|
CHG IAADIADOO RESPIRATORY SYNCTIAL VIRUS
|
Professional
|
$26.20
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
Z13005
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$31.44 |
| Rate for Payer: Coventry/First Health All Products |
$31.44
|
| Rate for Payer: Frontpath All Products |
$13.10
|
| Rate for Payer: Humana ChoiceCare |
$26.20
|
| Rate for Payer: Lutheran Preferred All Products |
$18.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$19.65
|
| Rate for Payer: PHP All Products |
$11.53
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$17.00
|
| Rate for Payer: United Healthcare Commercial |
$10.51
|
|
|
CHG IAADIADOO RESPIRATORY SYNCTIAL VIRUS
|
Professional
|
$26.20
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
Z13004
|
| Min. Negotiated Rate |
$10.51 |
| Max. Negotiated Rate |
$31.44 |
| Rate for Payer: Coventry/First Health All Products |
$31.44
|
| Rate for Payer: Frontpath All Products |
$13.10
|
| Rate for Payer: Humana ChoiceCare |
$26.20
|
| Rate for Payer: Lutheran Preferred All Products |
$18.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$19.65
|
| Rate for Payer: PHP All Products |
$11.53
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$17.00
|
| Rate for Payer: United Healthcare Commercial |
$10.51
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
$33.06
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
Z13006
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$39.67 |
| Rate for Payer: Coventry/First Health All Products |
$39.67
|
| Rate for Payer: Frontpath All Products |
$16.53
|
| Rate for Payer: Humana ChoiceCare |
$33.06
|
| Rate for Payer: Lutheran Preferred All Products |
$23.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$24.80
|
| Rate for Payer: PHP All Products |
$14.55
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$21.00
|
| Rate for Payer: United Healthcare Commercial |
$17.52
|
|
|
CHG IAADIADOO STREPTOCOCCUS GROUP A
|
Professional
|
$33.06
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
Z13007
|
| Min. Negotiated Rate |
$14.55 |
| Max. Negotiated Rate |
$39.67 |
| Rate for Payer: Coventry/First Health All Products |
$39.67
|
| Rate for Payer: Frontpath All Products |
$16.53
|
| Rate for Payer: Humana ChoiceCare |
$33.06
|
| Rate for Payer: Lutheran Preferred All Products |
$23.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$24.80
|
| Rate for Payer: PHP All Products |
$14.55
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$21.00
|
| Rate for Payer: United Healthcare Commercial |
$17.52
|
|
|
CHG IAAD IA INFLUENZA A/B EACH
|
Professional
|
$28.26
|
|
|
Service Code
|
CPT 87400
|
| Hospital Charge Code |
Z12994
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$33.91 |
| Rate for Payer: Anthem Exchange |
$5.67
|
| Rate for Payer: Anthem PPO |
$5.67
|
| Rate for Payer: Anthem Traditional |
$5.67
|
| Rate for Payer: Coventry/First Health All Products |
$33.91
|
| Rate for Payer: Frontpath All Products |
$14.13
|
| Rate for Payer: Humana ChoiceCare |
$28.26
|
| Rate for Payer: Lutheran Preferred All Products |
$20.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$21.20
|
| Rate for Payer: PHP All Products |
$12.43
|
| Rate for Payer: Signature Care EPO |
$15.30
|
| Rate for Payer: Signature Care PPO |
$15.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$18.00
|
| Rate for Payer: United Healthcare Commercial |
$10.51
|
|
|
CHG IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
$70.66
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
Z12995
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$84.79 |
| Rate for Payer: Coventry/First Health All Products |
$84.79
|
| Rate for Payer: Frontpath All Products |
$31.59
|
| Rate for Payer: Humana ChoiceCare |
$70.66
|
| Rate for Payer: Lutheran Preferred All Products |
$49.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$52.99
|
| Rate for Payer: PHP All Products |
$31.09
|
| Rate for Payer: Signature Care EPO |
$51.00
|
| Rate for Payer: Signature Care PPO |
$51.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$46.00
|
| Rate for Payer: United Healthcare Commercial |
$24.83
|
| Rate for Payer: United Healthcare Medicare |
$35.33
|
|
|
CHG IAAD IA SEVERE AQT RESPIR SYND CORONAVIRUS
|
Professional
|
$70.66
|
|
|
Service Code
|
CPT 87426
|
| Hospital Charge Code |
Z12996
|
| Min. Negotiated Rate |
$24.83 |
| Max. Negotiated Rate |
$84.79 |
| Rate for Payer: Coventry/First Health All Products |
$84.79
|
| Rate for Payer: Frontpath All Products |
$31.59
|
| Rate for Payer: Humana ChoiceCare |
$70.66
|
| Rate for Payer: Lutheran Preferred All Products |
$49.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$52.99
|
| Rate for Payer: PHP All Products |
$31.09
|
| Rate for Payer: Signature Care EPO |
$51.00
|
| Rate for Payer: Signature Care PPO |
$51.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$46.00
|
| Rate for Payer: United Healthcare Commercial |
$24.83
|
| Rate for Payer: United Healthcare Medicare |
$35.33
|
|
|
CHG IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH
|
Professional
|
$36.18
|
|
|
Service Code
|
CPT 86318
|
| Hospital Charge Code |
Z12990
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$43.42 |
| Rate for Payer: Coventry/First Health All Products |
$43.42
|
| Rate for Payer: Frontpath All Products |
$18.09
|
| Rate for Payer: Humana ChoiceCare |
$36.18
|
| Rate for Payer: Lutheran Preferred All Products |
$25.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$27.13
|
| Rate for Payer: PHP All Products |
$15.92
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$24.00
|
| Rate for Payer: United Healthcare Commercial |
$18.91
|
|
|
CHG IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH
|
Professional
|
$36.18
|
|
|
Service Code
|
CPT 86318
|
| Hospital Charge Code |
Z12989
|
| Min. Negotiated Rate |
$15.92 |
| Max. Negotiated Rate |
$43.42 |
| Rate for Payer: Coventry/First Health All Products |
$43.42
|
| Rate for Payer: Frontpath All Products |
$18.09
|
| Rate for Payer: Humana ChoiceCare |
$36.18
|
| Rate for Payer: Lutheran Preferred All Products |
$25.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$27.13
|
| Rate for Payer: PHP All Products |
$15.92
|
| Rate for Payer: Signature Care EPO |
$17.00
|
| Rate for Payer: Signature Care PPO |
$17.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$24.00
|
| Rate for Payer: United Healthcare Commercial |
$18.91
|
|
|
CHG INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Professional
|
$191.60
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
Z12997
|
| Min. Negotiated Rate |
$71.85 |
| Max. Negotiated Rate |
$229.92 |
| Rate for Payer: Coventry/First Health All Products |
$229.92
|
| Rate for Payer: Frontpath All Products |
$95.80
|
| Rate for Payer: Humana ChoiceCare |
$191.60
|
| Rate for Payer: Lutheran Preferred All Products |
$134.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$143.70
|
| Rate for Payer: PHP All Products |
$84.30
|
| Rate for Payer: Signature Care EPO |
$111.97
|
| Rate for Payer: Signature Care PPO |
$111.97
|
| Rate for Payer: Three Rivers Preferred All Products |
$125.00
|
| Rate for Payer: United Healthcare Commercial |
$71.85
|
|
|
CHG INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Professional
|
$191.60
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
Z12998
|
| Min. Negotiated Rate |
$71.85 |
| Max. Negotiated Rate |
$229.92 |
| Rate for Payer: Coventry/First Health All Products |
$229.92
|
| Rate for Payer: Frontpath All Products |
$95.80
|
| Rate for Payer: Humana ChoiceCare |
$191.60
|
| Rate for Payer: Lutheran Preferred All Products |
$134.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$143.70
|
| Rate for Payer: PHP All Products |
$84.30
|
| Rate for Payer: Signature Care EPO |
$111.97
|
| Rate for Payer: Signature Care PPO |
$111.97
|
| Rate for Payer: Three Rivers Preferred All Products |
$125.00
|
| Rate for Payer: United Healthcare Commercial |
$71.85
|
|
|
CHG MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS
|
Professional
|
$99.18
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
Z12968
|
| Min. Negotiated Rate |
$36.61 |
| Max. Negotiated Rate |
$119.02 |
| Rate for Payer: Aetna Medicare |
$50.83
|
| Rate for Payer: Anthem Medicare |
$50.83
|
| Rate for Payer: Caresource Just 4 Me |
$58.45
|
| Rate for Payer: Caresource Medicare |
$55.91
|
| Rate for Payer: Centivo/Paragon All Products |
$78.79
|
| Rate for Payer: Coventry/First Health All Products |
$119.02
|
| Rate for Payer: Frontpath All Products |
$91.58
|
| Rate for Payer: Humana ChoiceCare |
$99.18
|
| Rate for Payer: Humana Medicare |
$50.83
|
| Rate for Payer: Lucent/Coldwater Veneers |
$86.41
|
| Rate for Payer: PHCS/Multiplan All Products |
$74.39
|
| Rate for Payer: Plain Church Group Ministry All Products |
$50.83
|
| Rate for Payer: United Healthcare Commercial |
$36.61
|
| Rate for Payer: United Healthcare Medicare |
$49.59
|
|
|
CHG MYOCARDIAL SPECT MULTIPLE STUDIES
|
Professional
|
$795.48
|
|
|
Service Code
|
CPT 78452
|
| Hospital Charge Code |
Z12970
|
| Min. Negotiated Rate |
$389.30 |
| Max. Negotiated Rate |
$954.58 |
| Rate for Payer: Aetna Medicare |
$407.69
|
| Rate for Payer: Anthem Exchange |
$422.14
|
| Rate for Payer: Anthem Medicare |
$407.69
|
| Rate for Payer: Anthem PPO |
$422.14
|
| Rate for Payer: Anthem Traditional |
$422.14
|
| Rate for Payer: Caresource Just 4 Me |
$468.84
|
| Rate for Payer: Caresource Medicare |
$448.46
|
| Rate for Payer: Centivo/Paragon All Products |
$631.92
|
| Rate for Payer: Coventry/First Health All Products |
$954.58
|
| Rate for Payer: Frontpath All Products |
$730.71
|
| Rate for Payer: Humana ChoiceCare |
$795.48
|
| Rate for Payer: Humana Medicare |
$407.69
|
| Rate for Payer: Lucent/Coldwater Veneers |
$693.07
|
| Rate for Payer: Lutheran Preferred All Products |
$632.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$596.61
|
| Rate for Payer: PHP All Products |
$517.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$407.69
|
| Rate for Payer: Signature Care EPO |
$389.30
|
| Rate for Payer: Signature Care PPO |
$389.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$591.00
|
| Rate for Payer: United Healthcare Commercial |
$514.77
|
|
|
CHG MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS
|
Professional
|
$575.06
|
|
|
Service Code
|
CPT 78451
|
| Hospital Charge Code |
Z12969
|
| Min. Negotiated Rate |
$248.24 |
| Max. Negotiated Rate |
$690.07 |
| Rate for Payer: Aetna Medicare |
$294.71
|
| Rate for Payer: Anthem Exchange |
$248.24
|
| Rate for Payer: Anthem Medicare |
$294.71
|
| Rate for Payer: Anthem PPO |
$248.24
|
| Rate for Payer: Anthem Traditional |
$248.24
|
| Rate for Payer: Caresource Just 4 Me |
$338.92
|
| Rate for Payer: Caresource Medicare |
$324.18
|
| Rate for Payer: Centivo/Paragon All Products |
$456.80
|
| Rate for Payer: Coventry/First Health All Products |
$690.07
|
| Rate for Payer: Frontpath All Products |
$525.38
|
| Rate for Payer: Humana ChoiceCare |
$575.06
|
| Rate for Payer: Humana Medicare |
$294.71
|
| Rate for Payer: Lucent/Coldwater Veneers |
$501.01
|
| Rate for Payer: Lutheran Preferred All Products |
$457.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$431.29
|
| Rate for Payer: PHP All Products |
$373.78
|
| Rate for Payer: Plain Church Group Ministry All Products |
$294.71
|
| Rate for Payer: Signature Care EPO |
$279.59
|
| Rate for Payer: Signature Care PPO |
$279.59
|
| Rate for Payer: Three Rivers Preferred All Products |
$427.00
|
| Rate for Payer: United Healthcare Commercial |
$332.88
|
|
|
CHG RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS
|
Professional
|
$98.12
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
Z12912
|
| Min. Negotiated Rate |
$45.87 |
| Max. Negotiated Rate |
$117.74 |
| Rate for Payer: Aetna Medicare |
$50.28
|
| Rate for Payer: Anthem Medicare |
$50.28
|
| Rate for Payer: Caresource Just 4 Me |
$57.82
|
| Rate for Payer: Caresource Medicare |
$55.31
|
| Rate for Payer: Centivo/Paragon All Products |
$77.93
|
| Rate for Payer: Coventry/First Health All Products |
$117.74
|
| Rate for Payer: Frontpath All Products |
$87.64
|
| Rate for Payer: Humana ChoiceCare |
$98.12
|
| Rate for Payer: Humana Medicare |
$50.28
|
| Rate for Payer: Lucent/Coldwater Veneers |
$85.48
|
| Rate for Payer: PHCS/Multiplan All Products |
$73.59
|
| Rate for Payer: Plain Church Group Ministry All Products |
$50.28
|
| Rate for Payer: United Healthcare Commercial |
$45.87
|
|
|
CHG RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS
|
Professional
|
$85.66
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
Z12911
|
| Min. Negotiated Rate |
$38.83 |
| Max. Negotiated Rate |
$102.79 |
| Rate for Payer: Aetna Medicare |
$43.90
|
| Rate for Payer: Anthem Exchange |
$50.72
|
| Rate for Payer: Anthem Medicare |
$43.90
|
| Rate for Payer: Anthem PPO |
$50.72
|
| Rate for Payer: Anthem Traditional |
$50.72
|
| Rate for Payer: Caresource Just 4 Me |
$50.48
|
| Rate for Payer: Caresource Medicare |
$48.29
|
| Rate for Payer: Centivo/Paragon All Products |
$68.05
|
| Rate for Payer: Coventry/First Health All Products |
$102.79
|
| Rate for Payer: Frontpath All Products |
$76.53
|
| Rate for Payer: Humana ChoiceCare |
$85.66
|
| Rate for Payer: Humana Medicare |
$43.90
|
| Rate for Payer: Lucent/Coldwater Veneers |
$74.63
|
| Rate for Payer: Lutheran Preferred All Products |
$68.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$64.25
|
| Rate for Payer: PHP All Products |
$55.67
|
| Rate for Payer: Plain Church Group Ministry All Products |
$43.90
|
| Rate for Payer: Signature Care EPO |
$49.32
|
| Rate for Payer: Signature Care PPO |
$49.32
|
| Rate for Payer: Three Rivers Preferred All Products |
$64.00
|
| Rate for Payer: United Healthcare Commercial |
$38.83
|
|
|
CHG RADEX SPINE CERVICAL 2 OR 3 VIEWS
|
Professional
|
$72.40
|
|
|
Service Code
|
CPT 72040
|
| Hospital Charge Code |
Z12883
|
| Min. Negotiated Rate |
$33.52 |
| Max. Negotiated Rate |
$86.88 |
| Rate for Payer: Humana Medicare |
$37.10
|
| Rate for Payer: Aetna Medicare |
$37.10
|
| Rate for Payer: Anthem Exchange |
$51.56
|
| Rate for Payer: Anthem Medicare |
$37.10
|
| Rate for Payer: Anthem PPO |
$51.56
|
| Rate for Payer: Anthem Traditional |
$51.56
|
| Rate for Payer: Caresource Just 4 Me |
$42.66
|
| Rate for Payer: Caresource Medicare |
$40.81
|
| Rate for Payer: Centivo/Paragon All Products |
$57.51
|
| Rate for Payer: Coventry/First Health All Products |
$86.88
|
| Rate for Payer: Frontpath All Products |
$64.72
|
| Rate for Payer: Humana ChoiceCare |
$72.40
|
| Rate for Payer: Lucent/Coldwater Veneers |
$63.07
|
| Rate for Payer: Lutheran Preferred All Products |
$58.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$54.30
|
| Rate for Payer: PHP All Products |
$47.06
|
| Rate for Payer: Plain Church Group Ministry All Products |
$37.10
|
| Rate for Payer: Signature Care EPO |
$40.80
|
| Rate for Payer: Signature Care PPO |
$40.80
|
| Rate for Payer: Three Rivers Preferred All Products |
$54.00
|
| Rate for Payer: United Healthcare Commercial |
$33.52
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
$54.70
|
|
|
Service Code
|
CPT 74018
|
| Hospital Charge Code |
Z12924
|
| Min. Negotiated Rate |
$25.41 |
| Max. Negotiated Rate |
$65.64 |
| Rate for Payer: Aetna Medicare |
$28.03
|
| Rate for Payer: Anthem Exchange |
$25.41
|
| Rate for Payer: Anthem Medicare |
$28.03
|
| Rate for Payer: Anthem PPO |
$25.41
|
| Rate for Payer: Anthem Traditional |
$25.41
|
| Rate for Payer: Caresource Just 4 Me |
$32.23
|
| Rate for Payer: Caresource Medicare |
$30.83
|
| Rate for Payer: Centivo/Paragon All Products |
$43.45
|
| Rate for Payer: Coventry/First Health All Products |
$65.64
|
| Rate for Payer: Frontpath All Products |
$49.47
|
| Rate for Payer: Humana ChoiceCare |
$54.70
|
| Rate for Payer: Humana Medicare |
$28.03
|
| Rate for Payer: Lucent/Coldwater Veneers |
$47.65
|
| Rate for Payer: Lutheran Preferred All Products |
$43.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$41.03
|
| Rate for Payer: PHP All Products |
$35.55
|
| Rate for Payer: Plain Church Group Ministry All Products |
$28.03
|
| Rate for Payer: Signature Care EPO |
$30.23
|
| Rate for Payer: Signature Care PPO |
$30.23
|
| Rate for Payer: Three Rivers Preferred All Products |
$41.00
|
| Rate for Payer: United Healthcare Commercial |
$25.80
|
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
$78.72
|
|
|
Service Code
|
CPT 74021
|
| Hospital Charge Code |
Z12925
|
| Min. Negotiated Rate |
$36.87 |
| Max. Negotiated Rate |
$94.46 |
| Rate for Payer: Aetna Medicare |
$40.34
|
| Rate for Payer: Anthem Medicare |
$40.34
|
| Rate for Payer: Caresource Just 4 Me |
$46.39
|
| Rate for Payer: Caresource Medicare |
$44.37
|
| Rate for Payer: Centivo/Paragon All Products |
$62.53
|
| Rate for Payer: Coventry/First Health All Products |
$94.46
|
| Rate for Payer: Frontpath All Products |
$70.89
|
| Rate for Payer: Humana ChoiceCare |
$78.72
|
| Rate for Payer: Humana Medicare |
$40.34
|
| Rate for Payer: Lucent/Coldwater Veneers |
$68.58
|
| Rate for Payer: PHCS/Multiplan All Products |
$59.04
|
| Rate for Payer: PHP All Products |
$51.17
|
| Rate for Payer: Plain Church Group Ministry All Products |
$40.34
|
| Rate for Payer: Signature Care EPO |
$43.19
|
| Rate for Payer: Signature Care PPO |
$43.19
|
| Rate for Payer: United Healthcare Commercial |
$36.87
|
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
$61.56
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
Z12878
|
| Min. Negotiated Rate |
$28.46 |
| Max. Negotiated Rate |
$73.87 |
| Rate for Payer: Aetna Medicare |
$31.55
|
| Rate for Payer: Anthem Exchange |
$28.46
|
| Rate for Payer: Anthem Medicare |
$31.55
|
| Rate for Payer: Anthem PPO |
$28.46
|
| Rate for Payer: Anthem Traditional |
$28.46
|
| Rate for Payer: Caresource Just 4 Me |
$36.28
|
| Rate for Payer: Caresource Medicare |
$34.71
|
| Rate for Payer: Centivo/Paragon All Products |
$48.90
|
| Rate for Payer: Coventry/First Health All Products |
$73.87
|
| Rate for Payer: Frontpath All Products |
$55.05
|
| Rate for Payer: Humana ChoiceCare |
$61.56
|
| Rate for Payer: Humana Medicare |
$31.55
|
| Rate for Payer: Lucent/Coldwater Veneers |
$53.63
|
| Rate for Payer: Lutheran Preferred All Products |
$49.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$46.17
|
| Rate for Payer: PHP All Products |
$40.01
|
| Rate for Payer: Plain Church Group Ministry All Products |
$31.55
|
| Rate for Payer: Signature Care EPO |
$33.86
|
| Rate for Payer: Signature Care PPO |
$33.86
|
| Rate for Payer: Three Rivers Preferred All Products |
$46.00
|
| Rate for Payer: United Healthcare Commercial |
$28.89
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
$47.46
|
|
|
Service Code
|
CPT 71045
|
| Hospital Charge Code |
Z12877
|
| Min. Negotiated Rate |
$18.84 |
| Max. Negotiated Rate |
$56.95 |
| Rate for Payer: Aetna Medicare |
$24.33
|
| Rate for Payer: Anthem Medicare |
$24.33
|
| Rate for Payer: Caresource Just 4 Me |
$27.98
|
| Rate for Payer: Caresource Medicare |
$26.76
|
| Rate for Payer: Centivo/Paragon All Products |
$37.71
|
| Rate for Payer: Coventry/First Health All Products |
$56.95
|
| Rate for Payer: Frontpath All Products |
$42.50
|
| Rate for Payer: Humana ChoiceCare |
$47.46
|
| Rate for Payer: Humana Medicare |
$24.33
|
| Rate for Payer: Lucent/Coldwater Veneers |
$41.36
|
| Rate for Payer: PHCS/Multiplan All Products |
$35.59
|
| Rate for Payer: Plain Church Group Ministry All Products |
$24.33
|
| Rate for Payer: United Healthcare Commercial |
$18.84
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
$91.38
|
|
|
Service Code
|
CPT 74022
|
| Hospital Charge Code |
Z12926
|
| Min. Negotiated Rate |
$44.29 |
| Max. Negotiated Rate |
$109.66 |
| Rate for Payer: Aetna Medicare |
$46.83
|
| Rate for Payer: Anthem Exchange |
$47.62
|
| Rate for Payer: Anthem Medicare |
$46.83
|
| Rate for Payer: Anthem PPO |
$47.62
|
| Rate for Payer: Anthem Traditional |
$47.62
|
| Rate for Payer: Caresource Just 4 Me |
$53.85
|
| Rate for Payer: Caresource Medicare |
$51.51
|
| Rate for Payer: Centivo/Paragon All Products |
$72.59
|
| Rate for Payer: Coventry/First Health All Products |
$109.66
|
| Rate for Payer: Frontpath All Products |
$81.89
|
| Rate for Payer: Humana ChoiceCare |
$91.38
|
| Rate for Payer: Humana Medicare |
$46.83
|
| Rate for Payer: Lucent/Coldwater Veneers |
$79.61
|
| Rate for Payer: Lutheran Preferred All Products |
$73.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$68.53
|
| Rate for Payer: PHP All Products |
$59.39
|
| Rate for Payer: Plain Church Group Ministry All Products |
$46.83
|
| Rate for Payer: Signature Care EPO |
$53.55
|
| Rate for Payer: Signature Care PPO |
$53.55
|
| Rate for Payer: Three Rivers Preferred All Products |
$68.00
|
| Rate for Payer: United Healthcare Commercial |
$44.29
|
|
|
CHG RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS
|
Professional
|
$64.94
|
|
|
Service Code
|
CPT 73552
|
| Hospital Charge Code |
Z12913
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$77.93 |
| Rate for Payer: Aetna Medicare |
$33.28
|
| Rate for Payer: Anthem Medicare |
$33.28
|
| Rate for Payer: Caresource Just 4 Me |
$38.27
|
| Rate for Payer: Caresource Medicare |
$36.61
|
| Rate for Payer: Centivo/Paragon All Products |
$51.58
|
| Rate for Payer: Coventry/First Health All Products |
$77.93
|
| Rate for Payer: Frontpath All Products |
$57.53
|
| Rate for Payer: Humana ChoiceCare |
$64.94
|
| Rate for Payer: Humana Medicare |
$33.28
|
| Rate for Payer: Lucent/Coldwater Veneers |
$56.58
|
| Rate for Payer: PHCS/Multiplan All Products |
$48.70
|
| Rate for Payer: PHP All Products |
$42.21
|
| Rate for Payer: Plain Church Group Ministry All Products |
$33.28
|
| Rate for Payer: Signature Care EPO |
$38.63
|
| Rate for Payer: Signature Care PPO |
$38.63
|
| Rate for Payer: United Healthcare Commercial |
$30.43
|
|
|
CHG SMEAR,STAIN,WET MNT,INTERP
|
Professional
|
$11.64
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
Z12992
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$13.97 |
| Rate for Payer: Coventry/First Health All Products |
$13.97
|
| Rate for Payer: Frontpath All Products |
$5.82
|
| Rate for Payer: Humana ChoiceCare |
$11.64
|
| Rate for Payer: Lutheran Preferred All Products |
$8.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$8.73
|
| Rate for Payer: PHP All Products |
$5.12
|
| Rate for Payer: Signature Care EPO |
$5.95
|
| Rate for Payer: Signature Care PPO |
$5.95
|
| Rate for Payer: Three Rivers Preferred All Products |
$8.00
|
| Rate for Payer: United Healthcare Commercial |
$6.23
|
|
|
CHG SMEAR,STAIN,WET MNT,INTERP
|
Professional
|
$11.64
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
Z12993
|
| Min. Negotiated Rate |
$5.12 |
| Max. Negotiated Rate |
$13.97 |
| Rate for Payer: Coventry/First Health All Products |
$13.97
|
| Rate for Payer: Frontpath All Products |
$5.82
|
| Rate for Payer: Humana ChoiceCare |
$11.64
|
| Rate for Payer: Lutheran Preferred All Products |
$8.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$8.73
|
| Rate for Payer: PHP All Products |
$5.12
|
| Rate for Payer: Signature Care EPO |
$5.95
|
| Rate for Payer: Signature Care PPO |
$5.95
|
| Rate for Payer: Three Rivers Preferred All Products |
$8.00
|
| Rate for Payer: United Healthcare Commercial |
$6.23
|
|
