|
HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US
|
Facility
|
OP
|
$609.35
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
Px03612060001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$609.35 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$422.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$422.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$480.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$480.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$480.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$469.20
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$480.17
|
| Rate for Payer: Cash Price |
$609.35
|
| Rate for Payer: Cash Price |
$609.35
|
| Rate for Payer: Cigna Commercial |
$404.00
|
| Rate for Payer: Cigna Medicare Advantage |
$347.33
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$383.89
|
| Rate for Payer: Healthy Blue Medicaid |
$418.37
|
| Rate for Payer: Home State Health Plan Exchange |
$347.33
|
| Rate for Payer: Home State Health Plan Medicaid |
$387.38
|
| Rate for Payer: Humana Medicare |
$457.01
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$457.01
|
| Rate for Payer: Provider Network of America Commercial |
$487.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$402.17
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$609.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
|
|
HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US
|
Facility
|
IP
|
$609.35
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
Px03612060001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$457.01 |
| 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 |
$609.35
|
| Rate for Payer: Cash Price |
$609.35
|
| 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 |
$457.01
|
| Rate for Payer: Provider Network of America Commercial |
$487.48
|
|
|
HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US
|
Facility
|
OP
|
$644.70
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
Px07612060001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$644.70 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$454.51
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$409.13
|
| Rate for Payer: Aetna Workers' Compensation |
$454.51
|
| Rate for Payer: Aetna Workers' Compensation |
$409.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$446.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$402.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$446.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$402.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$508.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$457.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$508.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$457.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$457.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$508.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$446.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$496.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$508.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$457.30
|
| Rate for Payer: Cash Price |
$644.70
|
| Rate for Payer: Cash Price |
$644.70
|
| Rate for Payer: Cash Price |
$580.33
|
| Rate for Payer: Cash Price |
$580.33
|
| Rate for Payer: Cigna Commercial |
$394.56
|
| Rate for Payer: Cigna Commercial |
$355.16
|
| Rate for Payer: Cigna Medicare Advantage |
$330.79
|
| Rate for Payer: Cigna Medicare Advantage |
$367.48
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$406.16
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$365.61
|
| Rate for Payer: Healthy Blue Medicaid |
$418.37
|
| Rate for Payer: Healthy Blue Medicaid |
$418.37
|
| Rate for Payer: Home State Health Plan Exchange |
$367.48
|
| Rate for Payer: Home State Health Plan Exchange |
$330.79
|
| Rate for Payer: Home State Health Plan Medicaid |
$387.38
|
| Rate for Payer: Home State Health Plan Medicaid |
$387.38
|
| Rate for Payer: Humana Medicare |
$435.25
|
| Rate for Payer: Humana Medicare |
$483.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$435.25
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$483.52
|
| Rate for Payer: Provider Network of America Commercial |
$464.26
|
| Rate for Payer: Provider Network of America Commercial |
$515.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$383.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$425.50
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$580.33
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$644.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
|
|
HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US
|
Facility
|
IP
|
$644.70
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
Px07612060001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$483.52 |
| 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 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 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: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$580.33
|
| Rate for Payer: Cash Price |
$644.70
|
| Rate for Payer: Cash Price |
$644.70
|
| Rate for Payer: Cash Price |
$580.33
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$483.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$435.25
|
| Rate for Payer: Provider Network of America Commercial |
$515.76
|
| Rate for Payer: Provider Network of America Commercial |
$464.26
|
|
|
HC Arthrocentesis Aspir&/Inj Small Jt/Bursa W/O US
|
Facility
|
IP
|
$609.35
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
Px03602060001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$457.01 |
| 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 |
$609.35
|
| Rate for Payer: Cash Price |
$609.35
|
| 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 |
$457.01
|
| Rate for Payer: Provider Network of America Commercial |
$487.48
|
|
|
HC Arthrocentesis Im/Joint
|
Facility
|
OP
|
$918.75
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
Px07612060502
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$918.75 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$647.72
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$564.00
|
| Rate for Payer: Aetna Workers' Compensation |
$647.72
|
| Rate for Payer: Aetna Workers' Compensation |
$564.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$636.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$554.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$636.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$554.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$723.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$630.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$723.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$630.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$630.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$723.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$616.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$707.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$723.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$630.40
|
| Rate for Payer: Cash Price |
$918.75
|
| Rate for Payer: Cash Price |
$918.75
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cigna Commercial |
$562.27
|
| Rate for Payer: Cigna Commercial |
$489.60
|
| Rate for Payer: Cigna Medicare Advantage |
$456.00
|
| Rate for Payer: Cigna Medicare Advantage |
$523.69
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$578.81
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$504.00
|
| Rate for Payer: Healthy Blue Medicaid |
$418.37
|
| Rate for Payer: Healthy Blue Medicaid |
$418.37
|
| Rate for Payer: Home State Health Plan Exchange |
$523.69
|
| Rate for Payer: Home State Health Plan Exchange |
$456.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$387.38
|
| Rate for Payer: Home State Health Plan Medicaid |
$387.38
|
| Rate for Payer: Humana Medicare |
$600.00
|
| Rate for Payer: Humana Medicare |
$689.06
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$600.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$689.06
|
| Rate for Payer: Provider Network of America Commercial |
$640.00
|
| Rate for Payer: Provider Network of America Commercial |
$735.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$528.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$606.38
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$800.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$918.75
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
|
|
HC Arthrocentesis Im/Joint
|
Facility
|
IP
|
$918.75
|
|
|
Service Code
|
CPT 20605
|
| Hospital Charge Code |
Px07612060502
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$689.06 |
| 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 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 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: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cash Price |
$918.75
|
| Rate for Payer: Cash Price |
$918.75
|
| Rate for Payer: Cash Price |
$800.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$689.06
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$600.00
|
| Rate for Payer: Provider Network of America Commercial |
$735.00
|
| Rate for Payer: Provider Network of America Commercial |
$640.00
|
|
|
HC Arthrogram of Hip - Xr Hip Arthrogram Left
|
Facility
|
IP
|
$5,441.10
|
|
|
Service Code
|
CPT 73525 LT
|
| Hospital Charge Code |
Px03227352501
|
|
Hospital Revenue Code
|
322
|
| 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 |
$5,441.10
|
| Rate for Payer: Cash Price |
$5,441.10
|
| 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 |
$4,080.82
|
| Rate for Payer: Provider Network of America Commercial |
$4,352.88
|
|
|
HC Arthrogram of Hip - Xr Hip Arthrogram Left
|
Facility
|
OP
|
$5,441.10
|
|
|
Service Code
|
CPT 73525 LT
|
| Hospital Charge Code |
Px03227352501
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$5,441.10 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$3,835.98
|
| Rate for Payer: Aetna Workers' Compensation |
$3,835.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$3,770.68
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$3,770.68
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$4,287.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$4,287.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$4,287.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$4,189.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$4,287.59
|
| Rate for Payer: Cash Price |
$5,441.10
|
| Rate for Payer: Cash Price |
$5,441.10
|
| Rate for Payer: Cigna Commercial |
$3,329.95
|
| Rate for Payer: Cigna Medicare Advantage |
$3,101.43
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$3,427.89
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$3,101.43
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$4,080.82
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,080.82
|
| Rate for Payer: Provider Network of America Commercial |
$4,352.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,591.13
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5,441.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Hip - Xr Hip Arthrogram Right
|
Facility
|
IP
|
$5,441.10
|
|
|
Service Code
|
CPT 73525 RT
|
| Hospital Charge Code |
Px03227352502
|
|
Hospital Revenue Code
|
322
|
| 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 |
$5,441.10
|
| Rate for Payer: Cash Price |
$5,441.10
|
| 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 |
$4,080.82
|
| Rate for Payer: Provider Network of America Commercial |
$4,352.88
|
|
|
HC Arthrogram of Hip - Xr Hip Arthrogram Right
|
Facility
|
OP
|
$5,441.10
|
|
|
Service Code
|
CPT 73525 RT
|
| Hospital Charge Code |
Px03227352502
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$5,441.10 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$3,835.98
|
| Rate for Payer: Aetna Workers' Compensation |
$3,835.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$3,770.68
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$3,770.68
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$4,287.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$4,287.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$4,287.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$4,189.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$4,287.59
|
| Rate for Payer: Cash Price |
$5,441.10
|
| Rate for Payer: Cash Price |
$5,441.10
|
| Rate for Payer: Cigna Commercial |
$3,329.95
|
| Rate for Payer: Cigna Medicare Advantage |
$3,101.43
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$3,427.89
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$3,101.43
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$4,080.82
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,080.82
|
| Rate for Payer: Provider Network of America Commercial |
$4,352.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$3,591.13
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5,441.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Knee Joint - Xr Knee Arthrogram Bilateral
|
Facility
|
IP
|
$858.90
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
Px03227358003
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$644.17 |
| 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 |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| 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 |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
|
|
HC Arthrogram of Knee Joint - Xr Knee Arthrogram Bilateral
|
Facility
|
OP
|
$858.90
|
|
|
Service Code
|
CPT 73580
|
| Hospital Charge Code |
Px03227358003
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$858.90 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$605.52
|
| Rate for Payer: Aetna Workers' Compensation |
$605.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$661.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$676.81
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cigna Commercial |
$525.65
|
| Rate for Payer: Cigna Medicare Advantage |
$489.57
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$541.11
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$489.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$644.17
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$566.87
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$858.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Knee Joint - Xr Knee Arthrogram Left
|
Facility
|
OP
|
$858.90
|
|
|
Service Code
|
CPT 73580 LT
|
| Hospital Charge Code |
Px03227358001
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$858.90 |
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$605.52
|
| Rate for Payer: Aetna Workers' Compensation |
$605.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$661.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$676.81
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cigna Commercial |
$525.65
|
| Rate for Payer: Cigna Medicare Advantage |
$489.57
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$541.11
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$489.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$644.17
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$566.87
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$858.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Knee Joint - Xr Knee Arthrogram Left
|
Facility
|
IP
|
$858.90
|
|
|
Service Code
|
CPT 73580 LT
|
| Hospital Charge Code |
Px03227358001
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$644.17 |
| 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 |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| 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 |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
|
|
HC Arthrogram of Knee Joint - Xr Knee Arthrogram Right
|
Facility
|
IP
|
$858.90
|
|
|
Service Code
|
CPT 73580 RT
|
| Hospital Charge Code |
Px03227358002
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$644.17 |
| 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 |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| 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 |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
|
|
HC Arthrogram of Knee Joint - Xr Knee Arthrogram Right
|
Facility
|
OP
|
$858.90
|
|
|
Service Code
|
CPT 73580 RT
|
| Hospital Charge Code |
Px03227358002
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$858.90 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$605.52
|
| Rate for Payer: Aetna Workers' Compensation |
$605.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$661.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$676.81
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cigna Commercial |
$525.65
|
| Rate for Payer: Cigna Medicare Advantage |
$489.57
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$541.11
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$489.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$644.17
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$566.87
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$858.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Shoulder - Xr Shoulder Arthrogram Left
|
Facility
|
IP
|
$1,497.30
|
|
|
Service Code
|
CPT 73040 LT
|
| Hospital Charge Code |
Px03227304001
|
|
Hospital Revenue Code
|
322
|
| 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 |
$1,497.30
|
| Rate for Payer: Cash Price |
$1,497.30
|
| 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 |
$1,122.97
|
| Rate for Payer: Provider Network of America Commercial |
$1,197.84
|
|
|
HC Arthrogram of Shoulder - Xr Shoulder Arthrogram Left
|
Facility
|
OP
|
$1,497.30
|
|
|
Service Code
|
CPT 73040 LT
|
| Hospital Charge Code |
Px03227304001
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$1,497.30 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$1,055.60
|
| Rate for Payer: Aetna Workers' Compensation |
$1,055.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$1,037.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$1,037.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$1,179.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$1,179.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$1,179.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$1,152.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$1,179.87
|
| Rate for Payer: Cash Price |
$1,497.30
|
| Rate for Payer: Cash Price |
$1,497.30
|
| Rate for Payer: Cigna Commercial |
$916.35
|
| Rate for Payer: Cigna Medicare Advantage |
$853.46
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$943.30
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$853.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$1,122.97
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,122.97
|
| Rate for Payer: Provider Network of America Commercial |
$1,197.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$988.22
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,497.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Shoulder - Xr Shoulder Arthrogram Right
|
Facility
|
IP
|
$1,497.30
|
|
|
Service Code
|
CPT 73040 RT
|
| Hospital Charge Code |
Px03227304002
|
|
Hospital Revenue Code
|
322
|
| 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 |
$1,497.30
|
| Rate for Payer: Cash Price |
$1,497.30
|
| 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 |
$1,122.97
|
| Rate for Payer: Provider Network of America Commercial |
$1,197.84
|
|
|
HC Arthrogram of Shoulder - Xr Shoulder Arthrogram Right
|
Facility
|
OP
|
$1,497.30
|
|
|
Service Code
|
CPT 73040 RT
|
| Hospital Charge Code |
Px03227304002
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$1,497.30 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$1,055.60
|
| Rate for Payer: Aetna Workers' Compensation |
$1,055.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$1,037.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$1,037.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$1,179.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$1,179.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$1,179.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$1,152.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$1,179.87
|
| Rate for Payer: Cash Price |
$1,497.30
|
| Rate for Payer: Cash Price |
$1,497.30
|
| Rate for Payer: Cigna Commercial |
$916.35
|
| Rate for Payer: Cigna Medicare Advantage |
$853.46
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$943.30
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$853.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$1,122.97
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,122.97
|
| Rate for Payer: Provider Network of America Commercial |
$1,197.84
|
| Rate for Payer: UnitedHealthcare Commercial |
$988.22
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,497.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Wrist - Xr Wrist Arthrogram Left
|
Facility
|
OP
|
$858.90
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
Px03227311502
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$858.90 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$605.52
|
| Rate for Payer: Aetna Workers' Compensation |
$605.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$661.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$676.81
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cigna Commercial |
$525.65
|
| Rate for Payer: Cigna Medicare Advantage |
$489.57
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$541.11
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$489.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$644.17
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$566.87
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$858.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
|
HC Arthrogram of Wrist - Xr Wrist Arthrogram Left
|
Facility
|
IP
|
$858.90
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
Px03227311502
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$644.17 |
| 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 |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| 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 |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
|
|
HC Arthrogram of Wrist - Xr Wrist Arthrogram Right
|
Facility
|
IP
|
$858.90
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
Px03227311501
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$644.17 |
| 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 |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| 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 |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
|
|
HC Arthrogram of Wrist - Xr Wrist Arthrogram Right
|
Facility
|
OP
|
$858.90
|
|
|
Service Code
|
CPT 73115
|
| Hospital Charge Code |
Px03227311501
|
|
Hospital Revenue Code
|
322
|
| Min. Negotiated Rate |
$331.47 |
| Max. Negotiated Rate |
$858.90 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$605.52
|
| Rate for Payer: Aetna Workers' Compensation |
$605.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$595.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$676.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$661.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$676.81
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cash Price |
$858.90
|
| Rate for Payer: Cigna Commercial |
$525.65
|
| Rate for Payer: Cigna Medicare Advantage |
$489.57
|
| Rate for Payer: Family Health Partners Medicaid |
$440.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$541.11
|
| Rate for Payer: Healthy Blue Medicaid |
$475.51
|
| Rate for Payer: Home State Health Plan Exchange |
$489.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$440.29
|
| Rate for Payer: Humana Medicare |
$644.17
|
| Rate for Payer: Mercy CarePlus Medicaid |
$440.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$644.17
|
| Rate for Payer: Provider Network of America Commercial |
$687.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$566.87
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$858.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$331.47
|
|
