CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$128.63
|
|
Service Code
|
HCPCS 74018
|
Min. Negotiated Rate |
$96.47 |
Max. Negotiated Rate |
$96.47 |
Rate for Payer: Cash Price |
$35.43
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$96.47
|
Rate for Payer: SOMOS Essential |
$96.47
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$35.35
|
|
Service Code
|
HCPCS 74018 26
|
Min. Negotiated Rate |
$26.51 |
Max. Negotiated Rate |
$26.51 |
Rate for Payer: Cash Price |
$9.65
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.51
|
Rate for Payer: SOMOS Essential |
$26.51
|
|
CHG RADIOLOGIC EXAM ABDOMEN 1 VIEW
|
Professional
|
Both
|
$93.31
|
|
Service Code
|
HCPCS 74018 TC
|
Min. Negotiated Rate |
$69.98 |
Max. Negotiated Rate |
$69.98 |
Rate for Payer: Cash Price |
$25.77
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$69.98
|
Rate for Payer: SOMOS Essential |
$69.98
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$113.44
|
|
Service Code
|
HCPCS 74019 TC
|
Min. Negotiated Rate |
$85.08 |
Max. Negotiated Rate |
$85.08 |
Rate for Payer: Cash Price |
$30.88
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$85.08
|
Rate for Payer: SOMOS Essential |
$85.08
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$44.49
|
|
Service Code
|
HCPCS 74019 26
|
Min. Negotiated Rate |
$33.37 |
Max. Negotiated Rate |
$33.37 |
Rate for Payer: Cash Price |
$11.79
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$33.37
|
Rate for Payer: SOMOS Essential |
$33.37
|
|
CHG RADIOLOGIC EXAM ABDOMEN 2 VIEWS
|
Professional
|
Both
|
$157.92
|
|
Service Code
|
HCPCS 74019
|
Min. Negotiated Rate |
$118.44 |
Max. Negotiated Rate |
$118.44 |
Rate for Payer: Cash Price |
$42.67
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$118.44
|
Rate for Payer: SOMOS Essential |
$118.44
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$183.05
|
|
Service Code
|
HCPCS 74021
|
Min. Negotiated Rate |
$137.29 |
Max. Negotiated Rate |
$137.29 |
Rate for Payer: Cash Price |
$49.96
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$137.29
|
Rate for Payer: SOMOS Essential |
$137.29
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$50.93
|
|
Service Code
|
HCPCS 74021 26
|
Min. Negotiated Rate |
$38.20 |
Max. Negotiated Rate |
$38.20 |
Rate for Payer: Cash Price |
$13.97
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$38.20
|
Rate for Payer: SOMOS Essential |
$38.20
|
|
CHG RADIOLOGIC EXAM ABDOMEN 3+ VIEWS
|
Professional
|
Both
|
$132.13
|
|
Service Code
|
HCPCS 74021 TC
|
Min. Negotiated Rate |
$99.10 |
Max. Negotiated Rate |
$99.10 |
Rate for Payer: Cash Price |
$35.99
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$99.10
|
Rate for Payer: SOMOS Essential |
$99.10
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$34.27
|
|
Service Code
|
HCPCS 73565 26
|
Min. Negotiated Rate |
$25.70 |
Max. Negotiated Rate |
$25.70 |
Rate for Payer: Cash Price |
$8.96
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$25.70
|
Rate for Payer: SOMOS Essential |
$25.70
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$137.87
|
|
Service Code
|
HCPCS 73565 TC
|
Min. Negotiated Rate |
$103.40 |
Max. Negotiated Rate |
$103.40 |
Rate for Payer: Cash Price |
$37.95
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$103.40
|
Rate for Payer: SOMOS Essential |
$103.40
|
|
CHG RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST
|
Professional
|
Both
|
$172.13
|
|
Service Code
|
HCPCS 73565
|
Min. Negotiated Rate |
$129.10 |
Max. Negotiated Rate |
$129.10 |
Rate for Payer: Cash Price |
$46.91
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$129.10
|
Rate for Payer: SOMOS Essential |
$129.10
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$143.71
|
|
Service Code
|
HCPCS 71046
|
Min. Negotiated Rate |
$107.78 |
Max. Negotiated Rate |
$107.78 |
Rate for Payer: Cash Price |
$39.18
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$107.78
|
Rate for Payer: SOMOS Essential |
$107.78
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$101.92
|
|
Service Code
|
HCPCS 71046 TC
|
Min. Negotiated Rate |
$76.44 |
Max. Negotiated Rate |
$76.44 |
Rate for Payer: Cash Price |
$27.74
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$76.44
|
Rate for Payer: SOMOS Essential |
$76.44
|
|
CHG RADIOLOGIC EXAM CHEST 2 VIEWS
|
Professional
|
Both
|
$41.79
|
|
Service Code
|
HCPCS 71046 26
|
Min. Negotiated Rate |
$31.34 |
Max. Negotiated Rate |
$31.34 |
Rate for Payer: Cash Price |
$11.44
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$31.34
|
Rate for Payer: SOMOS Essential |
$31.34
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
Both
|
$180.18
|
|
Service Code
|
HCPCS 71047
|
Min. Negotiated Rate |
$135.14 |
Max. Negotiated Rate |
$135.14 |
Rate for Payer: Cash Price |
$49.17
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$135.14
|
Rate for Payer: SOMOS Essential |
$135.14
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
Both
|
$127.79
|
|
Service Code
|
HCPCS 71047 TC
|
Min. Negotiated Rate |
$95.84 |
Max. Negotiated Rate |
$95.84 |
Rate for Payer: Cash Price |
$34.81
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$95.84
|
Rate for Payer: SOMOS Essential |
$95.84
|
|
CHG RADIOLOGIC EXAM CHEST 3 VIEWS
|
Professional
|
Both
|
$52.36
|
|
Service Code
|
HCPCS 71047 26
|
Min. Negotiated Rate |
$39.27 |
Max. Negotiated Rate |
$39.27 |
Rate for Payer: Cash Price |
$14.36
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$39.27
|
Rate for Payer: SOMOS Essential |
$39.27
|
|
CHG RADIOLOGIC EXAM CHEST 4+ VIEWS
|
Professional
|
Both
|
$137.87
|
|
Service Code
|
HCPCS 71048 TC
|
Min. Negotiated Rate |
$103.40 |
Max. Negotiated Rate |
$103.40 |
Rate for Payer: Cash Price |
$37.17
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$103.40
|
Rate for Payer: SOMOS Essential |
$103.40
|
|
CHG RADIOLOGIC EXAM CHEST 4+ VIEWS
|
Professional
|
Both
|
$58.80
|
|
Service Code
|
HCPCS 71048 26
|
Min. Negotiated Rate |
$44.10 |
Max. Negotiated Rate |
$44.10 |
Rate for Payer: Cash Price |
$15.76
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$44.10
|
Rate for Payer: SOMOS Essential |
$44.10
|
|
CHG RADIOLOGIC EXAM CHEST 4+ VIEWS
|
Professional
|
Both
|
$196.67
|
|
Service Code
|
HCPCS 71048
|
Min. Negotiated Rate |
$147.50 |
Max. Negotiated Rate |
$147.50 |
Rate for Payer: Cash Price |
$52.93
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$147.50
|
Rate for Payer: SOMOS Essential |
$147.50
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$35.35
|
|
Service Code
|
HCPCS 71045 26
|
Min. Negotiated Rate |
$26.51 |
Max. Negotiated Rate |
$26.51 |
Rate for Payer: Cash Price |
$9.26
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$26.51
|
Rate for Payer: SOMOS Essential |
$26.51
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$111.41
|
|
Service Code
|
HCPCS 71045
|
Min. Negotiated Rate |
$83.56 |
Max. Negotiated Rate |
$83.56 |
Rate for Payer: Cash Price |
$29.93
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$83.56
|
Rate for Payer: SOMOS Essential |
$83.56
|
|
CHG RADIOLOGIC EXAM CHEST SINGLE VIEW
|
Professional
|
Both
|
$76.06
|
|
Service Code
|
HCPCS 71045 TC
|
Min. Negotiated Rate |
$57.04 |
Max. Negotiated Rate |
$57.04 |
Rate for Payer: Cash Price |
$20.67
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$57.04
|
Rate for Payer: SOMOS Essential |
$57.04
|
|
CHG RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY
|
Professional
|
Both
|
$241.64
|
|
Service Code
|
HCPCS 74280 26
|
Min. Negotiated Rate |
$181.23 |
Max. Negotiated Rate |
$181.23 |
Rate for Payer: Cash Price |
$65.61
|
Rate for Payer: SOMOS CHP/HARP/Medicaid |
$181.23
|
Rate for Payer: SOMOS Essential |
$181.23
|
|