MRI UPPR EXTREMITY W/O&W/DYE at Bertrand Chaffee Hospital

SPRINGVILLE, NY

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Pricing by billing methodology

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Payers reporting CPT 73220-RT at Bertrand Chaffee Hospital

Negotiated rates from the hospital’s own file: 7 payers, 7 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Aetna aetna medicare fee schedule · both	$97	$97	—	—	—	$97 – $97
2	Cigna cigna fee schedule · both	$97	$97	—	—	—	$97 – $97
3	Humana humana gold fee schedule · both	$97	$97	—	—	—	$97 – $97
4	Optum va optum community care fee schedule · both	$97	$97	—	—	—	$97 – $97
5	Tricare wps tricare for life fee schedule · both	$97	$97	—	—	—	$97 – $97
6	UnitedHealthcare aarp/united healthcare fee schedule · both	$97	$97	—	—	—	$97 – $97
7	WellCare wellcare fee schedule · both	$97	$97	—	—	—	$97 – $97

Last updated: Oct 1, 2026

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