|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$28.00
|
|
|
Service Code
|
HCPCS 74021
|
| Min. Negotiated Rate |
$8.09 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna Commercial |
$48.74
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCN Commercial |
$63.04
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.51
|
| Rate for Payer: Priority Health Narrow Network |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.48
|
| Rate for Payer: UHC Exchange |
$43.48
|
| Rate for Payer: UHCCP Medicaid |
$8.09
|
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$31.00
|
|
|
Service Code
|
HCPCS 73565
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$113.06 |
| Rate for Payer: Aetna Commercial |
$46.05
|
| Rate for Payer: Aetna Commercial |
$46.05
|
| Rate for Payer: Aetna Commercial |
$46.05
|
| Rate for Payer: Aetna Medicare |
$15.50
|
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| 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 |
$113.06
|
| Rate for Payer: BCBS Trust/PPO |
$113.06
|
| Rate for Payer: BCBS Trust/PPO |
$113.06
|
| Rate for Payer: BCN Commercial |
$58.65
|
| Rate for Payer: BCN Commercial |
$58.65
|
| Rate for Payer: BCN Commercial |
$58.65
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$40.00
|
| 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 |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| 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 |
$33.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.57
|
| Rate for Payer: UHC Exchange |
$33.57
|
| Rate for Payer: UHC Exchange |
$33.57
|
| Rate for Payer: UHC Exchange |
$33.57
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$58.00
|
|
|
Service Code
|
HCPCS 71046
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$1,811.01 |
| Rate for Payer: Aetna Commercial |
$38.26
|
| Rate for Payer: Aetna Medicare |
$29.00
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS Trust/PPO |
$1,811.01
|
| Rate for Payer: BCN Commercial |
$49.36
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Meridian Medicaid |
$6.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.91
|
| Rate for Payer: Priority Health Narrow Network |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$33.99
|
| Rate for Payer: UHC Exchange |
$33.99
|
| Rate for Payer: UHCCP Medicaid |
$6.60
|
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 71047
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$2,027.62 |
| Rate for Payer: Aetna Commercial |
$48.36
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCBS Complete |
$8.73
|
| Rate for Payer: BCBS Trust/PPO |
$2,027.62
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Meridian Medicaid |
$8.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.01
|
| Rate for Payer: Priority Health Narrow Network |
$20.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$43.44
|
| Rate for Payer: UHC Exchange |
$43.44
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 71045
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,646.71 |
| Rate for Payer: Aetna Commercial |
$29.34
|
| Rate for Payer: Aetna Commercial |
$29.34
|
| Rate for Payer: Aetna Medicare |
$9.00
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: BCBS Trust/PPO |
$1,646.71
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: BCN Commercial |
$38.12
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| 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: UHC All Payor (Choice/PPO) + Core |
$22.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$22.23
|
| Rate for Payer: UHC Exchange |
$22.23
|
| Rate for Payer: UHC Exchange |
$22.23
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
Both
|
$34.00
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$73.31 |
| Rate for Payer: Aetna Commercial |
$56.56
|
| Rate for Payer: Aetna Medicare |
$17.00
|
| Rate for Payer: BCBS Complete |
$10.29
|
| Rate for Payer: BCN Commercial |
$73.31
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Meridian Medicaid |
$10.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.10
|
| 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 |
$50.53
|
| Rate for Payer: UHC Exchange |
$50.53
|
| Rate for Payer: UHCCP Medicaid |
$9.80
|
|
|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 73600
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$1,179.17 |
| Rate for Payer: Aetna Commercial |
$36.89
|
| Rate for Payer: Aetna Commercial |
$36.89
|
| Rate for Payer: Aetna Medicare |
$14.00
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,179.17
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$22.40
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| 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 Cigna Priority Health |
$18.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| 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: 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: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 70030
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$5,212.15 |
| Rate for Payer: Aetna Commercial |
$36.58
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$5,212.15
|
| Rate for Payer: BCN Commercial |
$47.89
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.83
|
| Rate for Payer: Priority Health Narrow Network |
$12.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.02
|
| Rate for Payer: UHC Exchange |
$30.02
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR 1 VIEW
|
Professional
|
Both
|
$32.00
|
|
|
Service Code
|
HCPCS 73551
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$2,038.18 |
| Rate for Payer: Aetna Commercial |
$33.46
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: BCBS Complete |
$5.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,038.18
|
| Rate for Payer: BCN Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Meridian Medicaid |
$5.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.78
|
| Rate for Payer: UHC Exchange |
$30.78
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
Both
|
$20.00
|
|
|
Service Code
|
HCPCS 73552
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,676.30 |
| Rate for Payer: Aetna Commercial |
$40.02
|
| Rate for Payer: Aetna Commercial |
$40.02
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: Aetna Medicare |
$31.50
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,676.30
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: BCN Commercial |
$52.29
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$50.40
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health Narrow Network |
$13.34
|
| Rate for Payer: Priority Health Narrow Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$35.88
|
| Rate for Payer: UHC Exchange |
$35.88
|
| Rate for Payer: UHC Exchange |
$35.88
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAMINATION FOOT 2 VIEWS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 73620
|
| Min. Negotiated Rate |
$4.69 |
| Max. Negotiated Rate |
$954.11 |
| Rate for Payer: Aetna Commercial |
$32.31
|
| Rate for Payer: Aetna Commercial |
$32.31
|
| Rate for Payer: Aetna Commercial |
$32.31
|
| Rate for Payer: Aetna Medicare |
$13.50
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCBS Trust/PPO |
$954.11
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: BCN Commercial |
$41.54
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$21.60
|
| Rate for Payer: Cash Price |
$62.40
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Meridian Medicaid |
$4.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.29
|
| Rate for Payer: Priority Health Narrow Network |
$11.29
|
| Rate for Payer: Priority Health Narrow Network |
$11.29
|
| Rate for Payer: Priority Health Narrow Network |
$11.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.05
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
| Rate for Payer: UHCCP Medicaid |
$4.69
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS
|
Professional
|
Both
|
$42.00
|
|
|
Service Code
|
HCPCS 73560
|
| Min. Negotiated Rate |
$5.11 |
| Max. Negotiated Rate |
$1,586.48 |
| Rate for Payer: Aetna Commercial |
$38.80
|
| Rate for Payer: Aetna Commercial |
$38.80
|
| Rate for Payer: Aetna Commercial |
$38.80
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: Aetna Medicare |
$21.00
|
| Rate for Payer: Aetna Medicare |
$42.50
|
| 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 |
$1,586.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,586.48
|
| 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 |
$68.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$33.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$68.00
|
| 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 |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.30
|
| 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 |
$30.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.84
|
| Rate for Payer: UHC Exchange |
$30.84
|
| Rate for Payer: UHC Exchange |
$30.84
|
| Rate for Payer: UHC Exchange |
$30.84
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
| Rate for Payer: UHCCP Medicaid |
$5.11
|
|
|
CHG RADIOLOGIC EXAMINATION KNEE 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 73562
|
| Min. Negotiated Rate |
$5.75 |
| Max. Negotiated Rate |
$2,259.01 |
| Rate for Payer: Aetna Commercial |
$45.74
|
| Rate for Payer: Aetna Commercial |
$45.74
|
| Rate for Payer: Aetna Commercial |
$45.74
|
| Rate for Payer: Aetna Medicare |
$16.00
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna Medicare |
$47.50
|
| 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 |
$2,259.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.01
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.01
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: BCN Commercial |
$59.62
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$25.60
|
| Rate for Payer: Cash Price |
$76.00
|
| 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 |
$61.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.80
|
| 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 |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.71
|
| Rate for Payer: UHC Exchange |
$36.71
|
| Rate for Payer: UHC Exchange |
$36.71
|
| Rate for Payer: UHC Exchange |
$36.71
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
| Rate for Payer: UHCCP Medicaid |
$5.75
|
|
|
CHG RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 70100
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,040.22 |
| Rate for Payer: Aetna Commercial |
$43.45
|
| Rate for Payer: Aetna Medicare |
$9.00
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,040.22
|
| Rate for Payer: BCN Commercial |
$56.68
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health Narrow Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$32.76
|
| Rate for Payer: UHC Exchange |
$32.76
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAMINATION NECK SOFT TISSUE
|
Professional
|
Both
|
$33.00
|
|
|
Service Code
|
HCPCS 70360
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$35.82
|
| Rate for Payer: Aetna Medicare |
$16.50
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$2,020.75
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health Narrow Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.84
|
| Rate for Payer: UHC Exchange |
$28.84
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPLETE
|
Professional
|
Both
|
$57.00
|
|
|
Service Code
|
HCPCS 77075
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$146.60 |
| Rate for Payer: Aetna Commercial |
$112.43
|
| Rate for Payer: Aetna Medicare |
$28.50
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCN Commercial |
$146.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Cash Price |
$45.60
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.05
|
| 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 |
$105.16
|
| Rate for Payer: UHC Exchange |
$105.16
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
|
|
CHG RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS
|
Professional
|
Both
|
$39.00
|
|
|
Service Code
|
HCPCS 72170
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$1,953.65 |
| Rate for Payer: Aetna Commercial |
$31.59
|
| Rate for Payer: Aetna Commercial |
$31.59
|
| Rate for Payer: Aetna Commercial |
$31.59
|
| Rate for Payer: Aetna Medicare |
$59.50
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna Medicare |
$22.50
|
| 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 |
$1,953.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,953.65
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: BCN Commercial |
$41.05
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$95.20
|
| Rate for Payer: Cash Price |
$36.00
|
| 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 |
$29.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.35
|
| 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 |
$28.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.12
|
| Rate for Payer: UHC Exchange |
$28.12
|
| Rate for Payer: UHC Exchange |
$28.12
|
| Rate for Payer: UHC Exchange |
$28.12
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS
|
Professional
|
Both
|
$43.00
|
|
|
Service Code
|
HCPCS 72200
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$2,183.46 |
| Rate for Payer: Aetna Commercial |
$37.31
|
| Rate for Payer: Aetna Medicare |
$21.50
|
| Rate for Payer: BCBS Complete |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$2,183.46
|
| Rate for Payer: BCN Commercial |
$48.38
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Meridian Medicaid |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$30.80
|
| Rate for Payer: UHC Exchange |
$30.80
|
| Rate for Payer: UHCCP Medicaid |
$5.33
|
|
|
CHG RADIOLOGIC EXAMINATION SKULL 4< VIEWS
|
Professional
|
Both
|
$48.00
|
|
|
Service Code
|
HCPCS 70250
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$1,779.84 |
| Rate for Payer: Aetna Commercial |
$40.40
|
| Rate for Payer: Aetna Commercial |
$40.40
|
| Rate for Payer: Aetna Medicare |
$24.00
|
| Rate for Payer: Aetna Medicare |
$9.00
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Complete |
$5.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,779.84
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: BCN Commercial |
$52.78
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Meridian Medicaid |
$5.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.34
|
| Rate for Payer: Priority Health Narrow Network |
$13.34
|
| Rate for Payer: Priority Health Narrow Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$37.93
|
| Rate for Payer: UHC Exchange |
$37.93
|
| Rate for Payer: UHC Exchange |
$37.93
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
|
|
CHG RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS
|
Professional
|
Both
|
$37.00
|
|
|
Service Code
|
HCPCS 73590
|
| Min. Negotiated Rate |
$4.90 |
| Max. Negotiated Rate |
$598.56 |
| Rate for Payer: Aetna Commercial |
$35.75
|
| Rate for Payer: Aetna Commercial |
$35.75
|
| Rate for Payer: Aetna Commercial |
$35.75
|
| Rate for Payer: Aetna Medicare |
$15.00
|
| Rate for Payer: Aetna Medicare |
$18.50
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| 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 |
$598.56
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCBS Trust/PPO |
$598.56
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: BCN Commercial |
$46.43
|
| Rate for Payer: Cash Price |
$67.20
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$29.60
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$67.20
|
| 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 |
$54.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| 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 |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$28.84
|
| Rate for Payer: UHC Exchange |
$28.84
|
| Rate for Payer: UHC Exchange |
$28.84
|
| Rate for Payer: UHC Exchange |
$28.84
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
| Rate for Payer: UHCCP Medicaid |
$4.90
|
|
|
CHG RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 73564
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$1,700.07 |
| Rate for Payer: Aetna Commercial |
$51.99
|
| Rate for Payer: Aetna Commercial |
$51.99
|
| Rate for Payer: Aetna Commercial |
$51.99
|
| Rate for Payer: Aetna Medicare |
$56.50
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Aetna Medicare |
$30.50
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,700.07
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: BCN Commercial |
$68.41
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.93
|
| Rate for Payer: Priority Health Narrow Network |
$16.93
|
| Rate for Payer: Priority Health Narrow Network |
$16.93
|
| Rate for Payer: Priority Health Narrow Network |
$16.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.63
|
| Rate for Payer: UHC Exchange |
$42.63
|
| Rate for Payer: UHC Exchange |
$42.63
|
| Rate for Payer: UHC Exchange |
$42.63
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
|
|
CHG RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS
|
Professional
|
Both
|
$53.00
|
|
|
Service Code
|
HCPCS 72190
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$1,716.45 |
| Rate for Payer: Aetna Commercial |
$47.53
|
| Rate for Payer: Aetna Commercial |
$47.53
|
| Rate for Payer: Aetna Medicare |
$26.50
|
| Rate for Payer: Aetna Medicare |
$27.50
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,716.45
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: BCN Commercial |
$62.06
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Cash Price |
$42.40
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.47
|
| Rate for Payer: Priority Health Narrow Network |
$18.47
|
| Rate for Payer: Priority Health Narrow Network |
$18.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$42.22
|
| Rate for Payer: UHC Exchange |
$42.22
|
| Rate for Payer: UHC Exchange |
$42.22
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
|
|
CHG RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS
|
Professional
|
Both
|
$40.00
|
|
|
Service Code
|
HCPCS 72202
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$378.26 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCBS Trust/PPO |
$378.26
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: BCN Commercial |
$57.66
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Cash Price |
$32.00
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.42
|
| Rate for Payer: Priority Health Narrow Network |
$16.42
|
| Rate for Payer: Priority Health Narrow Network |
$16.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$36.29
|
| Rate for Payer: UHC Exchange |
$36.29
|
| Rate for Payer: UHC Exchange |
$36.29
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
| Rate for Payer: UHCCP Medicaid |
$6.82
|
|
|
CHG RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS
|
Professional
|
Both
|
$59.00
|
|
|
Service Code
|
HCPCS 70260
|
| Min. Negotiated Rate |
$8.52 |
| Max. Negotiated Rate |
$2,020.75 |
| Rate for Payer: Aetna Commercial |
$51.07
|
| Rate for Payer: Aetna Medicare |
$29.50
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS Trust/PPO |
$2,020.75
|
| Rate for Payer: BCN Commercial |
$65.48
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Cash Price |
$47.20
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.54
|
| Rate for Payer: Priority Health Narrow Network |
$20.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$49.40
|
| Rate for Payer: UHC Exchange |
$49.40
|
| Rate for Payer: UHCCP Medicaid |
$8.52
|
|
|
CHG RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY
|
Professional
|
Both
|
$236.00
|
|
|
Service Code
|
HCPCS 74250
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$181.79 |
| Rate for Payer: Aetna Commercial |
$143.54
|
| Rate for Payer: Aetna Medicare |
$118.00
|
| Rate for Payer: BCBS Complete |
$25.49
|
| Rate for Payer: BCN Commercial |
$181.79
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Cash Price |
$188.80
|
| Rate for Payer: Meridian Medicaid |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$57.99
|
| Rate for Payer: Priority Health Narrow Network |
$57.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$107.78
|
| Rate for Payer: UHC Exchange |
$107.78
|
| Rate for Payer: UHCCP Medicaid |
$24.28
|
|
