|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
$127.79
|
|
|
Service Code
|
HCPCS 71047 TC
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$135.14 |
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$32.86
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$32.86
|
| Rate for Payer: Fidelis Essential Plan QHP |
$34.68
|
| Rate for Payer: Fidelis Medicare Advantage |
$36.51
|
| Rate for Payer: Fidelis Qualified Health Plan |
$34.68
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$36.51
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$36.51
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$27.38
|
| Rate for Payer: Healthfirst Medicare Advantage |
$34.68
|
| Rate for Payer: Healthfirst QHP |
$36.51
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$25.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$36.51
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$31.03
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$25.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$36.51
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$95.84
|
| Rate for Payer: SOMOS Essential |
$95.84
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$36.51
|
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
$180.18
|
|
|
Service Code
|
HCPCS 71047
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$135.14 |
| Rate for Payer: Cash Price |
$49.17
|
| Rate for Payer: Cash Price |
$49.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$46.33
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$46.33
|
| Rate for Payer: Fidelis Essential Plan QHP |
$48.91
|
| Rate for Payer: Fidelis Medicare Advantage |
$51.48
|
| Rate for Payer: Fidelis Qualified Health Plan |
$48.91
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$51.48
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$51.48
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$38.61
|
| Rate for Payer: Healthfirst Medicare Advantage |
$48.91
|
| Rate for Payer: Healthfirst QHP |
$51.48
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$36.04
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$51.48
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$43.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$36.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$51.48
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.14
|
| Rate for Payer: SOMOS Essential |
$135.14
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$51.48
|
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
$52.36
|
|
|
Service Code
|
HCPCS 71047 26
|
| Min. Negotiated Rate |
$10.47 |
| Max. Negotiated Rate |
$135.14 |
| Rate for Payer: Cash Price |
$14.36
|
| Rate for Payer: Cash Price |
$14.36
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$13.46
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$13.46
|
| Rate for Payer: Fidelis Essential Plan QHP |
$14.21
|
| Rate for Payer: Fidelis Medicare Advantage |
$14.96
|
| Rate for Payer: Fidelis Qualified Health Plan |
$14.21
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$14.96
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$14.96
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$11.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$14.21
|
| Rate for Payer: Healthfirst QHP |
$14.96
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$10.47
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$14.96
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$12.72
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$10.47
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$14.96
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$39.27
|
| Rate for Payer: SOMOS Essential |
$39.27
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$14.96
|
|
|
CHG RADIOLOGIC EXAM CHEST 4+ VIEWS
|
Professional
|
$58.80
|
|
|
Service Code
|
HCPCS 71048 26
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Cash Price |
$15.76
|
| Rate for Payer: Cash Price |
$15.76
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$15.12
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$15.12
|
| Rate for Payer: Fidelis Essential Plan QHP |
$15.96
|
| Rate for Payer: Fidelis Medicare Advantage |
$16.80
|
| Rate for Payer: Fidelis Qualified Health Plan |
$15.96
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$16.80
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$16.80
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$12.60
|
| Rate for Payer: Healthfirst Medicare Advantage |
$15.96
|
| Rate for Payer: Healthfirst QHP |
$16.80
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$11.76
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$16.80
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$14.28
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$11.76
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$16.80
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.10
|
| Rate for Payer: SOMOS Essential |
$44.10
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$16.80
|
|
|
CHG RADIOLOGIC EXAM CHEST 4+ VIEWS
|
Professional
|
$196.67
|
|
|
Service Code
|
HCPCS 71048
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Cash Price |
$52.93
|
| Rate for Payer: Cash Price |
$52.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$50.57
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$50.57
|
| Rate for Payer: Fidelis Essential Plan QHP |
$53.38
|
| Rate for Payer: Fidelis Medicare Advantage |
$56.19
|
| Rate for Payer: Fidelis Qualified Health Plan |
$53.38
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$56.19
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$56.19
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$42.14
|
| Rate for Payer: Healthfirst Medicare Advantage |
$53.38
|
| Rate for Payer: Healthfirst QHP |
$56.19
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$39.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$56.19
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$47.76
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$39.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$56.19
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$147.50
|
| Rate for Payer: SOMOS Essential |
$147.50
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$56.19
|
|
|
CHG RADIOLOGIC EXAM CHEST 4+ VIEWS
|
Professional
|
$137.87
|
|
|
Service Code
|
HCPCS 71048 TC
|
| Min. Negotiated Rate |
$11.76 |
| Max. Negotiated Rate |
$147.50 |
| Rate for Payer: Cash Price |
$37.17
|
| Rate for Payer: Cash Price |
$37.17
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$35.45
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$35.45
|
| Rate for Payer: Fidelis Essential Plan QHP |
$37.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$39.39
|
| Rate for Payer: Fidelis Qualified Health Plan |
$37.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$39.39
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$39.39
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$29.54
|
| Rate for Payer: Healthfirst Medicare Advantage |
$37.42
|
| Rate for Payer: Healthfirst QHP |
$39.39
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$27.57
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$39.39
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$33.48
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$27.57
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$39.39
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$103.40
|
| Rate for Payer: SOMOS Essential |
$103.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$39.39
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
$76.06
|
|
|
Service Code
|
HCPCS 71045 TC
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$83.56 |
| Rate for Payer: Cash Price |
$20.67
|
| Rate for Payer: Cash Price |
$20.67
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$19.56
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$19.56
|
| Rate for Payer: Fidelis Essential Plan QHP |
$20.64
|
| Rate for Payer: Fidelis Medicare Advantage |
$21.73
|
| Rate for Payer: Fidelis Qualified Health Plan |
$20.64
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$21.73
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$21.73
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$16.30
|
| Rate for Payer: Healthfirst Medicare Advantage |
$20.64
|
| Rate for Payer: Healthfirst QHP |
$21.73
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$15.21
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$21.73
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$18.47
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$15.21
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$21.73
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57.04
|
| Rate for Payer: SOMOS Essential |
$57.04
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$21.73
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
$111.41
|
|
|
Service Code
|
HCPCS 71045
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$83.56 |
| Rate for Payer: Cash Price |
$29.93
|
| Rate for Payer: Cash Price |
$29.93
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$28.65
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$28.65
|
| Rate for Payer: Fidelis Essential Plan QHP |
$30.24
|
| Rate for Payer: Fidelis Medicare Advantage |
$31.83
|
| Rate for Payer: Fidelis Qualified Health Plan |
$30.24
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$31.83
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$31.83
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$23.87
|
| Rate for Payer: Healthfirst Medicare Advantage |
$30.24
|
| Rate for Payer: Healthfirst QHP |
$31.83
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$22.28
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$31.83
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$27.06
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$22.28
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$31.83
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$83.56
|
| Rate for Payer: SOMOS Essential |
$83.56
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$31.83
|
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
$35.35
|
|
|
Service Code
|
HCPCS 71045 26
|
| Min. Negotiated Rate |
$7.07 |
| Max. Negotiated Rate |
$83.56 |
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Cash Price |
$9.26
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$9.09
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$9.09
|
| Rate for Payer: Fidelis Essential Plan QHP |
$9.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$10.10
|
| Rate for Payer: Fidelis Qualified Health Plan |
$9.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$10.10
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$10.10
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$7.58
|
| Rate for Payer: Healthfirst Medicare Advantage |
$9.60
|
| Rate for Payer: Healthfirst QHP |
$10.10
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$7.07
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$10.10
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$8.58
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$7.07
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$10.10
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.51
|
| Rate for Payer: SOMOS Essential |
$26.51
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$10.10
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
$714.14
|
|
|
Service Code
|
HCPCS 74280 TC
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$716.86 |
| Rate for Payer: Cash Price |
$189.86
|
| Rate for Payer: Cash Price |
$189.86
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$183.64
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$183.64
|
| Rate for Payer: Fidelis Essential Plan QHP |
$193.84
|
| Rate for Payer: Fidelis Medicare Advantage |
$204.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$193.84
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$204.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$204.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$153.03
|
| Rate for Payer: Healthfirst Medicare Advantage |
$193.84
|
| Rate for Payer: Healthfirst QHP |
$204.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$142.83
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$204.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$173.43
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$142.83
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$204.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$535.60
|
| Rate for Payer: SOMOS Essential |
$535.60
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$204.04
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
$955.82
|
|
|
Service Code
|
HCPCS 74280
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$716.86 |
| Rate for Payer: Cash Price |
$255.47
|
| Rate for Payer: Cash Price |
$255.47
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$245.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$245.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$259.44
|
| Rate for Payer: Fidelis Medicare Advantage |
$273.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$259.44
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$273.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$273.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$204.82
|
| Rate for Payer: Healthfirst Medicare Advantage |
$259.44
|
| Rate for Payer: Healthfirst QHP |
$273.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$191.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$273.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$232.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$191.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$273.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$716.86
|
| Rate for Payer: SOMOS Essential |
$716.86
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$273.09
|
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
$241.64
|
|
|
Service Code
|
HCPCS 74280 26
|
| Min. Negotiated Rate |
$48.33 |
| Max. Negotiated Rate |
$716.86 |
| Rate for Payer: Cash Price |
$65.61
|
| Rate for Payer: Cash Price |
$65.61
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$62.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$62.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$65.59
|
| Rate for Payer: Fidelis Medicare Advantage |
$69.04
|
| Rate for Payer: Fidelis Qualified Health Plan |
$65.59
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$69.04
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$69.04
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$51.78
|
| Rate for Payer: Healthfirst Medicare Advantage |
$65.59
|
| Rate for Payer: Healthfirst QHP |
$69.04
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$48.33
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$69.04
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$58.68
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$48.33
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$69.04
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$181.23
|
| Rate for Payer: SOMOS Essential |
$181.23
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$69.04
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
$462.74
|
|
|
Service Code
|
HCPCS 74270 TC
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$493.92 |
| Rate for Payer: Cash Price |
$124.01
|
| Rate for Payer: Cash Price |
$124.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$118.99
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$118.99
|
| Rate for Payer: Fidelis Essential Plan QHP |
$125.60
|
| Rate for Payer: Fidelis Medicare Advantage |
$132.21
|
| Rate for Payer: Fidelis Qualified Health Plan |
$125.60
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$132.21
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$132.21
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$99.16
|
| Rate for Payer: Healthfirst Medicare Advantage |
$125.60
|
| Rate for Payer: Healthfirst QHP |
$132.21
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$92.55
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$132.21
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$112.38
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$92.55
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$132.21
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$347.06
|
| Rate for Payer: SOMOS Essential |
$347.06
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$132.21
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
$658.56
|
|
|
Service Code
|
HCPCS 74270
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$493.92 |
| Rate for Payer: Cash Price |
$177.55
|
| Rate for Payer: Cash Price |
$177.55
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$169.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$169.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$178.75
|
| Rate for Payer: Fidelis Medicare Advantage |
$188.16
|
| Rate for Payer: Fidelis Qualified Health Plan |
$178.75
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$188.16
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$188.16
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$141.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$178.75
|
| Rate for Payer: Healthfirst QHP |
$188.16
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$131.71
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$188.16
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$159.94
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$131.71
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$188.16
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$493.92
|
| Rate for Payer: SOMOS Essential |
$493.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$188.16
|
|
|
CHG RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY
|
Professional
|
$195.83
|
|
|
Service Code
|
HCPCS 74270 26
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$493.92 |
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Cash Price |
$53.54
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$50.36
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$50.36
|
| Rate for Payer: Fidelis Essential Plan QHP |
$53.15
|
| Rate for Payer: Fidelis Medicare Advantage |
$55.95
|
| Rate for Payer: Fidelis Qualified Health Plan |
$53.15
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$55.95
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$55.95
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$41.96
|
| Rate for Payer: Healthfirst Medicare Advantage |
$53.15
|
| Rate for Payer: Healthfirst QHP |
$55.95
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$39.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$55.95
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$47.56
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$39.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$55.95
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$146.87
|
| Rate for Payer: SOMOS Essential |
$146.87
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$55.95
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
$62.79
|
|
|
Service Code
|
HCPCS 74022 26
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$160.21 |
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$16.15
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$16.15
|
| Rate for Payer: Fidelis Essential Plan QHP |
$17.04
|
| Rate for Payer: Fidelis Medicare Advantage |
$17.94
|
| Rate for Payer: Fidelis Qualified Health Plan |
$17.04
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$17.94
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$17.94
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$13.46
|
| Rate for Payer: Healthfirst Medicare Advantage |
$17.04
|
| Rate for Payer: Healthfirst QHP |
$17.94
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$12.56
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$17.94
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$15.25
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$12.56
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$17.94
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$47.09
|
| Rate for Payer: SOMOS Essential |
$47.09
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$17.94
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
$213.61
|
|
|
Service Code
|
HCPCS 74022
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$160.21 |
| Rate for Payer: Cash Price |
$58.22
|
| Rate for Payer: Cash Price |
$58.22
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$54.93
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$54.93
|
| Rate for Payer: Fidelis Essential Plan QHP |
$57.98
|
| Rate for Payer: Fidelis Medicare Advantage |
$61.03
|
| Rate for Payer: Fidelis Qualified Health Plan |
$57.98
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$61.03
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$61.03
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$45.77
|
| Rate for Payer: Healthfirst Medicare Advantage |
$57.98
|
| Rate for Payer: Healthfirst QHP |
$61.03
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$42.72
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$61.03
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$51.88
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$42.72
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$61.03
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$160.21
|
| Rate for Payer: SOMOS Essential |
$160.21
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$61.03
|
|
|
CHG RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES
|
Professional
|
$150.82
|
|
|
Service Code
|
HCPCS 74022 TC
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$160.21 |
| Rate for Payer: Cash Price |
$41.49
|
| Rate for Payer: Cash Price |
$41.49
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$38.78
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$38.78
|
| Rate for Payer: Fidelis Essential Plan QHP |
$40.94
|
| Rate for Payer: Fidelis Medicare Advantage |
$43.09
|
| Rate for Payer: Fidelis Qualified Health Plan |
$40.94
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$43.09
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$43.09
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$32.32
|
| Rate for Payer: Healthfirst Medicare Advantage |
$40.94
|
| Rate for Payer: Healthfirst QHP |
$43.09
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$30.16
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$43.09
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$36.63
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$30.16
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$43.09
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$113.12
|
| Rate for Payer: SOMOS Essential |
$113.12
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$43.09
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
$476.53
|
|
|
Service Code
|
HCPCS 74221
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$357.40 |
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Cash Price |
$127.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$122.54
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$122.54
|
| Rate for Payer: Fidelis Essential Plan QHP |
$129.34
|
| Rate for Payer: Fidelis Medicare Advantage |
$136.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$129.34
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$136.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$136.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$102.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$129.34
|
| Rate for Payer: Healthfirst QHP |
$136.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$95.30
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$136.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$115.73
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$95.30
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$136.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$357.40
|
| Rate for Payer: SOMOS Essential |
$357.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$136.15
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
$134.54
|
|
|
Service Code
|
HCPCS 74221 26
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$357.40 |
| Rate for Payer: Cash Price |
$36.34
|
| Rate for Payer: Cash Price |
$36.34
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$34.60
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$34.60
|
| Rate for Payer: Fidelis Essential Plan QHP |
$36.52
|
| Rate for Payer: Fidelis Medicare Advantage |
$38.44
|
| Rate for Payer: Fidelis Qualified Health Plan |
$36.52
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$38.44
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$38.44
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$28.83
|
| Rate for Payer: Healthfirst Medicare Advantage |
$36.52
|
| Rate for Payer: Healthfirst QHP |
$38.44
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$26.91
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$38.44
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$32.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$26.91
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$38.44
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$100.90
|
| Rate for Payer: SOMOS Essential |
$100.90
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$38.44
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY
|
Professional
|
$341.99
|
|
|
Service Code
|
HCPCS 74221 TC
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$357.40 |
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Cash Price |
$91.00
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$87.94
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$87.94
|
| Rate for Payer: Fidelis Essential Plan QHP |
$92.82
|
| Rate for Payer: Fidelis Medicare Advantage |
$97.71
|
| Rate for Payer: Fidelis Qualified Health Plan |
$92.82
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$97.71
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$97.71
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$73.28
|
| Rate for Payer: Healthfirst Medicare Advantage |
$92.82
|
| Rate for Payer: Healthfirst QHP |
$97.71
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$68.40
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$97.71
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$83.05
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$68.40
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$97.71
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$256.49
|
| Rate for Payer: SOMOS Essential |
$256.49
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$97.71
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY
|
Professional
|
$425.22
|
|
|
Service Code
|
HCPCS 74220
|
| Min. Negotiated Rate |
$23.54 |
| Max. Negotiated Rate |
$318.92 |
| Rate for Payer: Cash Price |
$113.01
|
| Rate for Payer: Cash Price |
$113.01
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$109.34
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$109.34
|
| Rate for Payer: Fidelis Essential Plan QHP |
$115.42
|
| Rate for Payer: Fidelis Medicare Advantage |
$121.49
|
| Rate for Payer: Fidelis Qualified Health Plan |
$115.42
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$121.49
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$121.49
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$91.12
|
| Rate for Payer: Healthfirst Medicare Advantage |
$115.42
|
| Rate for Payer: Healthfirst QHP |
$121.49
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$85.04
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$121.49
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$103.27
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$85.04
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$121.49
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$318.92
|
| Rate for Payer: SOMOS Essential |
$318.92
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$121.49
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY
|
Professional
|
$117.71
|
|
|
Service Code
|
HCPCS 74220 26
|
| Min. Negotiated Rate |
$23.54 |
| Max. Negotiated Rate |
$318.92 |
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Cash Price |
$31.05
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$30.27
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$30.27
|
| Rate for Payer: Fidelis Essential Plan QHP |
$31.95
|
| Rate for Payer: Fidelis Medicare Advantage |
$33.63
|
| Rate for Payer: Fidelis Qualified Health Plan |
$31.95
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$33.63
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$33.63
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$25.22
|
| Rate for Payer: Healthfirst Medicare Advantage |
$31.95
|
| Rate for Payer: Healthfirst QHP |
$33.63
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$23.54
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$33.63
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$28.59
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$23.54
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$33.63
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$88.28
|
| Rate for Payer: SOMOS Essential |
$88.28
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$33.63
|
|
|
CHG RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY
|
Professional
|
$307.48
|
|
|
Service Code
|
HCPCS 74220 TC
|
| Min. Negotiated Rate |
$23.54 |
| Max. Negotiated Rate |
$318.92 |
| Rate for Payer: Cash Price |
$81.96
|
| Rate for Payer: Cash Price |
$81.96
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$79.06
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$79.06
|
| Rate for Payer: Fidelis Essential Plan QHP |
$83.46
|
| Rate for Payer: Fidelis Medicare Advantage |
$87.85
|
| Rate for Payer: Fidelis Qualified Health Plan |
$83.46
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$87.85
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$87.85
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$65.89
|
| Rate for Payer: Healthfirst Medicare Advantage |
$83.46
|
| Rate for Payer: Healthfirst QHP |
$87.85
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$61.50
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$87.85
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$74.67
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$61.50
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$87.85
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$230.61
|
| Rate for Payer: SOMOS Essential |
$230.61
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$87.85
|
|
|
CHG RADIOLOGIC EXAMINATION ANKLE 2 VIEWS
|
Professional
|
$140.53
|
|
|
Service Code
|
HCPCS 73600
|
| Min. Negotiated Rate |
$6.57 |
| Max. Negotiated Rate |
$105.40 |
| Rate for Payer: Cash Price |
$37.87
|
| Rate for Payer: Cash Price |
$37.87
|
| Rate for Payer: Fidelis CHP/HARP/Medicaid |
$36.14
|
| Rate for Payer: Fidelis Essential Plan Aliesa |
$36.14
|
| Rate for Payer: Fidelis Essential Plan QHP |
$38.14
|
| Rate for Payer: Fidelis Medicare Advantage |
$40.15
|
| Rate for Payer: Fidelis Qualified Health Plan |
$38.14
|
| Rate for Payer: Hamaspik Choice Inc Medicaid |
$40.15
|
| Rate for Payer: Hamaspik Choice Inc Medicare |
$40.15
|
| Rate for Payer: Healthfirst CHP/FHP/Medicaid |
$30.11
|
| Rate for Payer: Healthfirst Medicare Advantage |
$38.14
|
| Rate for Payer: Healthfirst QHP |
$40.15
|
| Rate for Payer: MetroPlus Health CHP/HARP/HIV SNP/Medicaid |
$28.10
|
| Rate for Payer: MetroPlus Health Commercial/Exchange/Gold Care/Medicare Advantage |
$40.15
|
| Rate for Payer: MetroPlus Health Essential Plan 1 (Non-Aliessa)/Essential Plan 2 (Non-Aliessa) |
$34.13
|
| Rate for Payer: MetroPlus Health Essential Plan 3 (Aliessa)/Essential Plan 4 (Aliessa) |
$28.10
|
| Rate for Payer: Senior Whole Health Medicare Advantage |
$40.15
|
| Rate for Payer: SOMOS CHP/HARP/Medicaid |
$105.40
|
| Rate for Payer: SOMOS Essential |
$105.40
|
| Rate for Payer: VNS Choice FIDA/MLTC Plus/Medicaid Advantage/Medicare Advantage/Special Needs Dual |
$40.15
|
|
