|
HOLTER HOOK UP AND DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9493225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER HOOK UP AND DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9293225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR, HOOK-UP
|
Facility
|
IP
|
$394.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
4500385
|
|
Hospital Revenue Code
|
731
|
| Rate for Payer: Cash Price |
$354.60
|
|
|
HOLTER MONITOR, HOOK-UP
|
Facility
|
OP
|
$394.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
4500385
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$119.94 |
| Max. Negotiated Rate |
$281.32 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$233.25
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$281.32
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Cash Price |
$354.60
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$119.94
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$262.80
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$141.84
|
|
|
HOLTER MONITOR HOOK UP AND DISCONNECT
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9893225
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$236.70
|
|
|
HOLTER MONITOR HOOK UP AND DISCONNECT
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9793225
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$236.70
|
|
|
HOLTER MONITOR HOOK UP AND DISCONNECT
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
3993225
|
|
Hospital Revenue Code
|
731
|
| Rate for Payer: Cash Price |
$236.70
|
|
|
HOLTER MONITOR HOOK UP AND DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9893225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR HOOK UP AND DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9793225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR HOOK UP AND DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
3993225
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$94.68 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$119.94
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$94.68
|
|
|
HOLTER MONITOR HOOK UP & DISCONNECT
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
4293225
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$144.00
|
|
|
HOLTER MONITOR HOOK UP & DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9693225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR HOOK UP & DISCONNECT
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
4193225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$155.70
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$187.78
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cash Price |
$236.70
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$175.42
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR HOOK UP & DISCONNECT
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
4293225
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$94.72 |
| Max. Negotiated Rate |
$271.86 |
| Rate for Payer: Aetna Better Health Medicaid/QHP |
$119.94
|
| Rate for Payer: Aetna Medicare Advantage |
$135.93
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$94.72
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$114.24
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cash Price |
$144.00
|
| Rate for Payer: Cigna Commercial HMO & PPO |
$135.93
|
| Rate for Payer: Healthy Blue CHP/Medicaid Managed Care |
$107.95
|
| Rate for Payer: Home State Health Plan Medicaid Managed Care |
$128.34
|
| Rate for Payer: Home State Health Plan Medicare Advantage |
$135.93
|
| Rate for Payer: Humana Commercial |
$271.86
|
| Rate for Payer: Humana Medicare Advantage |
$135.93
|
| Rate for Payer: UnitedHealthcare Commercial |
$106.72
|
| Rate for Payer: UnitedHealthcare Medicaid Managed Care |
$119.94
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR HOOK UP & DISCONNECT
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
4193225
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$236.70
|
|
|
HOLTER MONITOR HOOK UP & DISCONNECT
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
9693225
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$236.70
|
|
|
HOLTER MONITORING PHY REV & INTERPRET
|
Facility
|
OP
|
$315.00
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
4193227
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$173.53 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$186.48
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$224.91
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: Cash Price |
$283.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$210.10
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITORING PHY REV & INTERPRET
|
Facility
|
IP
|
$315.00
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
4193227
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$283.50
|
|
|
HOLTER MONITOR PHY REVIEW & INTERPRET
|
Facility
|
OP
|
$180.00
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
4293227
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$106.56 |
| Max. Negotiated Rate |
$173.53 |
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$106.56
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$128.52
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: Cash Price |
$162.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$120.06
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTER MONITOR PHY REVIEW & INTERPRET
|
Facility
|
IP
|
$180.00
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
4293227
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$162.00
|
|
|
HOLTER MONITOR, PROF. COMP.
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
5293227
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$94.50
|
|
|
HOLTER MONITOR, PROF. COMP.
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 93227
|
| Hospital Charge Code |
5293227
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$62.16 |
| Max. Negotiated Rate |
$173.53 |
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$62.16
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$74.97
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.03
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTOR MONITORING GLOBAL W/SUPERIMPOSITI
|
Facility
|
OP
|
$637.00
|
|
|
Service Code
|
CPT 93224
|
| Hospital Charge Code |
4493224
|
|
Hospital Revenue Code
|
521
|
| Min. Negotiated Rate |
$173.53 |
| Max. Negotiated Rate |
$454.82 |
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Blue Access/Blue Preferred and Pathway/Pathway X |
$377.10
|
| Rate for Payer: Anthem Blue Cross Blue Shield Missouri Traditional |
$454.82
|
| Rate for Payer: Cash Price |
$573.30
|
| Rate for Payer: Cash Price |
$573.30
|
| Rate for Payer: UnitedHealthcare Commercial |
$424.88
|
| Rate for Payer: UnitedHealthcare Medicare Advantage |
$173.53
|
|
|
HOLTOR MONITORING GLOBAL W/SUPERIMPOSITI
|
Facility
|
IP
|
$637.00
|
|
|
Service Code
|
CPT 93224
|
| Hospital Charge Code |
4493224
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$573.30
|
|
|
HOLTOR MONITORING HOOKUP,RECORD,& DISCON
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
5293225
|
|
Hospital Revenue Code
|
521
|
| Rate for Payer: Cash Price |
$236.70
|
|
