|
HC Anti-Mullerian Hormone
|
Facility
|
IP
|
$129.15
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
Px03018239707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$96.86 |
| 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 |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| 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 |
$96.86
|
| Rate for Payer: Provider Network of America Commercial |
$103.32
|
|
|
HC Anti-Mullerian Hormone
|
Facility
|
OP
|
$129.15
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
Px03018239707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$103.32 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$91.05
|
| Rate for Payer: Aetna Workers' Compensation |
$91.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$89.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$101.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$101.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$101.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$99.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$101.77
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cash Price |
$129.15
|
| Rate for Payer: Cigna Commercial |
$67.67
|
| Rate for Payer: Cigna Medicare Advantage |
$73.62
|
| Rate for Payer: Family Health Partners Medicaid |
$17.79
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$81.36
|
| Rate for Payer: Healthy Blue Medicaid |
$19.22
|
| Rate for Payer: Home State Health Plan Exchange |
$73.62
|
| Rate for Payer: Home State Health Plan Medicaid |
$17.79
|
| Rate for Payer: Humana Medicare |
$96.86
|
| Rate for Payer: Mercy CarePlus Medicaid |
$17.79
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$96.86
|
| Rate for Payer: Provider Network of America Commercial |
$103.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.24
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.40
|
|
|
HC Antinuclear Antibodies - Ana (Antinuclear Antibodies)
|
Facility
|
OP
|
$200.45
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
Px03028603801
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.47 |
| Max. Negotiated Rate |
$160.36 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$141.32
|
| Rate for Payer: Aetna Workers' Compensation |
$141.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$138.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$138.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$157.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$157.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$157.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$154.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$157.95
|
| Rate for Payer: Cash Price |
$200.45
|
| Rate for Payer: Cash Price |
$200.45
|
| Rate for Payer: Cigna Commercial |
$105.04
|
| Rate for Payer: Cigna Medicare Advantage |
$114.26
|
| Rate for Payer: Family Health Partners Medicaid |
$15.23
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$126.28
|
| Rate for Payer: Healthy Blue Medicaid |
$16.45
|
| Rate for Payer: Home State Health Plan Exchange |
$114.26
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.23
|
| Rate for Payer: Humana Medicare |
$150.34
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.23
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$150.34
|
| Rate for Payer: Provider Network of America Commercial |
$160.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$132.30
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.47
|
|
|
HC Antinuclear Antibodies - Ana (Antinuclear Antibodies)
|
Facility
|
IP
|
$200.45
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
Px03028603801
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$150.34 |
| 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 |
$200.45
|
| Rate for Payer: Cash Price |
$200.45
|
| 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 |
$150.34
|
| Rate for Payer: Provider Network of America Commercial |
$160.36
|
|
|
HC Antinuclear Antibodies Titer - Ana Body Fluid
|
Facility
|
OP
|
$130.20
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
Px03028603901
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$104.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$91.79
|
| Rate for Payer: Aetna Workers' Compensation |
$91.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$90.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$90.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$100.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$102.60
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna Commercial |
$68.22
|
| Rate for Payer: Cigna Medicare Advantage |
$74.21
|
| Rate for Payer: Family Health Partners Medicaid |
$14.06
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$82.03
|
| Rate for Payer: Healthy Blue Medicaid |
$15.18
|
| Rate for Payer: Home State Health Plan Exchange |
$74.21
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.06
|
| Rate for Payer: Humana Medicare |
$97.65
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.06
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$97.65
|
| Rate for Payer: Provider Network of America Commercial |
$104.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.93
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.58
|
|
|
HC Antinuclear Antibodies Titer - Ana Body Fluid
|
Facility
|
IP
|
$130.20
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
Px03028603901
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$97.65 |
| 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 |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| 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 |
$97.65
|
| Rate for Payer: Provider Network of America Commercial |
$104.16
|
|
|
HC Antinuclear Antibodies Titer - Ana Titer
|
Facility
|
IP
|
$130.20
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
Px03028603902
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$97.65 |
| 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 |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| 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 |
$97.65
|
| Rate for Payer: Provider Network of America Commercial |
$104.16
|
|
|
HC Antinuclear Antibodies Titer - Ana Titer
|
Facility
|
OP
|
$130.20
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
Px03028603902
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.58 |
| Max. Negotiated Rate |
$104.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$91.79
|
| Rate for Payer: Aetna Workers' Compensation |
$91.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$90.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$90.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$102.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$100.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$102.60
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cash Price |
$130.20
|
| Rate for Payer: Cigna Commercial |
$68.22
|
| Rate for Payer: Cigna Medicare Advantage |
$74.21
|
| Rate for Payer: Family Health Partners Medicaid |
$14.06
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$82.03
|
| Rate for Payer: Healthy Blue Medicaid |
$15.18
|
| Rate for Payer: Home State Health Plan Exchange |
$74.21
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.06
|
| Rate for Payer: Humana Medicare |
$97.65
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.06
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$97.65
|
| Rate for Payer: Provider Network of America Commercial |
$104.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.93
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.58
|
|
|
HC ANTIPHOS HS Ab IgG
|
Facility
|
IP
|
$202.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
Px03018351626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$151.99 |
| 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 |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| 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 |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
|
|
HC ANTIPHOS HS Ab IgG
|
Facility
|
OP
|
$202.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
Px03018351626
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.94 |
| Max. Negotiated Rate |
$162.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$142.87
|
| Rate for Payer: Aetna Workers' Compensation |
$142.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$156.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$159.69
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cigna Commercial |
$106.19
|
| Rate for Payer: Cigna Medicare Advantage |
$115.51
|
| Rate for Payer: Family Health Partners Medicaid |
$14.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$127.67
|
| Rate for Payer: Healthy Blue Medicaid |
$15.69
|
| Rate for Payer: Home State Health Plan Exchange |
$115.51
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.53
|
| Rate for Payer: Humana Medicare |
$151.99
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$133.75
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.94
|
|
|
HC Antipsychotics Nos 1-3 Loxapine (Loxatine)
|
Facility
|
IP
|
$197.92
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
Px03018034202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.44 |
| 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 |
$197.92
|
| Rate for Payer: Cash Price |
$197.92
|
| 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 |
$148.44
|
| Rate for Payer: Provider Network of America Commercial |
$158.34
|
|
|
HC Antipsychotics Nos 1-3 Loxapine (Loxatine)
|
Facility
|
OP
|
$197.92
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
Px03018034202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.71 |
| Max. Negotiated Rate |
$197.92 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$139.53
|
| Rate for Payer: Aetna Workers' Compensation |
$139.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$137.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$137.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$155.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$155.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$155.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$152.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$155.96
|
| Rate for Payer: Cash Price |
$197.92
|
| Rate for Payer: Cigna Commercial |
$103.71
|
| Rate for Payer: Cigna Medicare Advantage |
$112.81
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$124.69
|
| Rate for Payer: Home State Health Plan Exchange |
$112.81
|
| Rate for Payer: Humana Medicare |
$148.44
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.44
|
| Rate for Payer: Provider Network of America Commercial |
$158.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.63
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$197.92
|
|
|
HC Antistreptolysin O Titer - Antistreptolysin O Titer
|
Facility
|
IP
|
$155.40
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
Px03028606001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$116.55 |
| 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 |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| 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 |
$116.55
|
| Rate for Payer: Provider Network of America Commercial |
$124.32
|
|
|
HC Antistreptolysin O Titer - Antistreptolysin O Titer
|
Facility
|
OP
|
$155.40
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
Px03028606001
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$124.32 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$109.56
|
| Rate for Payer: Aetna Workers' Compensation |
$109.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$107.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$107.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$122.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$122.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$122.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$119.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$122.46
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cash Price |
$155.40
|
| Rate for Payer: Cigna Commercial |
$81.43
|
| Rate for Payer: Cigna Medicare Advantage |
$88.58
|
| Rate for Payer: Family Health Partners Medicaid |
$9.20
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$97.90
|
| Rate for Payer: Healthy Blue Medicaid |
$9.93
|
| Rate for Payer: Home State Health Plan Exchange |
$88.58
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.20
|
| Rate for Payer: Humana Medicare |
$116.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.20
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$116.55
|
| Rate for Payer: Provider Network of America Commercial |
$124.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$102.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.92
|
|
|
HC Antithrombin III Test,Activ - Antithrombin III
|
Facility
|
OP
|
$256.20
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
Px03058530001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$204.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$180.62
|
| Rate for Payer: Aetna Workers' Compensation |
$180.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$177.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$177.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$197.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$201.89
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cigna Commercial |
$134.25
|
| Rate for Payer: Cigna Medicare Advantage |
$146.03
|
| Rate for Payer: Family Health Partners Medicaid |
$14.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$161.41
|
| Rate for Payer: Healthy Blue Medicaid |
$16.13
|
| Rate for Payer: Home State Health Plan Exchange |
$146.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.94
|
| Rate for Payer: Humana Medicare |
$192.15
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.94
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$192.15
|
| Rate for Payer: Provider Network of America Commercial |
$204.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$169.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.25
|
|
|
HC Antithrombin III Test,Activ - Antithrombin III
|
Facility
|
IP
|
$256.20
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
Px03058530001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$192.15 |
| 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 |
$256.20
|
| Rate for Payer: Cash Price |
$256.20
|
| 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 |
$192.15
|
| Rate for Payer: Provider Network of America Commercial |
$204.96
|
|
|
HC Antithrombin III Test,Activ - Antithrombin Panel
|
Facility
|
IP
|
$256.20
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
Px03058530002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$192.15 |
| 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 |
$256.20
|
| Rate for Payer: Cash Price |
$256.20
|
| 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 |
$192.15
|
| Rate for Payer: Provider Network of America Commercial |
$204.96
|
|
|
HC Antithrombin III Test,Activ - Antithrombin Panel
|
Facility
|
OP
|
$256.20
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
Px03058530002
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.25 |
| Max. Negotiated Rate |
$204.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$180.62
|
| Rate for Payer: Aetna Workers' Compensation |
$180.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$177.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$177.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$201.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$197.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$201.89
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cash Price |
$256.20
|
| Rate for Payer: Cigna Commercial |
$134.25
|
| Rate for Payer: Cigna Medicare Advantage |
$146.03
|
| Rate for Payer: Family Health Partners Medicaid |
$14.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$161.41
|
| Rate for Payer: Healthy Blue Medicaid |
$16.13
|
| Rate for Payer: Home State Health Plan Exchange |
$146.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.94
|
| Rate for Payer: Humana Medicare |
$192.15
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.94
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$192.15
|
| Rate for Payer: Provider Network of America Commercial |
$204.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$169.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.25
|
|
|
HC Apoe Alzheimer's Disease Panel
|
Facility
|
IP
|
$467.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
Px03008140104
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$350.25 |
| 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 |
$467.00
|
| Rate for Payer: Cash Price |
$467.00
|
| 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 |
$350.25
|
| Rate for Payer: Provider Network of America Commercial |
$373.60
|
|
|
HC Apoe Alzheimer's Disease Panel
|
Facility
|
OP
|
$467.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
Px03008140104
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$129.96 |
| Max. Negotiated Rate |
$373.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$329.24
|
| Rate for Payer: Aetna Workers' Compensation |
$329.24
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$323.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$323.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$368.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$368.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$368.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$359.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$368.00
|
| Rate for Payer: Cash Price |
$467.00
|
| Rate for Payer: Cash Price |
$467.00
|
| Rate for Payer: Cigna Commercial |
$244.71
|
| Rate for Payer: Cigna Medicare Advantage |
$266.19
|
| Rate for Payer: Family Health Partners Medicaid |
$172.62
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$294.21
|
| Rate for Payer: Healthy Blue Medicaid |
$186.43
|
| Rate for Payer: Home State Health Plan Exchange |
$266.19
|
| Rate for Payer: Home State Health Plan Medicaid |
$172.62
|
| Rate for Payer: Humana Medicare |
$350.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$172.62
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$350.25
|
| Rate for Payer: Provider Network of America Commercial |
$373.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$308.22
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$137.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$129.96
|
|
|
HC Appendectomy
|
Facility
|
OP
|
$7,688.10
|
|
|
Service Code
|
CPT 44950
|
| Hospital Charge Code |
Px03614495001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,382.22 |
| Max. Negotiated Rate |
$8,823.76 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5,327.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5,327.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$6,058.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$6,058.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$6,058.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,919.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$6,058.22
|
| Rate for Payer: Cash Price |
$7,688.10
|
| Rate for Payer: Cash Price |
$7,688.10
|
| Rate for Payer: Cigna Commercial |
$5,097.21
|
| Rate for Payer: Cigna Medicare Advantage |
$4,382.22
|
| Rate for Payer: Family Health Partners Medicaid |
$8,170.15
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,843.50
|
| Rate for Payer: Healthy Blue Medicaid |
$8,823.76
|
| Rate for Payer: Home State Health Plan Exchange |
$4,382.22
|
| Rate for Payer: Home State Health Plan Medicaid |
$8,170.15
|
| Rate for Payer: Humana Medicare |
$5,766.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8,170.15
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$5,766.07
|
| Rate for Payer: Provider Network of America Commercial |
$6,150.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,074.15
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7,688.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6,150.95
|
|
|
HC Appendectomy
|
Facility
|
IP
|
$7,688.10
|
|
|
Service Code
|
CPT 44950
|
| Hospital Charge Code |
Px03614495001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$6,150.48 |
| 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 |
$7,688.10
|
| Rate for Payer: Cash Price |
$7,688.10
|
| 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 |
$5,766.07
|
| Rate for Payer: Provider Network of America Commercial |
$6,150.48
|
|
|
HC Application Long Leg Cast
|
Facility
|
OP
|
$562.63
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
Px07612934501
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$265.75 |
| Max. Negotiated Rate |
$562.63 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$396.65
|
| Rate for Payer: Aetna Workers' Compensation |
$396.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$389.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$389.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$443.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$443.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$443.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$433.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$443.35
|
| Rate for Payer: Cash Price |
$562.63
|
| Rate for Payer: Cash Price |
$562.63
|
| Rate for Payer: Cigna Commercial |
$344.33
|
| Rate for Payer: Cigna Medicare Advantage |
$320.70
|
| Rate for Payer: Family Health Partners Medicaid |
$352.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$354.46
|
| Rate for Payer: Healthy Blue Medicaid |
$381.22
|
| Rate for Payer: Home State Health Plan Exchange |
$320.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$352.98
|
| Rate for Payer: Humana Medicare |
$421.97
|
| Rate for Payer: Mercy CarePlus Medicaid |
$352.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$421.97
|
| Rate for Payer: Provider Network of America Commercial |
$450.10
|
| Rate for Payer: UnitedHealthcare Commercial |
$371.34
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$562.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$265.75
|
|
|
HC Application Long Leg Cast
|
Facility
|
IP
|
$562.63
|
|
|
Service Code
|
CPT 29345
|
| Hospital Charge Code |
Px07612934501
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$421.97 |
| 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 |
$562.63
|
| Rate for Payer: Cash Price |
$562.63
|
| 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 |
$421.97
|
| Rate for Payer: Provider Network of America Commercial |
$450.10
|
|
|
HC Application Long Leg Splint
|
Facility
|
IP
|
$329.50
|
|
|
Service Code
|
CPT 29505
|
| Hospital Charge Code |
Px07612950501
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$247.12 |
| 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 |
$329.50
|
| Rate for Payer: Cash Price |
$329.50
|
| 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 |
$247.12
|
| Rate for Payer: Provider Network of America Commercial |
$263.60
|
|
