|
CHG X-RAY FACIAL BONES 3+ VW
|
Professional
|
$85.88
|
|
|
Service Code
|
CPT 70150
|
| Hospital Charge Code |
Z12871
|
| Min. Negotiated Rate |
$38.82 |
| Max. Negotiated Rate |
$103.06 |
| Rate for Payer: Aetna Medicare |
$44.02
|
| Rate for Payer: Anthem Medicare |
$44.02
|
| Rate for Payer: Caresource Just 4 Me |
$50.62
|
| Rate for Payer: Caresource Medicare |
$48.42
|
| Rate for Payer: Centivo/Paragon All Products |
$68.23
|
| Rate for Payer: Coventry/First Health All Products |
$103.06
|
| Rate for Payer: Frontpath All Products |
$77.81
|
| Rate for Payer: Humana ChoiceCare |
$85.88
|
| Rate for Payer: Humana Medicare |
$44.02
|
| Rate for Payer: Lucent/Coldwater Veneers |
$74.83
|
| Rate for Payer: PHCS/Multiplan All Products |
$64.41
|
| Rate for Payer: PHP All Products |
$55.83
|
| Rate for Payer: Plain Church Group Ministry All Products |
$44.02
|
| Rate for Payer: Signature Care EPO |
$52.70
|
| Rate for Payer: Signature Care PPO |
$52.70
|
| Rate for Payer: United Healthcare Commercial |
$38.82
|
|
|
CHG X-RAY FOOT 2 VW
|
Professional
|
$51.56
|
|
|
Service Code
|
CPT 73620
|
| Hospital Charge Code |
Z12920
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$61.87 |
| Rate for Payer: Aetna Medicare |
$26.43
|
| Rate for Payer: Anthem Medicare |
$26.43
|
| Rate for Payer: Caresource Just 4 Me |
$30.39
|
| Rate for Payer: Caresource Medicare |
$29.07
|
| Rate for Payer: Centivo/Paragon All Products |
$40.97
|
| Rate for Payer: Coventry/First Health All Products |
$61.87
|
| Rate for Payer: Frontpath All Products |
$46.15
|
| Rate for Payer: Humana ChoiceCare |
$51.56
|
| Rate for Payer: Humana Medicare |
$26.43
|
| Rate for Payer: Lucent/Coldwater Veneers |
$44.93
|
| Rate for Payer: PHCS/Multiplan All Products |
$38.67
|
| Rate for Payer: PHP All Products |
$33.52
|
| Rate for Payer: Plain Church Group Ministry All Products |
$26.43
|
| Rate for Payer: Signature Care EPO |
$32.30
|
| Rate for Payer: Signature Care PPO |
$32.30
|
| Rate for Payer: United Healthcare Commercial |
$23.64
|
|
|
CHG X-RAY FOOT 3+ VW
|
Professional
|
$62.46
|
|
|
Service Code
|
CPT 73630
|
| Hospital Charge Code |
Z12921
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$74.95 |
| Rate for Payer: Aetna Medicare |
$32.01
|
| Rate for Payer: Anthem Exchange |
$34.40
|
| Rate for Payer: Anthem Medicare |
$32.01
|
| Rate for Payer: Anthem PPO |
$34.40
|
| Rate for Payer: Anthem Traditional |
$34.40
|
| Rate for Payer: Caresource Just 4 Me |
$36.81
|
| Rate for Payer: Caresource Medicare |
$35.21
|
| Rate for Payer: Centivo/Paragon All Products |
$49.62
|
| Rate for Payer: Coventry/First Health All Products |
$74.95
|
| Rate for Payer: Frontpath All Products |
$56.41
|
| Rate for Payer: Humana ChoiceCare |
$62.46
|
| Rate for Payer: Humana Medicare |
$32.01
|
| Rate for Payer: Lucent/Coldwater Veneers |
$54.42
|
| Rate for Payer: Lutheran Preferred All Products |
$50.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$46.84
|
| Rate for Payer: PHP All Products |
$40.60
|
| Rate for Payer: Plain Church Group Ministry All Products |
$32.01
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$46.00
|
| Rate for Payer: United Healthcare Commercial |
$27.64
|
|
|
CHG X-RAY FOREARM 2 VW
|
Professional
|
$53.38
|
|
|
Service Code
|
CPT 73090
|
| Hospital Charge Code |
Z12903
|
| Min. Negotiated Rate |
$24.63 |
| Max. Negotiated Rate |
$64.06 |
| Rate for Payer: Aetna Medicare |
$27.35
|
| Rate for Payer: Anthem Exchange |
$28.37
|
| Rate for Payer: Anthem Medicare |
$27.35
|
| Rate for Payer: Anthem PPO |
$28.37
|
| Rate for Payer: Anthem Traditional |
$28.37
|
| Rate for Payer: Caresource Just 4 Me |
$31.45
|
| Rate for Payer: Caresource Medicare |
$30.09
|
| Rate for Payer: Centivo/Paragon All Products |
$42.39
|
| Rate for Payer: Coventry/First Health All Products |
$64.06
|
| Rate for Payer: Frontpath All Products |
$47.77
|
| Rate for Payer: Humana ChoiceCare |
$53.38
|
| Rate for Payer: Humana Medicare |
$27.35
|
| Rate for Payer: Lucent/Coldwater Veneers |
$46.50
|
| Rate for Payer: Lutheran Preferred All Products |
$42.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$40.04
|
| Rate for Payer: PHP All Products |
$34.69
|
| Rate for Payer: Plain Church Group Ministry All Products |
$27.35
|
| Rate for Payer: Signature Care EPO |
$33.15
|
| Rate for Payer: Signature Care PPO |
$33.15
|
| Rate for Payer: Three Rivers Preferred All Products |
$40.00
|
| Rate for Payer: United Healthcare Commercial |
$24.63
|
|
|
CHG X-RAY HAND 2 VW
|
Professional
|
$56.98
|
|
|
Service Code
|
CPT 73120
|
| Hospital Charge Code |
Z12908
|
| Min. Negotiated Rate |
$24.30 |
| Max. Negotiated Rate |
$68.38 |
| Rate for Payer: Aetna Medicare |
$29.21
|
| Rate for Payer: Anthem Medicare |
$29.21
|
| Rate for Payer: Caresource Just 4 Me |
$33.59
|
| Rate for Payer: Caresource Medicare |
$32.13
|
| Rate for Payer: Centivo/Paragon All Products |
$45.28
|
| Rate for Payer: Coventry/First Health All Products |
$68.38
|
| Rate for Payer: Frontpath All Products |
$50.98
|
| Rate for Payer: Humana ChoiceCare |
$56.98
|
| Rate for Payer: Humana Medicare |
$29.21
|
| Rate for Payer: Lucent/Coldwater Veneers |
$49.66
|
| Rate for Payer: PHCS/Multiplan All Products |
$42.73
|
| Rate for Payer: PHP All Products |
$37.04
|
| Rate for Payer: Plain Church Group Ministry All Products |
$29.21
|
| Rate for Payer: Signature Care EPO |
$32.30
|
| Rate for Payer: Signature Care PPO |
$32.30
|
| Rate for Payer: United Healthcare Commercial |
$24.30
|
|
|
CHG X-RAY HAND 3+ VW
|
Professional
|
$67.28
|
|
|
Service Code
|
CPT 73130
|
| Hospital Charge Code |
Z12909
|
| Min. Negotiated Rate |
$27.97 |
| Max. Negotiated Rate |
$80.74 |
| Rate for Payer: Aetna Medicare |
$34.48
|
| Rate for Payer: Anthem Exchange |
$51.40
|
| Rate for Payer: Anthem Medicare |
$34.48
|
| Rate for Payer: Anthem PPO |
$51.40
|
| Rate for Payer: Anthem Traditional |
$51.40
|
| Rate for Payer: Caresource Just 4 Me |
$39.65
|
| Rate for Payer: Caresource Medicare |
$37.93
|
| Rate for Payer: Centivo/Paragon All Products |
$53.44
|
| Rate for Payer: Coventry/First Health All Products |
$80.74
|
| Rate for Payer: Frontpath All Products |
$59.64
|
| Rate for Payer: Humana ChoiceCare |
$67.28
|
| Rate for Payer: Humana Medicare |
$34.48
|
| Rate for Payer: Lucent/Coldwater Veneers |
$58.62
|
| Rate for Payer: Lutheran Preferred All Products |
$53.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$50.46
|
| Rate for Payer: PHP All Products |
$43.74
|
| Rate for Payer: Plain Church Group Ministry All Products |
$34.48
|
| Rate for Payer: Signature Care EPO |
$34.85
|
| Rate for Payer: Signature Care PPO |
$34.85
|
| Rate for Payer: Three Rivers Preferred All Products |
$50.00
|
| Rate for Payer: United Healthcare Commercial |
$27.97
|
|
|
CHG X-RAY HEEL
|
Professional
|
$52.16
|
|
|
Service Code
|
CPT 73650
|
| Hospital Charge Code |
Z12922
|
| Min. Negotiated Rate |
$23.97 |
| Max. Negotiated Rate |
$62.59 |
| Rate for Payer: Aetna Medicare |
$26.74
|
| Rate for Payer: Anthem Exchange |
$27.74
|
| Rate for Payer: Anthem Medicare |
$26.74
|
| Rate for Payer: Anthem PPO |
$27.74
|
| Rate for Payer: Anthem Traditional |
$27.74
|
| Rate for Payer: Caresource Just 4 Me |
$30.75
|
| Rate for Payer: Caresource Medicare |
$29.41
|
| Rate for Payer: Centivo/Paragon All Products |
$41.45
|
| Rate for Payer: Coventry/First Health All Products |
$62.59
|
| Rate for Payer: Frontpath All Products |
$47.23
|
| Rate for Payer: Humana ChoiceCare |
$52.16
|
| Rate for Payer: Humana Medicare |
$26.74
|
| Rate for Payer: Lucent/Coldwater Veneers |
$45.46
|
| Rate for Payer: Lutheran Preferred All Products |
$41.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$39.12
|
| Rate for Payer: PHP All Products |
$33.91
|
| Rate for Payer: Plain Church Group Ministry All Products |
$26.74
|
| Rate for Payer: Signature Care EPO |
$31.45
|
| Rate for Payer: Signature Care PPO |
$31.45
|
| Rate for Payer: Three Rivers Preferred All Products |
$39.00
|
| Rate for Payer: United Healthcare Commercial |
$23.97
|
|
|
CHG X-RAY HUMERUS
|
Professional
|
$58.80
|
|
|
Service Code
|
CPT 73060
|
| Hospital Charge Code |
Z12898
|
| Min. Negotiated Rate |
$26.41 |
| Max. Negotiated Rate |
$70.56 |
| Rate for Payer: Aetna Medicare |
$30.13
|
| Rate for Payer: Anthem Medicare |
$30.13
|
| Rate for Payer: Caresource Just 4 Me |
$34.65
|
| Rate for Payer: Caresource Medicare |
$33.14
|
| Rate for Payer: Centivo/Paragon All Products |
$46.70
|
| Rate for Payer: Coventry/First Health All Products |
$70.56
|
| Rate for Payer: Frontpath All Products |
$52.05
|
| Rate for Payer: Humana ChoiceCare |
$58.80
|
| Rate for Payer: Humana Medicare |
$30.13
|
| Rate for Payer: Lucent/Coldwater Veneers |
$51.22
|
| Rate for Payer: PHCS/Multiplan All Products |
$44.10
|
| Rate for Payer: PHP All Products |
$38.22
|
| Rate for Payer: Plain Church Group Ministry All Products |
$30.13
|
| Rate for Payer: Signature Care EPO |
$36.55
|
| Rate for Payer: Signature Care PPO |
$36.55
|
| Rate for Payer: United Healthcare Commercial |
$26.41
|
|
|
CHG X-RAY HYSTEROSALPINGOGRAM
|
Professional
|
$174.86
|
|
|
Service Code
|
CPT 74740
|
| Hospital Charge Code |
Z12927
|
| Min. Negotiated Rate |
$70.94 |
| Max. Negotiated Rate |
$209.83 |
| Rate for Payer: Aetna Medicare |
$89.61
|
| Rate for Payer: Anthem Exchange |
$73.38
|
| Rate for Payer: Anthem Medicare |
$89.61
|
| Rate for Payer: Anthem PPO |
$73.38
|
| Rate for Payer: Anthem Traditional |
$73.38
|
| Rate for Payer: Caresource Just 4 Me |
$103.05
|
| Rate for Payer: Caresource Medicare |
$98.57
|
| Rate for Payer: Centivo/Paragon All Products |
$138.90
|
| Rate for Payer: Coventry/First Health All Products |
$209.83
|
| Rate for Payer: Frontpath All Products |
$160.17
|
| Rate for Payer: Humana ChoiceCare |
$174.86
|
| Rate for Payer: Humana Medicare |
$89.61
|
| Rate for Payer: Lucent/Coldwater Veneers |
$152.34
|
| Rate for Payer: Lutheran Preferred All Products |
$139.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$131.15
|
| Rate for Payer: PHP All Products |
$113.65
|
| Rate for Payer: Plain Church Group Ministry All Products |
$89.61
|
| Rate for Payer: Signature Care EPO |
$83.30
|
| Rate for Payer: Signature Care PPO |
$83.30
|
| Rate for Payer: Three Rivers Preferred All Products |
$130.00
|
| Rate for Payer: United Healthcare Commercial |
$70.94
|
|
|
CHG X-RAY JAW 4+ VW
|
Professional
|
$79.20
|
|
|
Service Code
|
CPT 70110
|
| Hospital Charge Code |
Z12869
|
| Min. Negotiated Rate |
$35.92 |
| Max. Negotiated Rate |
$95.04 |
| Rate for Payer: Aetna Medicare |
$40.59
|
| Rate for Payer: Anthem Medicare |
$40.59
|
| Rate for Payer: Caresource Just 4 Me |
$46.68
|
| Rate for Payer: Caresource Medicare |
$44.65
|
| Rate for Payer: Centivo/Paragon All Products |
$62.91
|
| Rate for Payer: Coventry/First Health All Products |
$95.04
|
| Rate for Payer: Frontpath All Products |
$71.86
|
| Rate for Payer: Humana ChoiceCare |
$79.20
|
| Rate for Payer: Humana Medicare |
$40.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$69.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$59.40
|
| Rate for Payer: Plain Church Group Ministry All Products |
$40.59
|
| Rate for Payer: United Healthcare Commercial |
$35.92
|
|
|
CHG X-RAY KNEE 1 OR 2 VIEW
|
Professional
|
$62.40
|
|
|
Service Code
|
CPT 73560
|
| Hospital Charge Code |
Z12914
|
| Min. Negotiated Rate |
$25.65 |
| Max. Negotiated Rate |
$74.88 |
| Rate for Payer: Aetna Medicare |
$31.98
|
| Rate for Payer: Anthem Medicare |
$31.98
|
| Rate for Payer: Caresource Just 4 Me |
$36.78
|
| Rate for Payer: Caresource Medicare |
$35.18
|
| Rate for Payer: Centivo/Paragon All Products |
$49.57
|
| Rate for Payer: Coventry/First Health All Products |
$74.88
|
| Rate for Payer: Frontpath All Products |
$55.81
|
| Rate for Payer: Humana ChoiceCare |
$62.40
|
| Rate for Payer: Humana Medicare |
$31.98
|
| Rate for Payer: Lucent/Coldwater Veneers |
$54.37
|
| Rate for Payer: PHCS/Multiplan All Products |
$46.80
|
| Rate for Payer: PHP All Products |
$40.57
|
| Rate for Payer: Plain Church Group Ministry All Products |
$31.98
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: United Healthcare Commercial |
$25.65
|
|
|
CHG X-RAY KNEE 3 VIEW
|
Professional
|
$73.98
|
|
|
Service Code
|
CPT 73562
|
| Hospital Charge Code |
Z12915
|
| Min. Negotiated Rate |
$30.75 |
| Max. Negotiated Rate |
$88.78 |
| Rate for Payer: Aetna Medicare |
$37.91
|
| Rate for Payer: Anthem Exchange |
$72.30
|
| Rate for Payer: Anthem Medicare |
$37.91
|
| Rate for Payer: Anthem PPO |
$72.30
|
| Rate for Payer: Anthem Traditional |
$72.30
|
| Rate for Payer: Caresource Just 4 Me |
$43.60
|
| Rate for Payer: Caresource Medicare |
$41.70
|
| Rate for Payer: Centivo/Paragon All Products |
$58.76
|
| Rate for Payer: Coventry/First Health All Products |
$88.78
|
| Rate for Payer: Frontpath All Products |
$66.66
|
| Rate for Payer: Humana ChoiceCare |
$73.98
|
| Rate for Payer: Humana Medicare |
$37.91
|
| Rate for Payer: Lucent/Coldwater Veneers |
$64.45
|
| Rate for Payer: Lutheran Preferred All Products |
$59.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$55.48
|
| Rate for Payer: PHP All Products |
$48.08
|
| Rate for Payer: Plain Church Group Ministry All Products |
$37.91
|
| Rate for Payer: Signature Care EPO |
$37.40
|
| Rate for Payer: Signature Care PPO |
$37.40
|
| Rate for Payer: Three Rivers Preferred All Products |
$55.00
|
| Rate for Payer: United Healthcare Commercial |
$30.75
|
|
|
CHG X-RAY KNEE 4+ VIEW
|
Professional
|
$85.04
|
|
|
Service Code
|
CPT 73564
|
| Hospital Charge Code |
Z12916
|
| Min. Negotiated Rate |
$35.83 |
| Max. Negotiated Rate |
$102.05 |
| Rate for Payer: Aetna Medicare |
$43.59
|
| Rate for Payer: Anthem Exchange |
$54.60
|
| Rate for Payer: Anthem Medicare |
$43.59
|
| Rate for Payer: Anthem PPO |
$54.60
|
| Rate for Payer: Anthem Traditional |
$54.60
|
| Rate for Payer: Caresource Just 4 Me |
$50.13
|
| Rate for Payer: Caresource Medicare |
$47.95
|
| Rate for Payer: Centivo/Paragon All Products |
$67.56
|
| Rate for Payer: Coventry/First Health All Products |
$102.05
|
| Rate for Payer: Frontpath All Products |
$75.46
|
| Rate for Payer: Humana ChoiceCare |
$85.04
|
| Rate for Payer: Humana Medicare |
$43.59
|
| Rate for Payer: Lucent/Coldwater Veneers |
$74.10
|
| Rate for Payer: Lutheran Preferred All Products |
$68.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$63.78
|
| Rate for Payer: PHP All Products |
$55.28
|
| Rate for Payer: Plain Church Group Ministry All Products |
$43.59
|
| Rate for Payer: Signature Care EPO |
$42.50
|
| Rate for Payer: Signature Care PPO |
$42.50
|
| Rate for Payer: Three Rivers Preferred All Products |
$63.00
|
| Rate for Payer: United Healthcare Commercial |
$35.83
|
|
|
CHG X-RAY LUMBAR SPINE 2/3 VW
|
Professional
|
$73.00
|
|
|
Service Code
|
CPT 72100
|
| Hospital Charge Code |
Z12887
|
| Min. Negotiated Rate |
$35.17 |
| Max. Negotiated Rate |
$87.60 |
| Rate for Payer: Aetna Medicare |
$37.41
|
| Rate for Payer: Anthem Exchange |
$39.60
|
| Rate for Payer: Anthem Medicare |
$37.41
|
| Rate for Payer: Anthem PPO |
$39.60
|
| Rate for Payer: Anthem Traditional |
$39.60
|
| Rate for Payer: Caresource Just 4 Me |
$43.02
|
| Rate for Payer: Caresource Medicare |
$41.15
|
| Rate for Payer: Centivo/Paragon All Products |
$57.99
|
| Rate for Payer: Coventry/First Health All Products |
$87.60
|
| Rate for Payer: Frontpath All Products |
$65.26
|
| Rate for Payer: Humana ChoiceCare |
$73.00
|
| Rate for Payer: Humana Medicare |
$37.41
|
| Rate for Payer: Lucent/Coldwater Veneers |
$63.60
|
| Rate for Payer: Lutheran Preferred All Products |
$58.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$54.75
|
| Rate for Payer: PHP All Products |
$47.45
|
| Rate for Payer: Plain Church Group Ministry All Products |
$37.41
|
| Rate for Payer: Signature Care EPO |
$44.20
|
| Rate for Payer: Signature Care PPO |
$44.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$54.00
|
| Rate for Payer: United Healthcare Commercial |
$35.17
|
|
|
CHG X-RAY LUMBAR SPINE 4 VW
|
Professional
|
$93.72
|
|
|
Service Code
|
CPT 72110
|
| Hospital Charge Code |
Z12888
|
| Min. Negotiated Rate |
$48.03 |
| Max. Negotiated Rate |
$112.46 |
| Rate for Payer: Aetna Medicare |
$48.03
|
| Rate for Payer: Anthem Exchange |
$62.10
|
| Rate for Payer: Anthem Medicare |
$48.03
|
| Rate for Payer: Anthem PPO |
$62.10
|
| Rate for Payer: Anthem Traditional |
$62.10
|
| Rate for Payer: Caresource Just 4 Me |
$55.23
|
| Rate for Payer: Caresource Medicare |
$52.83
|
| Rate for Payer: Centivo/Paragon All Products |
$74.45
|
| Rate for Payer: Coventry/First Health All Products |
$112.46
|
| Rate for Payer: Frontpath All Products |
$83.72
|
| Rate for Payer: Humana ChoiceCare |
$93.72
|
| Rate for Payer: Humana Medicare |
$48.03
|
| Rate for Payer: Lucent/Coldwater Veneers |
$81.65
|
| Rate for Payer: Lutheran Preferred All Products |
$74.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$70.29
|
| Rate for Payer: PHP All Products |
$60.92
|
| Rate for Payer: Plain Church Group Ministry All Products |
$48.03
|
| Rate for Payer: Signature Care EPO |
$61.20
|
| Rate for Payer: Signature Care PPO |
$61.20
|
| Rate for Payer: Three Rivers Preferred All Products |
$70.00
|
| Rate for Payer: United Healthcare Commercial |
$49.11
|
|
|
CHG X-RAY NASAL BONES
|
Professional
|
$69.70
|
|
|
Service Code
|
CPT 70160
|
| Hospital Charge Code |
Z12872
|
| Min. Negotiated Rate |
$28.96 |
| Max. Negotiated Rate |
$83.64 |
| Rate for Payer: Aetna Medicare |
$35.72
|
| Rate for Payer: Anthem Exchange |
$30.31
|
| Rate for Payer: Anthem Medicare |
$35.72
|
| Rate for Payer: Anthem PPO |
$30.31
|
| Rate for Payer: Anthem Traditional |
$30.31
|
| Rate for Payer: Caresource Just 4 Me |
$41.08
|
| Rate for Payer: Caresource Medicare |
$39.29
|
| Rate for Payer: Centivo/Paragon All Products |
$55.37
|
| Rate for Payer: Coventry/First Health All Products |
$83.64
|
| Rate for Payer: Frontpath All Products |
$62.32
|
| Rate for Payer: Humana ChoiceCare |
$69.70
|
| Rate for Payer: Humana Medicare |
$35.72
|
| Rate for Payer: Lucent/Coldwater Veneers |
$60.72
|
| Rate for Payer: Lutheran Preferred All Products |
$55.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$52.28
|
| Rate for Payer: PHP All Products |
$45.30
|
| Rate for Payer: Plain Church Group Ministry All Products |
$35.72
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$52.00
|
| Rate for Payer: United Healthcare Commercial |
$28.96
|
|
|
CHG X-RAY NECK SOFT TISSUE
|
Professional
|
$57.70
|
|
|
Service Code
|
CPT 70360
|
| Hospital Charge Code |
Z12876
|
| Min. Negotiated Rate |
$24.66 |
| Max. Negotiated Rate |
$69.24 |
| Rate for Payer: Aetna Medicare |
$29.58
|
| Rate for Payer: Anthem Medicare |
$29.58
|
| Rate for Payer: Caresource Just 4 Me |
$34.02
|
| Rate for Payer: Caresource Medicare |
$32.54
|
| Rate for Payer: Centivo/Paragon All Products |
$45.85
|
| Rate for Payer: Coventry/First Health All Products |
$69.24
|
| Rate for Payer: Frontpath All Products |
$51.63
|
| Rate for Payer: Humana ChoiceCare |
$57.70
|
| Rate for Payer: Humana Medicare |
$29.58
|
| Rate for Payer: Lucent/Coldwater Veneers |
$50.29
|
| Rate for Payer: PHCS/Multiplan All Products |
$43.28
|
| Rate for Payer: PHP All Products |
$37.51
|
| Rate for Payer: Plain Church Group Ministry All Products |
$29.58
|
| Rate for Payer: Signature Care EPO |
$29.75
|
| Rate for Payer: Signature Care PPO |
$29.75
|
| Rate for Payer: United Healthcare Commercial |
$24.66
|
|
|
CHG X-RAY ORBITS
|
Professional
|
$87.82
|
|
|
Service Code
|
CPT 70200
|
| Hospital Charge Code |
Z12873
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$105.38 |
| Rate for Payer: Aetna Medicare |
$45.00
|
| Rate for Payer: Anthem Exchange |
$45.51
|
| Rate for Payer: Anthem Medicare |
$45.00
|
| Rate for Payer: Anthem PPO |
$45.51
|
| Rate for Payer: Anthem Traditional |
$45.51
|
| Rate for Payer: Caresource Just 4 Me |
$51.75
|
| Rate for Payer: Caresource Medicare |
$49.50
|
| Rate for Payer: Centivo/Paragon All Products |
$69.75
|
| Rate for Payer: Coventry/First Health All Products |
$105.38
|
| Rate for Payer: Frontpath All Products |
$79.53
|
| Rate for Payer: Humana ChoiceCare |
$87.82
|
| Rate for Payer: Humana Medicare |
$45.00
|
| Rate for Payer: Lucent/Coldwater Veneers |
$76.50
|
| Rate for Payer: Lutheran Preferred All Products |
$70.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$65.86
|
| Rate for Payer: PHP All Products |
$57.08
|
| Rate for Payer: Plain Church Group Ministry All Products |
$45.00
|
| Rate for Payer: Signature Care EPO |
$53.55
|
| Rate for Payer: Signature Care PPO |
$53.55
|
| Rate for Payer: Three Rivers Preferred All Products |
$65.00
|
| Rate for Payer: United Healthcare Commercial |
$40.20
|
|
|
CHG X-RAY PELVIS 1/2 VW
|
Professional
|
$51.02
|
|
|
Service Code
|
CPT 72170
|
| Hospital Charge Code |
Z12889
|
| Min. Negotiated Rate |
$23.67 |
| Max. Negotiated Rate |
$61.22 |
| Rate for Payer: Aetna Medicare |
$26.15
|
| Rate for Payer: Anthem Medicare |
$26.15
|
| Rate for Payer: Caresource Just 4 Me |
$30.07
|
| Rate for Payer: Caresource Medicare |
$28.77
|
| Rate for Payer: Centivo/Paragon All Products |
$40.53
|
| Rate for Payer: Coventry/First Health All Products |
$61.22
|
| Rate for Payer: Frontpath All Products |
$45.66
|
| Rate for Payer: Humana ChoiceCare |
$51.02
|
| Rate for Payer: Humana Medicare |
$26.15
|
| Rate for Payer: Lucent/Coldwater Veneers |
$44.45
|
| Rate for Payer: PHCS/Multiplan All Products |
$38.27
|
| Rate for Payer: PHP All Products |
$33.16
|
| Rate for Payer: Plain Church Group Ministry All Products |
$26.15
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: United Healthcare Commercial |
$23.67
|
|
|
CHG X-RAY RIBS 2 VW UNILAT
|
Professional
|
$67.58
|
|
|
Service Code
|
CPT 71100
|
| Hospital Charge Code |
Z12879
|
| Min. Negotiated Rate |
$29.87 |
| Max. Negotiated Rate |
$81.10 |
| Rate for Payer: Aetna Medicare |
$34.64
|
| Rate for Payer: Anthem Exchange |
$34.52
|
| Rate for Payer: Anthem Medicare |
$34.64
|
| Rate for Payer: Anthem PPO |
$34.52
|
| Rate for Payer: Anthem Traditional |
$34.52
|
| Rate for Payer: Caresource Just 4 Me |
$39.84
|
| Rate for Payer: Caresource Medicare |
$38.10
|
| Rate for Payer: Centivo/Paragon All Products |
$53.69
|
| Rate for Payer: Coventry/First Health All Products |
$81.10
|
| Rate for Payer: Frontpath All Products |
$60.42
|
| Rate for Payer: Humana ChoiceCare |
$67.58
|
| Rate for Payer: Humana Medicare |
$34.64
|
| Rate for Payer: Lucent/Coldwater Veneers |
$58.89
|
| Rate for Payer: Lutheran Preferred All Products |
$54.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$50.69
|
| Rate for Payer: PHP All Products |
$43.93
|
| Rate for Payer: Plain Church Group Ministry All Products |
$34.64
|
| Rate for Payer: Signature Care EPO |
$39.95
|
| Rate for Payer: Signature Care PPO |
$39.95
|
| Rate for Payer: Three Rivers Preferred All Products |
$50.00
|
| Rate for Payer: United Healthcare Commercial |
$29.87
|
|
|
CHG X-RAY RIBS, CHEST 3+ VW
|
Professional
|
$77.52
|
|
|
Service Code
|
CPT 71101
|
| Hospital Charge Code |
Z12880
|
| Min. Negotiated Rate |
$35.98 |
| Max. Negotiated Rate |
$93.02 |
| Rate for Payer: Aetna Medicare |
$39.73
|
| Rate for Payer: Anthem Exchange |
$41.16
|
| Rate for Payer: Anthem Medicare |
$39.73
|
| Rate for Payer: Anthem PPO |
$41.16
|
| Rate for Payer: Anthem Traditional |
$41.16
|
| Rate for Payer: Caresource Just 4 Me |
$45.69
|
| Rate for Payer: Caresource Medicare |
$43.70
|
| Rate for Payer: Centivo/Paragon All Products |
$61.58
|
| Rate for Payer: Coventry/First Health All Products |
$93.02
|
| Rate for Payer: Frontpath All Products |
$69.27
|
| Rate for Payer: Humana ChoiceCare |
$77.52
|
| Rate for Payer: Humana Medicare |
$39.73
|
| Rate for Payer: Lucent/Coldwater Veneers |
$67.54
|
| Rate for Payer: Lutheran Preferred All Products |
$62.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$58.14
|
| Rate for Payer: PHP All Products |
$50.38
|
| Rate for Payer: Plain Church Group Ministry All Products |
$39.73
|
| Rate for Payer: Signature Care EPO |
$47.60
|
| Rate for Payer: Signature Care PPO |
$47.60
|
| Rate for Payer: Three Rivers Preferred All Products |
$58.00
|
| Rate for Payer: United Healthcare Commercial |
$35.98
|
|
|
CHG X-RAY RIBS, CHEST 4+ VW
|
Professional
|
$96.20
|
|
|
Service Code
|
CPT 71111
|
| Hospital Charge Code |
Z12881
|
| Min. Negotiated Rate |
$47.49 |
| Max. Negotiated Rate |
$115.44 |
| Rate for Payer: Aetna Medicare |
$49.30
|
| Rate for Payer: Anthem Exchange |
$52.95
|
| Rate for Payer: Anthem Medicare |
$49.30
|
| Rate for Payer: Anthem PPO |
$52.95
|
| Rate for Payer: Anthem Traditional |
$52.95
|
| Rate for Payer: Caresource Just 4 Me |
$56.69
|
| Rate for Payer: Caresource Medicare |
$54.23
|
| Rate for Payer: Centivo/Paragon All Products |
$76.41
|
| Rate for Payer: Coventry/First Health All Products |
$115.44
|
| Rate for Payer: Frontpath All Products |
$86.17
|
| Rate for Payer: Humana ChoiceCare |
$96.20
|
| Rate for Payer: Humana Medicare |
$49.30
|
| Rate for Payer: Lucent/Coldwater Veneers |
$83.81
|
| Rate for Payer: Lutheran Preferred All Products |
$76.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$72.15
|
| Rate for Payer: PHP All Products |
$62.52
|
| Rate for Payer: Plain Church Group Ministry All Products |
$49.30
|
| Rate for Payer: Signature Care EPO |
$60.35
|
| Rate for Payer: Signature Care PPO |
$60.35
|
| Rate for Payer: Three Rivers Preferred All Products |
$71.00
|
| Rate for Payer: United Healthcare Commercial |
$47.49
|
|
|
CHG X-RAY SACROILIAC JTS 3+ VW
|
Professional
|
$71.86
|
|
|
Service Code
|
CPT 72202
|
| Hospital Charge Code |
Z12890
|
| Min. Negotiated Rate |
$31.77 |
| Max. Negotiated Rate |
$86.23 |
| Rate for Payer: Aetna Medicare |
$36.83
|
| Rate for Payer: Anthem Medicare |
$36.83
|
| Rate for Payer: Caresource Just 4 Me |
$42.35
|
| Rate for Payer: Caresource Medicare |
$40.51
|
| Rate for Payer: Centivo/Paragon All Products |
$57.09
|
| Rate for Payer: Coventry/First Health All Products |
$86.23
|
| Rate for Payer: Frontpath All Products |
$64.23
|
| Rate for Payer: Humana ChoiceCare |
$71.86
|
| Rate for Payer: Humana Medicare |
$36.83
|
| Rate for Payer: Lucent/Coldwater Veneers |
$62.61
|
| Rate for Payer: PHCS/Multiplan All Products |
$53.89
|
| Rate for Payer: PHP All Products |
$46.71
|
| Rate for Payer: Plain Church Group Ministry All Products |
$36.83
|
| Rate for Payer: Signature Care EPO |
$39.95
|
| Rate for Payer: Signature Care PPO |
$39.95
|
| Rate for Payer: United Healthcare Commercial |
$31.77
|
|
|
CHG X-RAY SACRUM/COCCYX 2+ VW
|
Professional
|
$59.46
|
|
|
Service Code
|
CPT 72220
|
| Hospital Charge Code |
Z12891
|
| Min. Negotiated Rate |
$26.75 |
| Max. Negotiated Rate |
$71.35 |
| Rate for Payer: Aetna Medicare |
$30.47
|
| Rate for Payer: Anthem Medicare |
$30.47
|
| Rate for Payer: Caresource Just 4 Me |
$35.04
|
| Rate for Payer: Caresource Medicare |
$33.52
|
| Rate for Payer: Centivo/Paragon All Products |
$47.23
|
| Rate for Payer: Coventry/First Health All Products |
$71.35
|
| Rate for Payer: Frontpath All Products |
$53.18
|
| Rate for Payer: Humana ChoiceCare |
$59.46
|
| Rate for Payer: Humana Medicare |
$30.47
|
| Rate for Payer: Lucent/Coldwater Veneers |
$51.80
|
| Rate for Payer: PHCS/Multiplan All Products |
$44.59
|
| Rate for Payer: PHP All Products |
$38.65
|
| Rate for Payer: Plain Church Group Ministry All Products |
$30.47
|
| Rate for Payer: Signature Care EPO |
$36.55
|
| Rate for Payer: Signature Care PPO |
$36.55
|
| Rate for Payer: United Healthcare Commercial |
$26.75
|
|
|
CHG X-RAY SCAPULA
|
Professional
|
$43.20
|
|
|
Service Code
|
CPT 73010
|
| Hospital Charge Code |
Z12895
|
| Min. Negotiated Rate |
$22.14 |
| Max. Negotiated Rate |
$51.84 |
| Rate for Payer: Aetna Medicare |
$22.14
|
| Rate for Payer: Anthem Exchange |
$29.62
|
| Rate for Payer: Anthem Medicare |
$22.14
|
| Rate for Payer: Anthem PPO |
$29.62
|
| Rate for Payer: Anthem Traditional |
$29.62
|
| Rate for Payer: Caresource Just 4 Me |
$25.46
|
| Rate for Payer: Caresource Medicare |
$24.35
|
| Rate for Payer: Centivo/Paragon All Products |
$34.32
|
| Rate for Payer: Coventry/First Health All Products |
$51.84
|
| Rate for Payer: Frontpath All Products |
$39.22
|
| Rate for Payer: Humana ChoiceCare |
$43.20
|
| Rate for Payer: Humana Medicare |
$22.14
|
| Rate for Payer: Lucent/Coldwater Veneers |
$37.64
|
| Rate for Payer: Lutheran Preferred All Products |
$34.00
|
| Rate for Payer: PHCS/Multiplan All Products |
$32.40
|
| Rate for Payer: PHP All Products |
$28.07
|
| Rate for Payer: Plain Church Group Ministry All Products |
$22.14
|
| Rate for Payer: Signature Care EPO |
$34.00
|
| Rate for Payer: Signature Care PPO |
$34.00
|
| Rate for Payer: Three Rivers Preferred All Products |
$32.00
|
| Rate for Payer: United Healthcare Commercial |
$25.65
|
|
