|
HC Arthroscopy Knee Diagnostic W/WO Synovial Bx Spx
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 29870
|
| Hospital Charge Code |
Px03612987001
|
|
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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthroscopy Knee Diagnostic W/WO Synovial Bx Spx
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 29870
|
| Hospital Charge Code |
Px03612987001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthroscopy Knee Synovectomy Limited Spx
|
Facility
|
OP
|
$6,604.87
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
Px03612987501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.87 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,577.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,577.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.64
|
| Rate for Payer: Cash Price |
$6,604.87
|
| Rate for Payer: Cash Price |
$6,604.87
|
| Rate for Payer: Cigna Commercial |
$4,379.03
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.78
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,161.07
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.78
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.65
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.65
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,359.21
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthroscopy Knee Synovectomy Limited Spx
|
Facility
|
IP
|
$6,604.87
|
|
|
Service Code
|
CPT 29875
|
| Hospital Charge Code |
Px03612987501
|
|
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 |
$6,604.87
|
| Rate for Payer: Cash Price |
$6,604.87
|
| 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 |
$4,953.65
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.90
|
|
|
HC Arthroscopy/ Removal FB
|
Facility
|
OP
|
$257.25
|
|
|
Service Code
|
CPT G0289
|
| Hospital Charge Code |
Px0360G028901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$146.63 |
| Max. Negotiated Rate |
$257.25 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$178.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$178.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$202.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$202.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$202.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$198.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$202.71
|
| Rate for Payer: Cash Price |
$257.25
|
| Rate for Payer: Cigna Commercial |
$170.56
|
| Rate for Payer: Cigna Medicare Advantage |
$146.63
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$162.07
|
| Rate for Payer: Home State Health Plan Exchange |
$146.63
|
| Rate for Payer: Humana Medicare |
$192.94
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$192.94
|
| Rate for Payer: Provider Network of America Commercial |
$205.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$169.78
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$257.25
|
|
|
HC Arthroscopy/ Removal FB
|
Facility
|
IP
|
$257.25
|
|
|
Service Code
|
CPT G0289
|
| Hospital Charge Code |
Px0360G028901
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$192.94 |
| 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 |
$257.25
|
| Rate for Payer: Cash Price |
$257.25
|
| 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 |
$192.94
|
| Rate for Payer: Provider Network of America Commercial |
$205.80
|
|
|
HC Arthroscopy Shoulder Debridement
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
Px03602982201
|
|
Hospital Revenue Code
|
360
|
| 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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthroscopy Shoulder Debridement
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 29822
|
| Hospital Charge Code |
Px03602982201
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthroscopy With Meniscus Repair
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
Px03602988201
|
|
Hospital Revenue Code
|
360
|
| 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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthroscopy With Meniscus Repair
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 29882
|
| Hospital Charge Code |
Px03602988201
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthrotomy Ankle
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
Px03612761001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthrotomy Ankle
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 27626
|
| Hospital Charge Code |
Px03612762601
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthrotomy Ankle
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 27626
|
| Hospital Charge Code |
Px03612762601
|
|
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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthrotomy Ankle
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 27610
|
| Hospital Charge Code |
Px03612761001
|
|
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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthrotomy Knee / Exploration
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
Px03612731001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthrotomy Knee / Exploration
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 27310
|
| Hospital Charge Code |
Px03612731001
|
|
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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthrp Interpos Intercarpal/Metacarpal Joints
|
Facility
|
OP
|
$7,220.85
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
Px03602544701
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$7,220.85 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5,004.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5,004.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,690.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,690.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,690.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,560.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,690.03
|
| Rate for Payer: Cash Price |
$7,220.85
|
| Rate for Payer: Cash Price |
$7,220.85
|
| Rate for Payer: Cigna Commercial |
$4,787.42
|
| Rate for Payer: Cigna Medicare Advantage |
$4,115.88
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,549.14
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$4,115.88
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$5,415.64
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$5,415.64
|
| Rate for Payer: Provider Network of America Commercial |
$5,776.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,765.76
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7,220.85
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Arthrp Interpos Intercarpal/Metacarpal Joints
|
Facility
|
IP
|
$7,220.85
|
|
|
Service Code
|
CPT 25447
|
| Hospital Charge Code |
Px03602544701
|
|
Hospital Revenue Code
|
360
|
| 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 |
$7,220.85
|
| Rate for Payer: Cash Price |
$7,220.85
|
| 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 |
$5,415.64
|
| Rate for Payer: Provider Network of America Commercial |
$5,776.68
|
|
|
HC Arthrt W/Expl Drg/Rmvl Loose/FB Mttarphlngl Jt
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 28022
|
| Hospital Charge Code |
Px03612802201
|
|
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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Arthrt W/Expl Drg/Rmvl Loose/FB Mttarphlngl Jt
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 28022
|
| Hospital Charge Code |
Px03612802201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Aspergillus Antibody - Aspergillus Abs
|
Facility
|
OP
|
$99.75
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
Px03028660601
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$79.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$70.32
|
| Rate for Payer: Aetna Workers' Compensation |
$70.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$69.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$69.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$78.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$78.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$78.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$76.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$78.60
|
| Rate for Payer: Cash Price |
$99.75
|
| Rate for Payer: Cash Price |
$99.75
|
| Rate for Payer: Cigna Commercial |
$52.27
|
| Rate for Payer: Cigna Medicare Advantage |
$56.86
|
| Rate for Payer: Family Health Partners Medicaid |
$18.97
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$62.84
|
| Rate for Payer: Healthy Blue Medicaid |
$20.49
|
| Rate for Payer: Home State Health Plan Exchange |
$56.86
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.97
|
| Rate for Payer: Humana Medicare |
$74.81
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.97
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$74.81
|
| Rate for Payer: Provider Network of America Commercial |
$79.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.83
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$15.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.28
|
|
|
HC Aspergillus Antibody - Aspergillus Abs
|
Facility
|
IP
|
$99.75
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
Px03028660601
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$74.81 |
| 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 |
$99.75
|
| Rate for Payer: Cash Price |
$99.75
|
| 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 |
$74.81
|
| Rate for Payer: Provider Network of America Commercial |
$79.80
|
|
|
HC Aspirat/Injection Ganglion Cyst(S)
|
Facility
|
IP
|
$644.70
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
Px05102061201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$515.76 |
| 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 |
$644.70
|
| Rate for Payer: Cash Price |
$644.70
|
| 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 |
$515.76
|
|
|
HC Aspirat/Injection Ganglion Cyst(S)
|
Facility
|
OP
|
$630.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
Px03612061201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$630.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$436.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$436.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$496.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$496.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$496.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$485.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$496.44
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cash Price |
$630.00
|
| Rate for Payer: Cigna Commercial |
$417.69
|
| Rate for Payer: Cigna Medicare Advantage |
$359.10
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$396.90
|
| Rate for Payer: Healthy Blue Medicaid |
$418.37
|
| Rate for Payer: Home State Health Plan Exchange |
$359.10
|
| Rate for Payer: Home State Health Plan Medicaid |
$387.38
|
| Rate for Payer: Humana Medicare |
$472.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$472.50
|
| Rate for Payer: Provider Network of America Commercial |
$504.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$415.80
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$630.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
|
|
HC Aspirat/Injection Ganglion Cyst(S)
|
Facility
|
OP
|
$644.70
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
Px05102061201
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$291.64 |
| Max. Negotiated Rate |
$644.70 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$454.51
|
| Rate for Payer: Aetna Workers' Compensation |
$454.51
|
| 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 Care (HMO) |
$446.78
|
| 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 Select |
$508.02
|
| 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) |
$496.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$508.02
|
| Rate for Payer: Cash Price |
$644.70
|
| Rate for Payer: Cash Price |
$644.70
|
| Rate for Payer: Cigna Medicare Advantage |
$367.48
|
| Rate for Payer: Family Health Partners Medicaid |
$387.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$406.16
|
| 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 Medicaid |
$387.38
|
| Rate for Payer: Humana Medicare |
$483.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$387.38
|
| Rate for Payer: Provider Network of America Commercial |
$515.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$425.50
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$644.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$291.64
|
|
