50.50
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$379.85
|
| Rate for Payer: BCBS Trust/PPO |
$379.85
|
| Rate for Payer: BCBS Trust/PPO |
$379.85
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.26
|
| Rate for Payer: UHC Exchange |
$36.26
|
| Rate for Payer: UHC Exchange |
$36.26
|
| Rate for Payer: UHC Exchange |
$36.26
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 72081
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$62.55 |
| Rate for Payer: Aetna Commercial |
$47.94
|
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCN Commercial |
$62.55
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.00
|
| Rate for Payer: Priority Health Narrow Network |
$19.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.08
|
| Rate for Payer: UHC Exchange |
$43.08
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 72082
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$380.38 |
| Rate for Payer: Aetna Commercial |
$79.03
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS Trust/PPO |
$380.38
|
| Rate for Payer: BCN Commercial |
$103.11
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| 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 |
$68.90
|
| Rate for Payer: UHC Exchange |
$68.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 72083
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$115.82 |
| Rate for Payer: Aetna Commercial |
$89.48
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCN Commercial |
$115.82
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.18
|
| Rate for Payer: Priority Health Narrow Network |
$26.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$74.82
|
| Rate for Payer: UHC Exchange |
$74.82
|
| Rate for Payer: UHCCP Medicaid |
$10.86
|
|
|
CHG RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72084
|
| Min. Negotiated Rate |
$12.78 |
| Max. Negotiated Rate |
$145.62 |
| Rate for Payer: Aetna Commercial |
$110.33
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: BCBS Complete |
$13.42
|
| Rate for Payer: BCN Commercial |
$145.62
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Meridian Medicaid |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.28
|
| Rate for Payer: Priority Health Narrow Network |
$30.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$89.35
|
| Rate for Payer: UHC Exchange |
$89.35
|
| Rate for Payer: UHCCP Medicaid |
$12.78
|
|
|
CHG RADEX FACIAL BONES < 3 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70140
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$1,212.45 |
| Rate for Payer: Aetna Commercial |
$36.62
|
| Rate for Payer: Aetna Medicare |
$9.00
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,212.45
|
| Rate for Payer: BCN Commercial |
$47.41
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.37
|
| Rate for Payer: Priority Health Narrow Network |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.82
|
| Rate for Payer: UHC Exchange |
$30.82
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
|
|
CHG RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$92.00
|
|
|
Service Code
|
HCPCS 70150
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$916.60 |
| Rate for Payer: Aetna Commercial |
$53.67
|
| Rate for Payer: Aetna Commercial |
$53.67
|
| Rate for Payer: Aetna Commercial |
$53.67
|
| Rate for Payer: Aetna Medicare |
$46.00
|
| Rate for Payer: Aetna Medicare |
$29.00
|
| Rate for Payer: Aetna Medicare |
$13.00
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS Trust/PPO |
$916.60
|
| Rate for Payer: BCBS Trust/PPO |
$916.60
|
| Rate for Payer: BCBS Trust/PPO |
$916.60
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: BCN Commercial |
$68.90
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$20.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.00
|
| Rate for Payer: Priority Health Narrow Network |
$19.00
|
| Rate for Payer: Priority Health Narrow Network |
$19.00
|
| Rate for Payer: Priority Health Narrow Network |
$19.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$44.20
|
| Rate for Payer: UHC Exchange |
$44.20
|
| Rate for Payer: UHC Exchange |
$44.20
|
| Rate for Payer: UHC Exchange |
$44.20
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
| Rate for Payer: UHCCP Medicaid |
$7.88
|
|
|
CHG RADEX FINGR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$51.00
|
|
|
Service Code
|
HCPCS 73140
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$349.73 |
| Rate for Payer: Aetna Commercial |
$42.12
|
| Rate for Payer: Aetna Commercial |
$42.12
|
| Rate for Payer: Aetna Commercial |
$42.12
|
| Rate for Payer: Aetna Medicare |
$11.00
|
| Rate for Payer: Aetna Medicare |
$25.50
|
| Rate for Payer: Aetna Medicare |
$40.50
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCBS Trust/PPO |
$349.73
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: BCN Commercial |
$55.71
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.27
|
| Rate for Payer: Priority Health Narrow Network |
$10.27
|
| Rate for Payer: Priority Health Narrow Network |
$10.27
|
| Rate for Payer: Priority Health Narrow Network |
$10.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$31.12
|
| Rate for Payer: UHC Exchange |
$31.12
|
| Rate for Payer: UHC Exchange |
$31.12
|
| Rate for Payer: UHC Exchange |
$31.12
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
|
|
CHG RADEX FOOT COMPLETE MINIMUM 3 VIEWS
|
Professional
|
Both
|
$45.00
|
|
|
Service Code
|
HCPCS 73630
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$910.26 |
| Rate for Payer: Aetna Commercial |
$38.84
|
| Rate for Payer: Aetna Commercial |
$38.84
|
| Rate for Payer: Aetna Commercial |
$38.84
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$910.26
|
| Rate for Payer: BCBS Trust/PPO |
$910.26
|
| Rate for Payer: BCBS Trust/PPO |
$910.26
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: BCN Commercial |
$50.33
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.75
|
| Rate for Payer: UHC Exchange |
$32.75
|
| Rate for Payer: UHC Exchange |
$32.75
|
| Rate for Payer: UHC Exchange |
$32.75
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADEX FOREARM 2 VIEWS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 73090
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$439.55 |
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Commercial |
$33.08
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Trust/PPO |
$439.55
|
| Rate for Payer: BCBS Trust/PPO |
$439.55
|
| Rate for Payer: BCBS Trust/PPO |
$439.55
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Meridian Medicaid |
$5.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.81
|
| Rate for Payer: Priority Health Narrow Network |
$11.81
|
| Rate for Payer: Priority Health Narrow Network |
$11.81
|
| Rate for Payer: Priority Health Narrow Network |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.83
|
| Rate for Payer: UHC Exchange |
$28.83
|
| Rate for Payer: UHC Exchange |
$28.83
|
| Rate for Payer: UHC Exchange |
$28.83
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADEX HAND 2 VIEWS
|
Professional
|
Both
|
$38.00
|
|
|
Service Code
|
HCPCS 73120
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$138.94 |
| Rate for Payer: Aetna Commercial |
$35.37
|
| Rate for Payer: Aetna Commercial |
$35.37
|
| Rate for Payer: Aetna Commercial |
$35.37
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna Medicare |
$19.00
|
| Rate for Payer: Aetna Medicare |
$41.00
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$138.94
|
| Rate for Payer: BCBS Trust/PPO |
$138.94
|
| Rate for Payer: BCBS Trust/PPO |
$138.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: BCN Commercial |
$45.94
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$30.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.44
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHC Exchange |
$28.44
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
