|
HC Allergen Spec Igg Quant,Each - Allergen, Food, Wheat Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600142
|
|
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, Wheat Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600142
|
|
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, Whey Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600129
|
|
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, Whey Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600129
|
|
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 Penicillum Notatum Igg
|
Facility
|
OP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600139
|
|
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 Penicillum Notatum Igg
|
Facility
|
IP
|
$54.60
|
|
|
Service Code
|
CPT 86001
|
| Hospital Charge Code |
Px03028600139
|
|
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 All Purpose Solution Bowl
|
Facility
|
OP
|
$3.41
|
|
|
Service Code
|
LOCAL 2700002617
|
| Hospital Charge Code |
Px02700002617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$3.41 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2.40
|
| Rate for Payer: Aetna Workers' Compensation |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2.69
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cigna Commercial |
$2.09
|
| Rate for Payer: Cigna Medicare Advantage |
$1.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2.15
|
| Rate for Payer: Home State Health Plan Exchange |
$1.94
|
| Rate for Payer: Humana Medicare |
$2.56
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.25
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.41
|
|
|
HC All Purpose Solution Bowl
|
Facility
|
IP
|
$3.41
|
|
|
Service Code
|
LOCAL 2700002617
|
| Hospital Charge Code |
Px02700002617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.56 |
| 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 |
$3.41
|
| Rate for Payer: Cash Price |
$3.41
|
| 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 |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
|
|
HC Alpha-1-Antitrypsin, Phenotype
|
Facility
|
OP
|
$239.40
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
Px03018210401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$191.52 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$168.78
|
| Rate for Payer: Aetna Workers' Compensation |
$168.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$184.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$188.65
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cigna Commercial |
$125.45
|
| Rate for Payer: Cigna Medicare Advantage |
$136.46
|
| Rate for Payer: Family Health Partners Medicaid |
$18.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$150.82
|
| Rate for Payer: Healthy Blue Medicaid |
$19.67
|
| Rate for Payer: Home State Health Plan Exchange |
$136.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.21
|
| Rate for Payer: Humana Medicare |
$179.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$179.55
|
| Rate for Payer: Provider Network of America Commercial |
$191.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$158.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.71
|
|
|
HC Alpha-1-Antitrypsin, Phenotype
|
Facility
|
IP
|
$239.40
|
|
|
Service Code
|
CPT 82104
|
| Hospital Charge Code |
Px03018210401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$179.55 |
| 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 |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| 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 |
$179.55
|
| Rate for Payer: Provider Network of America Commercial |
$191.52
|
|
|
HC Alpha-1-Antitrypsin, Total - Alpha-1-Antitrypsin
|
Facility
|
IP
|
$239.40
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
Px03018210301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$179.55 |
| 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 |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| 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 |
$179.55
|
| Rate for Payer: Provider Network of America Commercial |
$191.52
|
|
|
HC Alpha-1-Antitrypsin, Total - Alpha-1-Antitrypsin
|
Facility
|
OP
|
$239.40
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
Px03018210301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$191.52 |
| Rate for Payer: Cigna Commercial |
$125.45
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$168.78
|
| Rate for Payer: Aetna Workers' Compensation |
$168.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$184.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$188.65
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cigna Medicare Advantage |
$136.46
|
| Rate for Payer: Family Health Partners Medicaid |
$16.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$150.82
|
| Rate for Payer: Healthy Blue Medicaid |
$18.30
|
| Rate for Payer: Home State Health Plan Exchange |
$136.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.94
|
| Rate for Payer: Humana Medicare |
$179.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.94
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$179.55
|
| Rate for Payer: Provider Network of America Commercial |
$191.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$158.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.75
|
|
|
HC Alpha-1-Antitrypsin, Total - Alpha-1-Antitrypsin, Stool
|
Facility
|
OP
|
$239.40
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
Px03018210302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$191.52 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$168.78
|
| Rate for Payer: Aetna Workers' Compensation |
$168.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$165.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$188.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$184.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$188.65
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| Rate for Payer: Cigna Commercial |
$125.45
|
| Rate for Payer: Cigna Medicare Advantage |
$136.46
|
| Rate for Payer: Family Health Partners Medicaid |
$16.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$150.82
|
| Rate for Payer: Healthy Blue Medicaid |
$18.30
|
| Rate for Payer: Home State Health Plan Exchange |
$136.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.94
|
| Rate for Payer: Humana Medicare |
$179.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.94
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$179.55
|
| Rate for Payer: Provider Network of America Commercial |
$191.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$158.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.44
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.75
|
|
|
HC Alpha-1-Antitrypsin, Total - Alpha-1-Antitrypsin, Stool
|
Facility
|
IP
|
$239.40
|
|
|
Service Code
|
CPT 82103
|
| Hospital Charge Code |
Px03018210302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$179.55 |
| 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 |
$239.40
|
| Rate for Payer: Cash Price |
$239.40
|
| 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 |
$179.55
|
| Rate for Payer: Provider Network of America Commercial |
$191.52
|
|
|
HC Alpha-Fetoprotein, Serum
|
Facility
|
IP
|
$198.45
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
Px03018210503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.84 |
| 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 |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| 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 |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
|
|
HC Alpha-Fetoprotein, Serum
|
Facility
|
OP
|
$198.45
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
Px03018210503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$158.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$139.91
|
| Rate for Payer: Aetna Workers' Compensation |
$139.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$156.38
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cigna Commercial |
$103.99
|
| Rate for Payer: Cigna Medicare Advantage |
$113.12
|
| Rate for Payer: Family Health Partners Medicaid |
$21.13
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$125.02
|
| Rate for Payer: Healthy Blue Medicaid |
$22.82
|
| Rate for Payer: Home State Health Plan Exchange |
$113.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.13
|
| Rate for Payer: Humana Medicare |
$148.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.13
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.90
|
|
|
HC Alpha-Fetoprotein, Serum - Alpha-Fetoprotein Marker
|
Facility
|
OP
|
$198.45
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
Px03018210501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$158.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$139.91
|
| Rate for Payer: Aetna Workers' Compensation |
$139.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$156.38
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cigna Commercial |
$103.99
|
| Rate for Payer: Cigna Medicare Advantage |
$113.12
|
| Rate for Payer: Family Health Partners Medicaid |
$21.13
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$125.02
|
| Rate for Payer: Healthy Blue Medicaid |
$22.82
|
| Rate for Payer: Home State Health Plan Exchange |
$113.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.13
|
| Rate for Payer: Humana Medicare |
$148.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.13
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.90
|
|
|
HC Alpha-Fetoprotein, Serum - Alpha-Fetoprotein Marker
|
Facility
|
IP
|
$198.45
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
Px03018210501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.84 |
| 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 |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| 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 |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
|
|
HC Alpha-Fetoprotein, Serum - Alpha Fetoprotein, Maternal
|
Facility
|
IP
|
$198.45
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
Px03018210502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.84 |
| 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 |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| 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 |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
|
|
HC Alpha-Fetoprotein, Serum - Alpha Fetoprotein, Maternal
|
Facility
|
OP
|
$198.45
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
Px03018210502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.90 |
| Max. Negotiated Rate |
$158.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$139.91
|
| Rate for Payer: Aetna Workers' Compensation |
$139.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$156.38
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cigna Commercial |
$103.99
|
| Rate for Payer: Cigna Medicare Advantage |
$113.12
|
| Rate for Payer: Family Health Partners Medicaid |
$21.13
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$125.02
|
| Rate for Payer: Healthy Blue Medicaid |
$22.82
|
| Rate for Payer: Home State Health Plan Exchange |
$113.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.13
|
| Rate for Payer: Humana Medicare |
$148.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.13
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.77
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.90
|
|
|
HC Alpha Melanocyte Stimulating Hormone - Quest
|
Facility
|
OP
|
$264.60
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
Px03018352033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$211.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$186.54
|
| Rate for Payer: Aetna Workers' Compensation |
$186.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$183.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$183.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$203.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$208.50
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$138.65
|
| Rate for Payer: Cigna Medicare Advantage |
$150.82
|
| Rate for Payer: Family Health Partners Medicaid |
$21.76
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$166.70
|
| Rate for Payer: Healthy Blue Medicaid |
$23.50
|
| Rate for Payer: Home State Health Plan Exchange |
$150.82
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.76
|
| Rate for Payer: Humana Medicare |
$198.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.76
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$198.45
|
| Rate for Payer: Provider Network of America Commercial |
$211.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$174.64
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.38
|
|
|
HC Alpha Melanocyte Stimulating Hormone - Quest
|
Facility
|
IP
|
$264.60
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
Px03018352033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$198.45 |
| 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 |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| 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 |
$198.45
|
| Rate for Payer: Provider Network of America Commercial |
$211.68
|
|
|
HC Alpha Subunit Hcg Tumr Morph - Ref Lab
|
Facility
|
OP
|
$264.60
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
Px03018352025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$211.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$186.54
|
| Rate for Payer: Aetna Workers' Compensation |
$186.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$183.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$183.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$203.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$208.50
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$138.65
|
| Rate for Payer: Cigna Medicare Advantage |
$150.82
|
| Rate for Payer: Family Health Partners Medicaid |
$21.76
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$166.70
|
| Rate for Payer: Healthy Blue Medicaid |
$23.50
|
| Rate for Payer: Home State Health Plan Exchange |
$150.82
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.76
|
| Rate for Payer: Humana Medicare |
$198.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.76
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$198.45
|
| Rate for Payer: Provider Network of America Commercial |
$211.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$174.64
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.38
|
|
|
HC Alpha Subunit Hcg Tumr Morph - Ref Lab
|
Facility
|
IP
|
$264.60
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
Px03018352025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$198.45 |
| 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 |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| 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 |
$198.45
|
| Rate for Payer: Provider Network of America Commercial |
$211.68
|
|
|
HC Amino Acids 1 Quantitative Each Specimen
|
Facility
|
IP
|
$302.40
|
|
|
Service Code
|
CPT 82131
|
| Hospital Charge Code |
Px03018213103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$226.80 |
| 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 |
$302.40
|
| Rate for Payer: Cash Price |
$302.40
|
| 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 |
$226.80
|
| Rate for Payer: Provider Network of America Commercial |
$241.92
|
|
