|
HC Anna -Arup
|
Facility
|
IP
|
$359.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
Px03028625513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$269.32 |
| 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 |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| 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 |
$269.32
|
| Rate for Payer: Provider Network of America Commercial |
$287.28
|
|
|
HC Anna -Arup
|
Facility
|
OP
|
$359.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
Px03028625513
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$287.28 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$253.17
|
| Rate for Payer: Aetna Workers' Compensation |
$253.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$248.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$248.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$282.97
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$282.97
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$282.97
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$276.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$282.97
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cigna Commercial |
$188.17
|
| Rate for Payer: Cigna Medicare Advantage |
$204.69
|
| Rate for Payer: Family Health Partners Medicaid |
$15.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$226.23
|
| Rate for Payer: Healthy Blue Medicaid |
$16.41
|
| Rate for Payer: Home State Health Plan Exchange |
$204.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.19
|
| Rate for Payer: Humana Medicare |
$269.32
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.19
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$269.32
|
| Rate for Payer: Provider Network of America Commercial |
$287.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$237.01
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.44
|
|
|
HC Anorectal Exam
|
Facility
|
IP
|
$6,090.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
Px07504599001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$875.00 |
| 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 |
$6,090.00
|
| Rate for Payer: Cash Price |
$6,090.00
|
| 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 |
$4,567.50
|
| Rate for Payer: Provider Network of America Commercial |
$4,872.00
|
|
|
HC Anorectal Exam
|
Facility
|
OP
|
$6,090.00
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
Px07504599001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,637.22 |
| Max. Negotiated Rate |
$6,090.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,220.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,220.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$4,798.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$4,798.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$4,798.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$4,689.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$4,798.92
|
| Rate for Payer: Cash Price |
$6,090.00
|
| Rate for Payer: Cash Price |
$6,090.00
|
| Rate for Payer: Cigna Commercial |
$4,037.67
|
| Rate for Payer: Cigna Medicare Advantage |
$3,471.30
|
| Rate for Payer: Family Health Partners Medicaid |
$3,502.95
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$3,836.70
|
| Rate for Payer: Healthy Blue Medicaid |
$3,783.19
|
| Rate for Payer: Home State Health Plan Exchange |
$3,471.30
|
| Rate for Payer: Home State Health Plan Medicaid |
$3,502.95
|
| Rate for Payer: Humana Medicare |
$4,567.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$3,502.95
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,567.50
|
| Rate for Payer: Provider Network of America Commercial |
$4,872.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,019.40
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,090.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,637.22
|
|
|
HC Anoscopy and Biopsy - Endoscopy, Anus
|
Facility
|
OP
|
$2,625.00
|
|
|
Service Code
|
CPT 46606
|
| Hospital Charge Code |
Px07504660601
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$1,136.96 |
| Max. Negotiated Rate |
$2,625.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$1,819.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$1,819.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,068.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,068.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,068.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,021.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,068.50
|
| Rate for Payer: Cash Price |
$2,625.00
|
| Rate for Payer: Cash Price |
$2,625.00
|
| Rate for Payer: Cigna Commercial |
$1,740.38
|
| Rate for Payer: Cigna Medicare Advantage |
$1,496.25
|
| Rate for Payer: Family Health Partners Medicaid |
$1,510.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,653.75
|
| Rate for Payer: Healthy Blue Medicaid |
$1,631.01
|
| Rate for Payer: Home State Health Plan Exchange |
$1,496.25
|
| Rate for Payer: Home State Health Plan Medicaid |
$1,510.19
|
| Rate for Payer: Humana Medicare |
$1,968.75
|
| Rate for Payer: Mercy CarePlus Medicaid |
$1,510.19
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,968.75
|
| Rate for Payer: Provider Network of America Commercial |
$2,100.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,732.50
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$2,625.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,136.96
|
|
|
HC Anoscopy and Biopsy - Endoscopy, Anus
|
Facility
|
IP
|
$2,625.00
|
|
|
Service Code
|
CPT 46606
|
| Hospital Charge Code |
Px07504660601
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,968.75
|
| 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 |
$2,625.00
|
| Rate for Payer: Cash Price |
$2,625.00
|
| 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: Provider Network of America Commercial |
$2,100.00
|
|
|
HC Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd
|
Facility
|
OP
|
$262.50
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
Px07614660001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.42 |
| Max. Negotiated Rate |
$262.50 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$185.06
|
| Rate for Payer: Aetna Workers' Compensation |
$185.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$181.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$181.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$206.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$206.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$206.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$202.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$206.85
|
| Rate for Payer: Cash Price |
$262.50
|
| Rate for Payer: Cash Price |
$262.50
|
| Rate for Payer: Cigna Commercial |
$160.65
|
| Rate for Payer: Cigna Medicare Advantage |
$149.62
|
| Rate for Payer: Family Health Partners Medicaid |
$167.92
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$165.38
|
| Rate for Payer: Healthy Blue Medicaid |
$181.35
|
| Rate for Payer: Home State Health Plan Exchange |
$149.62
|
| Rate for Payer: Home State Health Plan Medicaid |
$167.92
|
| Rate for Payer: Humana Medicare |
$196.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$167.92
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$196.88
|
| Rate for Payer: Provider Network of America Commercial |
$210.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$173.25
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$262.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$126.42
|
|
|
HC Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd
|
Facility
|
IP
|
$262.50
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
Px07614660001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.88 |
| 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 |
$262.50
|
| Rate for Payer: Cash Price |
$262.50
|
| 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 |
$196.88
|
| Rate for Payer: Provider Network of America Commercial |
$210.00
|
|
|
HC Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd - Endoscopy, Anus
|
Facility
|
IP
|
$156.37
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
Px07504660001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$117.28 |
| 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 |
$156.37
|
| Rate for Payer: Cash Price |
$156.37
|
| 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 |
$117.28
|
| Rate for Payer: Provider Network of America Commercial |
$125.10
|
|
|
HC Anoscopy Dx W/Collj Spec Br/Wa Spx When Prfrmd - Endoscopy, Anus
|
Facility
|
OP
|
$156.37
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
Px07504660001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$89.13 |
| Max. Negotiated Rate |
$181.35 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$108.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$108.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$123.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$123.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$123.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$120.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$123.22
|
| Rate for Payer: Cash Price |
$156.37
|
| Rate for Payer: Cash Price |
$156.37
|
| Rate for Payer: Cigna Commercial |
$103.67
|
| Rate for Payer: Cigna Medicare Advantage |
$89.13
|
| Rate for Payer: Family Health Partners Medicaid |
$167.92
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$98.51
|
| Rate for Payer: Healthy Blue Medicaid |
$181.35
|
| Rate for Payer: Home State Health Plan Exchange |
$89.13
|
| Rate for Payer: Home State Health Plan Medicaid |
$167.92
|
| Rate for Payer: Humana Medicare |
$117.28
|
| Rate for Payer: Mercy CarePlus Medicaid |
$167.92
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$117.28
|
| Rate for Payer: Provider Network of America Commercial |
$125.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$156.37
|
| Rate for Payer: UnitedHealthcare Medicaid |
$126.42
|
|
|
HC Anrct Xm Surg Req Anes General Spi/Edrl Dx
|
Facility
|
IP
|
$6,079.50
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
Px03614599001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$875.00 |
| 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 |
$6,079.50
|
| Rate for Payer: Cash Price |
$6,079.50
|
| 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 |
$4,559.62
|
| Rate for Payer: Provider Network of America Commercial |
$4,863.60
|
|
|
HC Anrct Xm Surg Req Anes General Spi/Edrl Dx
|
Facility
|
OP
|
$6,079.50
|
|
|
Service Code
|
CPT 45990
|
| Hospital Charge Code |
Px03614599001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,637.22 |
| Max. Negotiated Rate |
$6,079.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,213.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,213.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$4,790.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$4,790.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$4,790.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$4,681.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$4,790.65
|
| Rate for Payer: Cash Price |
$6,079.50
|
| Rate for Payer: Cash Price |
$6,079.50
|
| Rate for Payer: Cigna Commercial |
$4,030.71
|
| Rate for Payer: Cigna Medicare Advantage |
$3,465.32
|
| Rate for Payer: Family Health Partners Medicaid |
$3,502.95
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$3,830.09
|
| Rate for Payer: Healthy Blue Medicaid |
$3,783.19
|
| Rate for Payer: Home State Health Plan Exchange |
$3,465.32
|
| Rate for Payer: Home State Health Plan Medicaid |
$3,502.95
|
| Rate for Payer: Humana Medicare |
$4,559.62
|
| Rate for Payer: Mercy CarePlus Medicaid |
$3,502.95
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,559.62
|
| Rate for Payer: Provider Network of America Commercial |
$4,863.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,012.47
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,079.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,637.22
|
|
|
HC Antepartum Care Only 7/> Visits
|
Facility
|
IP
|
$1,292.55
|
|
|
Service Code
|
CPT 59426
|
| Hospital Charge Code |
Px05105942601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$875.00 |
| 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 |
$1,292.55
|
| Rate for Payer: Cash Price |
$1,292.55
|
| 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: Provider Network of America Commercial |
$1,034.04
|
|
|
HC Antepartum Care Only 7/> Visits
|
Facility
|
OP
|
$1,292.55
|
|
|
Service Code
|
CPT 59426
|
| Hospital Charge Code |
Px05105942601
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$736.75 |
| Max. Negotiated Rate |
$1,292.55 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$911.25
|
| Rate for Payer: Aetna Workers' Compensation |
$911.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$895.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$895.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$1,018.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$1,018.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$1,018.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$995.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$1,018.53
|
| Rate for Payer: Cash Price |
$1,292.55
|
| Rate for Payer: Cigna Medicare Advantage |
$736.75
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$814.31
|
| Rate for Payer: Home State Health Plan Exchange |
$736.75
|
| Rate for Payer: Humana Medicare |
$969.41
|
| Rate for Payer: Provider Network of America Commercial |
$1,034.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$853.08
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,292.55
|
|
|
HC Antibiotic Culture Sensitivity Mic Each
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
Px03068718603
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$10.91
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$11.78
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.91
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.91
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.21
|
|
|
HC Antibiotic Culture Sensitivity Mic Each
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
Px03068718603
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$102.38 |
| 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 |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| 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 |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Antibiotic Sens,Disk,Each - Susceptbility Disk
|
Facility
|
OP
|
$162.75
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
Px03068718401
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.09 |
| Max. Negotiated Rate |
$130.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$114.74
|
| Rate for Payer: Aetna Workers' Compensation |
$114.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$112.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$112.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$128.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$128.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$128.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$125.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$128.25
|
| Rate for Payer: Cash Price |
$162.75
|
| Rate for Payer: Cash Price |
$162.75
|
| Rate for Payer: Cigna Commercial |
$85.28
|
| Rate for Payer: Cigna Medicare Advantage |
$92.77
|
| Rate for Payer: Family Health Partners Medicaid |
$9.42
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$102.53
|
| Rate for Payer: Healthy Blue Medicaid |
$10.18
|
| Rate for Payer: Home State Health Plan Exchange |
$92.77
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.42
|
| Rate for Payer: Humana Medicare |
$122.06
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.42
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$122.06
|
| Rate for Payer: Provider Network of America Commercial |
$130.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$107.42
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.09
|
|
|
HC Antibiotic Sens,Disk,Each - Susceptbility Disk
|
Facility
|
IP
|
$162.75
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
Px03068718401
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$122.06 |
| 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 |
$162.75
|
| Rate for Payer: Cash Price |
$162.75
|
| 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 |
$122.06
|
| Rate for Payer: Provider Network of America Commercial |
$130.20
|
|
|
HC Antibiotic Sens,Mic,Each - Susceptibility
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
Px03068718601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$102.38 |
| 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 |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| 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 |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Antibiotic Sens,Mic,Each - Susceptibility
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
Px03068718601
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$10.91
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$11.78
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.91
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.91
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.65
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.21
|
|
|
HC Antibody Treponema Pallidum - Fta Antibodies, Igg and Igm
|
Facility
|
IP
|
$114.45
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
Px03028678002
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$85.84 |
| 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 |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| 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 |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
|
|
HC Antibody Treponema Pallidum - Fta Antibodies, Igg and Igm
|
Facility
|
OP
|
$114.45
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
Px03028678002
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$80.69
|
| Rate for Payer: Aetna Workers' Compensation |
$80.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$88.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$90.19
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cigna Commercial |
$59.97
|
| Rate for Payer: Cigna Medicare Advantage |
$65.24
|
| Rate for Payer: Family Health Partners Medicaid |
$16.69
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$72.10
|
| Rate for Payer: Healthy Blue Medicaid |
$18.02
|
| Rate for Payer: Home State Health Plan Exchange |
$65.24
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.69
|
| Rate for Payer: Humana Medicare |
$85.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.69
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.56
|
|
|
HC Antibody Treponema Pallidum - T. Pallidum Confirmatory
|
Facility
|
OP
|
$114.45
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
Px03028678001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.56 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$80.69
|
| Rate for Payer: Aetna Workers' Compensation |
$80.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$88.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$90.19
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cigna Commercial |
$59.97
|
| Rate for Payer: Cigna Medicare Advantage |
$65.24
|
| Rate for Payer: Family Health Partners Medicaid |
$16.69
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$72.10
|
| Rate for Payer: Healthy Blue Medicaid |
$18.02
|
| Rate for Payer: Home State Health Plan Exchange |
$65.24
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.69
|
| Rate for Payer: Humana Medicare |
$85.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.69
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.56
|
|
|
HC Antibody Treponema Pallidum - T. Pallidum Confirmatory
|
Facility
|
IP
|
$114.45
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
Px03028678001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$85.84 |
| 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 |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| 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 |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
|
|
HC Antidepressants Tricyclic Other Cyclicals 1 or 2 - Amitriptyline Lvl
|
Facility
|
IP
|
$57.80
|
|
|
Service Code
|
CPT 80335
|
| Hospital Charge Code |
Px03018033502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.35 |
| 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 |
$57.80
|
| Rate for Payer: Cash Price |
$57.80
|
| 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 |
$43.35
|
| Rate for Payer: Provider Network of America Commercial |
$46.24
|
|
