|
CHG RADN RX DELIVERY COMPLX 11-19 MEV
|
Professional
|
Both
|
$475.00
|
|
|
Service Code
|
HCPCS 77414
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$308.75 |
| Rate for Payer: Aetna Medicare |
$237.50
|
| Rate for Payer: BCBS Complete |
$190.00
|
| Rate for Payer: Cash Price |
$380.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.75
|
|
|
CHG RADN RX DELIVERY COMPLX 6-10 MEV
|
Professional
|
Both
|
$422.00
|
|
|
Service Code
|
HCPCS 77413
|
| Min. Negotiated Rate |
$168.80 |
| Max. Negotiated Rate |
$274.30 |
| Rate for Payer: Aetna Medicare |
$211.00
|
| Rate for Payer: BCBS Complete |
$168.80
|
| Rate for Payer: Cash Price |
$337.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.30
|
|
|
CHG RADN RX DELIVERY SIMPLE 11-19 MEV
|
Professional
|
Both
|
$261.00
|
|
|
Service Code
|
HCPCS 77404
|
| Min. Negotiated Rate |
$104.40 |
| Max. Negotiated Rate |
$169.65 |
| Rate for Payer: Aetna Medicare |
$130.50
|
| Rate for Payer: BCBS Complete |
$104.40
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.65
|
|
|
CHG RADN RX DELIVERY SIMPLE 6-10 MEV
|
Professional
|
Both
|
$234.00
|
|
|
Service Code
|
HCPCS 77403
|
| Min. Negotiated Rate |
$93.60 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Aetna Medicare |
$117.00
|
| Rate for Payer: BCBS Complete |
$93.60
|
| Rate for Payer: Cash Price |
$187.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.10
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,1 CHANNEL
|
Professional
|
Both
|
$456.00
|
|
|
Service Code
|
HCPCS 77785
|
| Min. Negotiated Rate |
$182.40 |
| Max. Negotiated Rate |
$296.40 |
| Rate for Payer: Aetna Medicare |
$228.00
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: BCBS Complete |
$182.40
|
| Rate for Payer: Cash Price |
$364.80
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$296.40
|
|
|
CHG REMOTE AFTLD RADIONUC BRACHYTHERAPY,2-12 CHANNEL
|
Professional
|
Both
|
$1,005.00
|
|
|
Service Code
|
HCPCS 77786
|
| Min. Negotiated Rate |
$402.00 |
| Max. Negotiated Rate |
$653.25 |
| Rate for Payer: Aetna Medicare |
$502.50
|
| Rate for Payer: Aetna Medicare |
$341.00
|
| Rate for Payer: BCBS Complete |
$272.80
|
| Rate for Payer: BCBS Complete |
$402.00
|
| Rate for Payer: Cash Price |
$804.00
|
| Rate for Payer: Cash Price |
$545.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$653.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$443.30
|
|
|
CHG REPAIR,ILIAC ANRYSM/PSEUDO/AV MALF/TRAUMA W/ ENDOPROSTHESIS
|
Professional
|
Both
|
$220.00
|
|
|
Service Code
|
HCPCS 75954
|
| Min. Negotiated Rate |
$88.00 |
| Max. Negotiated Rate |
$143.00 |
| Rate for Payer: Aetna Medicare |
$110.00
|
| Rate for Payer: BCBS Complete |
$88.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$143.00
|
|
|
CHG RESPIRATORY MOTION MANAGEMENT SIMULATION
|
Professional
|
Both
|
$618.00
|
|
|
Service Code
|
HCPCS 77293
|
| Min. Negotiated Rate |
$67.52 |
| Max. Negotiated Rate |
$604.01 |
| Rate for Payer: Aetna Commercial |
$505.24
|
| Rate for Payer: Aetna Commercial |
$505.24
|
| Rate for Payer: Aetna Medicare |
$309.00
|
| Rate for Payer: Aetna Medicare |
$413.00
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS Complete |
$70.90
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$218.19
|
| Rate for Payer: BCN Commercial |
$604.01
|
| Rate for Payer: BCN Commercial |
$604.01
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Cash Price |
$494.40
|
| Rate for Payer: Cash Price |
$660.80
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Meridian Medicaid |
$70.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$536.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.65
|
| Rate for Payer: Priority Health Narrow Network |
$160.65
|
| Rate for Payer: Priority Health Narrow Network |
$160.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$582.44
|
| Rate for Payer: UHC Exchange |
$582.44
|
| Rate for Payer: UHC Exchange |
$582.44
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
| Rate for Payer: UHCCP Medicaid |
$67.52
|
|
|
CHG RP LOCLZJ TUM SPECT 1 AREA/ACQUISJ 1 DAY IMG
|
Professional
|
Both
|
$87.00
|
|
|
Service Code
|
HCPCS 78803
|
| Min. Negotiated Rate |
$31.52 |
| Max. Negotiated Rate |
$1,043.92 |
| Rate for Payer: Aetna Commercial |
$438.41
|
| Rate for Payer: Aetna Commercial |
$438.41
|
| Rate for Payer: Aetna Commercial |
$438.41
|
| Rate for Payer: Aetna Medicare |
$43.50
|
| Rate for Payer: Aetna Medicare |
$306.00
|
| Rate for Payer: Aetna Medicare |
$349.50
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Complete |
$33.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,043.92
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: BCN Commercial |
$519.46
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$559.20
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$69.60
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Meridian Medicaid |
$33.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$454.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.97
|
| Rate for Payer: Priority Health Narrow Network |
$75.97
|
| Rate for Payer: Priority Health Narrow Network |
$75.97
|
| Rate for Payer: Priority Health Narrow Network |
$75.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$343.06
|
| Rate for Payer: UHC Exchange |
$343.06
|
| Rate for Payer: UHC Exchange |
$343.06
|
| Rate for Payer: UHC Exchange |
$343.06
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
| Rate for Payer: UHCCP Medicaid |
$31.52
|
|
|
CHG RP THERAPY INTRAVENOUS ADMINISTRATION
|
Professional
|
Both
|
$293.00
|
|
|
Service Code
|
HCPCS 79101
|
| Min. Negotiated Rate |
$58.58 |
| Max. Negotiated Rate |
$1,781.96 |
| Rate for Payer: Aetna Commercial |
$172.32
|
| Rate for Payer: Aetna Commercial |
$172.32
|
| Rate for Payer: Aetna Medicare |
$146.50
|
| Rate for Payer: Aetna Medicare |
$263.50
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS Complete |
$61.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.96
|
| Rate for Payer: BCBS Trust/PPO |
$1,781.96
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: BCN Commercial |
$214.05
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$421.60
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Cash Price |
$234.40
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Meridian Medicaid |
$61.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.15
|
| Rate for Payer: Priority Health Narrow Network |
$141.15
|
| Rate for Payer: Priority Health Narrow Network |
$141.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.03
|
| Rate for Payer: UHC Exchange |
$170.03
|
| Rate for Payer: UHC Exchange |
$170.03
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
| Rate for Payer: UHCCP Medicaid |
$58.58
|
|
|
CHG RP THERAPY ORAL ADMINISTRATION
|
Professional
|
Both
|
$155.00
|
|
|
Service Code
|
HCPCS 79005
|
| Min. Negotiated Rate |
$53.04 |
| Max. Negotiated Rate |
$1,228.83 |
| Rate for Payer: Aetna Commercial |
$158.75
|
| Rate for Payer: Aetna Commercial |
$158.75
|
| Rate for Payer: Aetna Medicare |
$77.50
|
| Rate for Payer: Aetna Medicare |
$130.00
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS Complete |
$55.69
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCBS Trust/PPO |
$1,228.83
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: BCN Commercial |
$196.45
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Cash Price |
$124.00
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Meridian Medicaid |
$55.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$126.77
|
| Rate for Payer: Priority Health Narrow Network |
$126.77
|
| Rate for Payer: Priority Health Narrow Network |
$126.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$150.79
|
| Rate for Payer: UHC Exchange |
$150.79
|
| Rate for Payer: UHC Exchange |
$150.79
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
| Rate for Payer: UHCCP Medicaid |
$53.04
|
|
|
CHG SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER
|
Professional
|
Both
|
$240.00
|
|
|
Service Code
|
HCPCS 76831
|
| Min. Negotiated Rate |
$21.73 |
| Max. Negotiated Rate |
$764.98 |
| Rate for Payer: Aetna Commercial |
$138.24
|
| Rate for Payer: Aetna Medicare |
$120.00
|
| Rate for Payer: BCBS Complete |
$22.82
|
| Rate for Payer: BCBS Trust/PPO |
$764.98
|
| Rate for Payer: BCN Commercial |
$171.04
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Cash Price |
$192.00
|
| Rate for Payer: Meridian Medicaid |
$22.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$156.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.35
|
| Rate for Payer: Priority Health Narrow Network |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$127.68
|
| Rate for Payer: UHC Exchange |
$127.68
|
| Rate for Payer: UHCCP Medicaid |
$21.73
|
|
|
CHG SCREENING DIGITAL BREAST TOMOSYNTHESIS BI
|
Professional
|
Both
|
$62.00
|
|
|
Service Code
|
HCPCS 77063
|
| Min. Negotiated Rate |
$18.11 |
| Max. Negotiated Rate |
$77.21 |
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: Aetna Medicare |
$31.00
|
| Rate for Payer: BCBS Complete |
$19.02
|
| Rate for Payer: BCN Commercial |
$77.21
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.11
|
| Rate for Payer: Priority Health Narrow Network |
$43.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$70.32
|
| Rate for Payer: UHC Exchange |
$70.32
|
| Rate for Payer: UHCCP Medicaid |
$18.11
|
|
|
CHG SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD
|
Professional
|
Both
|
$79.00
|
|
|
Service Code
|
HCPCS 77067
|
| Min. Negotiated Rate |
$23.00 |
| Max. Negotiated Rate |
$188.15 |
| Rate for Payer: Aetna Commercial |
$149.83
|
| Rate for Payer: Aetna Medicare |
$39.50
|
| Rate for Payer: BCBS Complete |
$24.15
|
| Rate for Payer: BCN Commercial |
$188.15
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Cash Price |
$63.20
|
| Rate for Payer: Meridian Medicaid |
$24.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$54.92
|
| Rate for Payer: Priority Health Narrow Network |
$54.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$170.93
|
| Rate for Payer: UHC Exchange |
$170.93
|
| Rate for Payer: UHCCP Medicaid |
$23.00
|
|
|
CHG SEDIMENTATION RATE RBC NON-AUTOMATED
|
Professional
|
Both
|
$15.00
|
|
|
Service Code
|
HCPCS 85651
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$2,682.02 |
| Rate for Payer: Aetna Commercial |
$4.06
|
| Rate for Payer: Aetna Medicare |
$7.50
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,682.02
|
| Rate for Payer: BCN Commercial |
$3.20
|
| 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 |
$4.33
|
| Rate for Payer: Priority Health Narrow Network |
$4.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$5.08
|
| Rate for Payer: UHC Exchange |
$5.08
|
|
|
CHG SEMEN ALYS MOTILITY&CNT X W/HUHNER TST
|
Professional
|
Both
|
$21.00
|
|
|
Service Code
|
HCPCS 89310
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$940.90 |
| Rate for Payer: Aetna Commercial |
$8.18
|
| Rate for Payer: Aetna Medicare |
$10.50
|
| Rate for Payer: BCBS Complete |
$8.40
|
| Rate for Payer: BCBS Trust/PPO |
$940.90
|
| Rate for Payer: BCN Commercial |
$6.46
|
| 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 |
$13.40
|
| Rate for Payer: Priority Health Narrow Network |
$13.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.33
|
| Rate for Payer: UHC Exchange |
$12.33
|
|
|
CHG SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER
|
Professional
|
Both
|
$47.00
|
|
|
Service Code
|
HCPCS 89300
|
| Min. Negotiated Rate |
$7.38 |
| Max. Negotiated Rate |
$3,455.08 |
| Rate for Payer: Aetna Commercial |
$9.35
|
| Rate for Payer: Aetna Medicare |
$23.50
|
| Rate for Payer: BCBS Complete |
$18.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,455.08
|
| Rate for Payer: BCN Commercial |
$7.38
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Cash Price |
$37.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.48
|
| Rate for Payer: Priority Health Narrow Network |
$15.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.12
|
| Rate for Payer: UHC Exchange |
$10.12
|
|
|
CHG SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM
|
Professional
|
Both
|
$29.00
|
|
|
Service Code
|
HCPCS 89321
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$1,251.54 |
| Rate for Payer: Aetna Commercial |
$11.45
|
| Rate for Payer: Aetna Medicare |
$14.50
|
| Rate for Payer: BCBS Complete |
$11.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,251.54
|
| Rate for Payer: BCN Commercial |
$9.04
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Cash Price |
$23.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.56
|
| Rate for Payer: Priority Health Narrow Network |
$18.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$10.36
|
| Rate for Payer: UHC Exchange |
$10.36
|
|
|
CHG SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I
|
Professional
|
Both
|
$192.00
|
|
|
Service Code
|
HCPCS 75809
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$124.80 |
| Rate for Payer: Aetna Commercial |
$101.45
|
| Rate for Payer: Aetna Medicare |
$96.00
|
| Rate for Payer: BCBS Complete |
$15.20
|
| Rate for Payer: BCBS Trust/PPO |
$122.04
|
| Rate for Payer: BCN Commercial |
$120.70
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Cash Price |
$153.60
|
| Rate for Payer: Meridian Medicaid |
$15.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$124.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.38
|
| Rate for Payer: Priority Health Narrow Network |
$34.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$95.29
|
| Rate for Payer: UHC Exchange |
$95.29
|
| Rate for Payer: UHCCP Medicaid |
$14.48
|
|
|
CHG SKIN TEST TUBERCULOSIS INTRADERMAL
|
Professional
|
Both
|
$16.00
|
|
|
Service Code
|
HCPCS 86580
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$2,063.01 |
| Rate for Payer: Aetna Commercial |
$8.78
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: BCBS Complete |
$6.40
|
| Rate for Payer: BCBS Trust/PPO |
$2,063.01
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Cash Price |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.78
|
| Rate for Payer: UHC Exchange |
$6.78
|
|
|
CHG SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS
|
Professional
|
Both
|
$49.00
|
|
|
Service Code
|
HCPCS 87209
|
| Min. Negotiated Rate |
$13.49 |
| Max. Negotiated Rate |
$378.81 |
| Rate for Payer: Aetna Commercial |
$17.08
|
| Rate for Payer: Aetna Medicare |
$24.50
|
| Rate for Payer: BCBS Complete |
$19.60
|
| Rate for Payer: BCBS Trust/PPO |
$378.81
|
| Rate for Payer: BCN Commercial |
$13.49
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Cash Price |
$39.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$15.44
|
| Rate for Payer: UHC Exchange |
$15.44
|
|
|
CHG SMR PRIM SRC WET MOUNT NFCT AGT
|
Professional
|
Both
|
$18.00
|
|
|
Service Code
|
HCPCS 87210
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$368.23 |
| Rate for Payer: Aetna Commercial |
$5.53
|
| Rate for Payer: Aetna Medicare |
$9.00
|
| Rate for Payer: BCBS Complete |
$7.20
|
| Rate for Payer: BCBS Trust/PPO |
$368.23
|
| Rate for Payer: BCN Commercial |
$5.82
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.66
|
| Rate for Payer: Priority Health Narrow Network |
$5.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6.11
|
| Rate for Payer: UHC Exchange |
$6.11
|
|
|
CHG SONO GUIDE PERICARD TAP
|
Professional
|
Both
|
$121.00
|
|
|
Service Code
|
HCPCS 76930
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$78.65 |
| Rate for Payer: Aetna Medicare |
$60.50
|
| Rate for Payer: BCBS Complete |
$48.40
|
| Rate for Payer: Cash Price |
$96.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.65
|
|
|
CHG SONO GUIDE RAD THERAPY FIELDS
|
Professional
|
Both
|
$138.00
|
|
|
Service Code
|
HCPCS 76950
|
| Min. Negotiated Rate |
$55.20 |
| Max. Negotiated Rate |
$89.70 |
| Rate for Payer: Aetna Medicare |
$69.00
|
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: BCBS Complete |
$55.20
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.70
|
|
|
CHG SPEC DOSIM ONLY PRESCRIBED TREATING PHYS
|
Professional
|
Both
|
$125.00
|
|
|
Service Code
|
HCPCS 77331
|
| Min. Negotiated Rate |
$29.61 |
| Max. Negotiated Rate |
$5,193.72 |
| Rate for Payer: Aetna Commercial |
$75.48
|
| Rate for Payer: Aetna Commercial |
$75.48
|
| Rate for Payer: Aetna Medicare |
$62.50
|
| Rate for Payer: Aetna Medicare |
$18.00
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS Complete |
$31.09
|
| Rate for Payer: BCBS Trust/PPO |
$5,193.72
|
| Rate for Payer: BCBS Trust/PPO |
$5,193.72
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: BCN Commercial |
$94.31
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Meridian Medicaid |
$31.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.31
|
| Rate for Payer: Priority Health Narrow Network |
$70.31
|
| Rate for Payer: Priority Health Narrow Network |
$70.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$84.73
|
| Rate for Payer: UHC Exchange |
$84.73
|
| Rate for Payer: UHC Exchange |
$84.73
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
| Rate for Payer: UHCCP Medicaid |
$29.61
|
|
