|
HC Allergen Spec Igg Quant,Each - Allergen, Food, Chicken Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600107
|
|
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, Corn Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600110
|
|
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, Corn Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600110
|
|
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, Egg White Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600111
|
|
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, Egg White Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600111
|
|
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, Garlic Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600113
|
|
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, Garlic Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600113
|
|
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, Gluten Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600138
|
|
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, Gluten Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600138
|
|
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, Milk (Cow's) Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600116
|
|
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, Milk (Cow's) Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600116
|
|
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, Oat Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600118
|
|
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, Oat Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600118
|
|
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, Orange Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600121
|
|
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, Orange Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600121
|
|
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, Peanut Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600122
|
|
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, Peanut Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600122
|
|
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, Potato Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600124
|
|
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, Potato Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600124
|
|
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, Rice Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600125
|
|
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, Rice Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600125
|
|
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, Soybean Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600127
|
|
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, Soybean Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600127
|
|
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, Tomato Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.95 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Cigna Medicare Advantage |
$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: 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, Tomato Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600141
|
|
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
|
|
