|
HC Alkaloids Not Otherwise Specified - Nicotine Serum
|
Facility
|
IP
|
$78.90
|
|
|
Service Code
|
CPT 80323
|
| Hospital Charge Code |
Px03018032306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.17 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$78.90
|
| Rate for Payer: Cash Price |
$78.90
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$59.17
|
| Rate for Payer: Provider Network of America Commercial |
$63.12
|
|
|
HC Allergen Ea Quest Ref
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CY
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$168.27 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$224.36
|
| Rate for Payer: Cash Price |
$224.36
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$168.27
|
| Rate for Payer: Provider Network of America Commercial |
$179.49
|
|
|
HC Allergen Ea Quest Ref
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CY
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$179.49 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$158.17
|
| Rate for Payer: Aetna Workers' Compensation |
$158.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$155.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$155.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$176.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$176.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$176.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$172.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$176.80
|
| Rate for Payer: Cash Price |
$224.36
|
| Rate for Payer: Cash Price |
$224.36
|
| Rate for Payer: Cigna Commercial |
$117.56
|
| Rate for Payer: Cigna Medicare Advantage |
$127.89
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$141.35
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$127.89
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$168.27
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$168.27
|
| Rate for Payer: Provider Network of America Commercial |
$179.49
|
| Rate for Payer: UnitedHealthcare Commercial |
$148.08
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Ash, White Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Ash, White Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600308
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Aspergillus Fumagatus Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Aspergillus Fumagatus Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600310
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Bermuda Grass Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Bermuda Grass Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Cat Hair/Dander,Stan
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860038K
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Cat Hair/Dander,Stan
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860038K
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Clams Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Clams Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600359
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Cockroach, American Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600362
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Cockroach, American Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600362
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Codfish Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600364
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Codfish Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600364
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Corn Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600366
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Corn Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600366
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen Cottonwood Tree Ige
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600369
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Cottonwood Tree Ige
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px03028600369
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen D Farinae
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860038U
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
|
HC Allergen Spec Ige - Allergen D Farinae
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860038U
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Dog Dander
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860038Z
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
|
|
HC Allergen Spec Ige - Allergen Dog Dander
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860038Z
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$43.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$38.49
|
| Rate for Payer: Aetna Workers' Compensation |
$38.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$37.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.02
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cash Price |
$54.60
|
| Rate for Payer: Cigna Commercial |
$28.61
|
| Rate for Payer: Cigna Medicare Advantage |
$31.12
|
| Rate for Payer: Family Health Partners Medicaid |
$6.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$7.11
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.58
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$40.95
|
| Rate for Payer: Provider Network of America Commercial |
$43.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.04
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.22
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.95
|
|
