|
HC Allergen Spec Ige - Allergen Tree: Pecan, Hickory
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860033D
|
|
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 Tree: Pecan, Hickory
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px0302860033D
|
|
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 Walnut Ige
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003S5
|
|
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 Walnut Ige
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003S5
|
|
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 Spec Ige - Allergen Watermelon Ige
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003U5
|
|
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 Watermelon Ige
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003U5
|
|
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 Spec Ige - Allergen Wheat Ige
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003V5
|
|
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 Wheat Ige
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003V5
|
|
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 Spec Ige - Cladisporium Herbarum Ige
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CM
|
|
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 Spec Ige - Cladisporium Herbarum Ige
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CM
|
|
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 - Latex, Ige
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CK
|
|
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 - Latex, Ige
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CK
|
|
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 Spec Ige - Oak Tree Ige
|
Facility
|
IP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CP
|
|
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 Spec Ige - Oak Tree Ige
|
Facility
|
OP
|
$224.36
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
Px030286003CP
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$179.49 |
| Rate for Payer: Cash Price |
$224.36
|
| 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: 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 Igg Quant,Each
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| 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 |
$9.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$10.64
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.86
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.86
|
| 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 |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.42
|
|
|
HC Allergen Spec Igg Quant,Each
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600144
|
|
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 Igg Quant,Each - Allergen Cladosporium Herbarum Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600140
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| 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 |
$9.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$10.64
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.86
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.86
|
| 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 |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.42
|
|
|
HC Allergen Spec Igg Quant,Each - Allergen Cladosporium Herbarum Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600140
|
|
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 Igg Quant,Each - Allergen, Food, Almond Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| 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 |
$9.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$10.64
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.86
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.86
|
| 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 |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.42
|
|
|
HC Allergen Spec Igg Quant,Each - Allergen, Food, Almond Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600103
|
|
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 Igg Quant,Each - Allergen, Food, Baker's Yeast Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| 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 |
$9.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$10.64
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.86
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.86
|
| 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 |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.42
|
|
|
HC Allergen Spec Igg Quant,Each - Allergen, Food, Baker's Yeast Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600104
|
|
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 Igg Quant,Each - Allergen, Food, Banana Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600101
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| 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 |
$9.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$10.64
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.86
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.86
|
| 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 |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.42
|
|
|
HC Allergen Spec Igg Quant,Each - Allergen, Food, Banana Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600101
|
|
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 Igg Quant,Each - Allergen, Food, Chicken Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600107
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.42 |
| 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 |
$9.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$34.40
|
| Rate for Payer: Healthy Blue Medicaid |
$10.64
|
| Rate for Payer: Home State Health Plan Exchange |
$31.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.86
|
| Rate for Payer: Humana Medicare |
$40.95
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.86
|
| 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 |
$7.82
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.42
|
|
