|
CHEST PAIN
|
Facility
|
IP
|
$8,153.33
|
|
|
Service Code
|
APR-DRG 2033
|
| Min. Negotiated Rate |
$8,153.33 |
| Max. Negotiated Rate |
$8,153.33 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$8,153.33
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$8,153.33
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$8,153.33
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$8,153.33
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$3,419.80
|
|
|
Service Code
|
APR-DRG 2031
|
| Min. Negotiated Rate |
$3,419.80 |
| Max. Negotiated Rate |
$3,419.80 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$3,419.80
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$3,419.80
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$3,419.80
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$3,419.80
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$14,913.24
|
|
|
Service Code
|
MSDRG 313
|
| Min. Negotiated Rate |
$7,456.62 |
| Max. Negotiated Rate |
$14,913.24 |
| Rate for Payer: Aetna Medicare Advantage |
$7,456.62
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$7,456.62
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$7,456.62
|
| Rate for Payer: Humana Commercial |
$14,913.24
|
| Rate for Payer: Humana Medicare Advantage |
$7,456.62
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$4,526.45
|
|
|
Service Code
|
APR-DRG 2032
|
| Min. Negotiated Rate |
$4,526.45 |
| Max. Negotiated Rate |
$4,526.45 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$4,526.45
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$4,526.45
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$4,526.45
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$4,526.45
|
|
|
CHEST PAIN
|
Facility
|
IP
|
$13,110.60
|
|
|
Service Code
|
APR-DRG 2034
|
| Min. Negotiated Rate |
$13,110.60 |
| Max. Negotiated Rate |
$13,110.60 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$13,110.60
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$13,110.60
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$13,110.60
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$13,110.60
|
|
|
CHEST TOMO
|
Facility
|
OP
|
$731.00
|
|
|
Service Code
|
CPT 76100
|
| Hospital Charge Code |
323150
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$94.24 |
| Max. Negotiated Rate |
$521.93 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$94.24
|
| Rate for Payer: Aetna Medicare Advantage |
$106.81
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$432.75
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$521.93
|
| Rate for Payer: Cash Price |
$657.90
|
| Rate for Payer: Cash Price |
$657.90
|
| Rate for Payer: Cash Price |
$657.90
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$106.81
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$94.24
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$100.84
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$106.81
|
| Rate for Payer: Humana Commercial |
$213.62
|
| Rate for Payer: Humana Medicare Advantage |
$106.81
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$94.24
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$263.16
|
|
|
CHEST TOMO
|
Facility
|
IP
|
$731.00
|
|
|
Service Code
|
CPT 76100
|
| Hospital Charge Code |
323150
|
|
Hospital Revenue Code
|
320
|
| Rate for Payer: Cash Price |
$657.90
|
|
|
CHEST TUBE C THORA
|
Professional
|
Both
|
$1,272.00
|
|
|
Service Code
|
CPT 32556
|
| Hospital Charge Code |
1832020
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$109.08 |
| Max. Negotiated Rate |
$642.09 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$109.08
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care |
$583.72
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cash Price |
$1,144.80
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$109.08
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$583.72
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$642.09
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$109.08
|
| Rate for Payer: Optum Medicare Advantage |
$445.20
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$583.72
|
|
|
CHEST TUBE INSERTION
|
Professional
|
Both
|
$1,896.00
|
|
|
Service Code
|
CPT 32551
|
| Hospital Charge Code |
1832551
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$127.10 |
| Max. Negotiated Rate |
$663.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$138.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Medicaid Managed Care |
$127.10
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cash Price |
$1,706.40
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$138.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$127.10
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$139.81
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$138.93
|
| Rate for Payer: Optum Medicare Advantage |
$663.60
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$127.10
|
|
|
CHEST (W/ LORDOTIC)
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
3271021
|
|
Hospital Revenue Code
|
324
|
| Rate for Payer: Cash Price |
$359.10
|
|
|
CHEST (W/ LORDOTIC)
|
Facility
|
OP
|
$399.00
|
|
|
Service Code
|
CPT 71047
|
| Hospital Charge Code |
3271021
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$78.45 |
| Max. Negotiated Rate |
$284.89 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$78.45
|
| Rate for Payer: Aetna Medicare Advantage |
$88.91
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$236.21
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$284.89
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$88.91
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$78.45
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$83.94
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$88.91
|
| Rate for Payer: Humana Commercial |
$177.82
|
| Rate for Payer: Humana Medicare Advantage |
$88.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$78.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$143.64
|
|
|
CHEST XRAY 2V
|
Facility
|
IP
|
$465.00
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
323138
|
|
Hospital Revenue Code
|
324
|
| Rate for Payer: Cash Price |
$418.50
|
|
|
CHEST XRAY 2V
|
Facility
|
OP
|
$465.00
|
|
|
Service Code
|
CPT 71046
|
| Hospital Charge Code |
323138
|
|
Hospital Revenue Code
|
324
|
| Min. Negotiated Rate |
$78.45 |
| Max. Negotiated Rate |
$332.01 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$78.45
|
| Rate for Payer: Aetna Medicare Advantage |
$88.91
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$275.28
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$332.01
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cash Price |
$418.50
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$88.91
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$78.45
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$83.94
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$88.91
|
| Rate for Payer: Humana Commercial |
$177.82
|
| Rate for Payer: Humana Medicare Advantage |
$88.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.00
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$78.45
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$167.40
|
|
|
CHIBA BIOPSY NEEDLE
|
Facility
|
IP
|
$40.00
|
|
| Hospital Charge Code |
3200132
|
|
Hospital Revenue Code
|
271
|
| Rate for Payer: Cash Price |
$36.00
|
|
|
CHIBA BIOPSY NEEDLE
|
Facility
|
OP
|
$40.00
|
|
| Hospital Charge Code |
3200132
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$14.40 |
| Max. Negotiated Rate |
$28.56 |
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$23.68
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$28.56
|
| Rate for Payer: Cash Price |
$36.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$26.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$14.40
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$688,647.18
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$344,323.59 |
| Max. Negotiated Rate |
$688,647.18 |
| Rate for Payer: Aetna Medicare Advantage |
$344,323.59
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$344,323.59
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$344,323.59
|
| Rate for Payer: Humana Commercial |
$688,647.18
|
| Rate for Payer: Humana Medicare Advantage |
$344,323.59
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$135,261.50
|
|
|
Service Code
|
APR-DRG 0111
|
| Min. Negotiated Rate |
$135,261.50 |
| Max. Negotiated Rate |
$135,261.50 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$135,261.50
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$135,261.50
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$135,261.50
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$135,261.50
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$380,701.00
|
|
|
Service Code
|
APR-DRG 0112
|
| Min. Negotiated Rate |
$380,701.00 |
| Max. Negotiated Rate |
$380,701.00 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$380,701.00
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$380,701.00
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$380,701.00
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$380,701.00
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$485,451.97
|
|
|
Service Code
|
APR-DRG 0114
|
| Min. Negotiated Rate |
$485,451.97 |
| Max. Negotiated Rate |
$485,451.97 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$485,451.97
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$485,451.97
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$485,451.97
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$485,451.97
|
|
|
CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$485,451.97
|
|
|
Service Code
|
APR-DRG 0113
|
| Min. Negotiated Rate |
$485,451.97 |
| Max. Negotiated Rate |
$485,451.97 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$485,451.97
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$485,451.97
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$485,451.97
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$485,451.97
|
|
|
CHIX CLEAN
|
Facility
|
OP
|
$28.00
|
|
| Hospital Charge Code |
283775
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$10.08 |
| Max. Negotiated Rate |
$19.99 |
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$16.58
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$19.99
|
| Rate for Payer: Cash Price |
$25.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$18.68
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$10.08
|
|
|
CHIX CLEAN
|
Facility
|
IP
|
$28.00
|
|
| Hospital Charge Code |
283775
|
|
Hospital Revenue Code
|
271
|
| Rate for Payer: Cash Price |
$25.20
|
|
|
CHLAMYDIA
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
4286317
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$173.53 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$13.49
|
| Rate for Payer: Aetna Medicare Advantage |
$14.99
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$25.46
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$30.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cash Price |
$38.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$14.99
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$12.14
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$14.43
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Humana Commercial |
$29.98
|
| Rate for Payer: Humana Medicare Advantage |
$14.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$28.68
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$13.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
CHLAMYDIA
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
5286317
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$173.53 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$13.49
|
| Rate for Payer: Aetna Medicare Advantage |
$14.99
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$18.94
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$22.85
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$14.99
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$12.14
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$14.43
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Humana Commercial |
$29.98
|
| Rate for Payer: Humana Medicare Advantage |
$14.99
|
| Rate for Payer: UnitedHealthcare Commercial |
$21.34
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$13.49
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
CHLAMYDIA
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
4286317
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$38.70
|
|
