|
HC Aspirat/Injection Ganglion Cyst(S)
|
Facility
|
IP
|
$630.00
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
Px03612061201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$472.50 |
| 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 |
$630.00
|
| Rate for Payer: Cash Price |
$630.00
|
| 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 |
$472.50
|
| Rate for Payer: Provider Network of America Commercial |
$504.00
|
|
|
HC Aspiration &/or Inj of Ganglion Cyst
|
Facility
|
OP
|
$644.70
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
Px07612061201
|
|
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 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 Commercial |
$394.56
|
| 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: Oscar Health EPO/HMO/POS/PPO |
$483.52
|
| 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
|
|
|
HC Aspiration &/or Inj of Ganglion Cyst
|
Facility
|
IP
|
$644.70
|
|
|
Service Code
|
CPT 20612
|
| Hospital Charge Code |
Px07612061201
|
|
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 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: Oscar Health EPO/HMO/POS/PPO |
$483.52
|
| Rate for Payer: Provider Network of America Commercial |
$515.76
|
|
|
HC Assay Alkal Phosphatase - Alkaline Phosphatase
|
Facility
|
IP
|
$93.45
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
Px03018407501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.09 |
| 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 |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| 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 |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
|
|
HC Assay Alkal Phosphatase - Alkaline Phosphatase
|
Facility
|
OP
|
$93.45
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
Px03018407501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$74.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.88
|
| Rate for Payer: Aetna Workers' Compensation |
$65.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.64
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cigna Commercial |
$48.97
|
| Rate for Payer: Cigna Medicare Advantage |
$53.27
|
| Rate for Payer: Family Health Partners Medicaid |
$6.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.87
|
| Rate for Payer: Healthy Blue Medicaid |
$7.05
|
| Rate for Payer: Home State Health Plan Exchange |
$53.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.52
|
| Rate for Payer: Humana Medicare |
$70.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.91
|
|
|
HC Assay Alkal Phosphatase - Alkaline Phosphatase Body Fluid
|
Facility
|
IP
|
$93.45
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
Px03018407502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.09 |
| 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 |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| 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 |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
|
|
HC Assay Alkal Phosphatase - Alkaline Phosphatase Body Fluid
|
Facility
|
OP
|
$93.45
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
Px03018407502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$74.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.88
|
| Rate for Payer: Aetna Workers' Compensation |
$65.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.64
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cigna Commercial |
$48.97
|
| Rate for Payer: Cigna Medicare Advantage |
$53.27
|
| Rate for Payer: Family Health Partners Medicaid |
$6.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.87
|
| Rate for Payer: Healthy Blue Medicaid |
$7.05
|
| Rate for Payer: Home State Health Plan Exchange |
$53.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.52
|
| Rate for Payer: Humana Medicare |
$70.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.91
|
|
|
HC Assay Alkal Phosphatase - Alkaline Phosphatase Bone Specific
|
Facility
|
OP
|
$93.45
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
Px03018407504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$74.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.88
|
| Rate for Payer: Aetna Workers' Compensation |
$65.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.64
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cigna Commercial |
$48.97
|
| Rate for Payer: Cigna Medicare Advantage |
$53.27
|
| Rate for Payer: Family Health Partners Medicaid |
$6.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.87
|
| Rate for Payer: Healthy Blue Medicaid |
$7.05
|
| Rate for Payer: Home State Health Plan Exchange |
$53.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.52
|
| Rate for Payer: Humana Medicare |
$70.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.91
|
|
|
HC Assay Alkal Phosphatase - Alkaline Phosphatase Bone Specific
|
Facility
|
IP
|
$93.45
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
Px03018407504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.09 |
| 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 |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| 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 |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
|
|
HC Assay Alkal Phosphatase,Isoenzymes - Alkaline Phosphatase,Isoenzymes
|
Facility
|
IP
|
$50.00
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
Px03018408001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.50 |
| 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 |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| 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 |
$37.50
|
| Rate for Payer: Provider Network of America Commercial |
$40.00
|
|
|
HC Assay Alkal Phosphatase,Isoenzymes - Alkaline Phosphatase,Isoenzymes
|
Facility
|
OP
|
$50.00
|
|
|
Service Code
|
CPT 84080
|
| Hospital Charge Code |
Px03018408001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.02 |
| Max. Negotiated Rate |
$40.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$35.25
|
| Rate for Payer: Aetna Workers' Compensation |
$35.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$34.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$39.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$39.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$39.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$38.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$39.40
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cash Price |
$50.00
|
| Rate for Payer: Cigna Commercial |
$26.20
|
| Rate for Payer: Cigna Medicare Advantage |
$28.50
|
| Rate for Payer: Family Health Partners Medicaid |
$18.62
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$31.50
|
| Rate for Payer: Healthy Blue Medicaid |
$20.11
|
| Rate for Payer: Home State Health Plan Exchange |
$28.50
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.62
|
| Rate for Payer: Humana Medicare |
$37.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.62
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$37.50
|
| Rate for Payer: Provider Network of America Commercial |
$40.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$33.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.02
|
|
|
HC Assay, Bld/Serum Cholesterol - Cholesterol Fluid
|
Facility
|
IP
|
$72.45
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
Px03018246501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.34 |
| 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 |
$72.45
|
| Rate for Payer: Cash Price |
$72.45
|
| 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 |
$54.34
|
| Rate for Payer: Provider Network of America Commercial |
$57.96
|
|
|
HC Assay, Bld/Serum Cholesterol - Cholesterol Fluid
|
Facility
|
OP
|
$72.45
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
Px03018246501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$57.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$51.08
|
| Rate for Payer: Aetna Workers' Compensation |
$51.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$50.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$50.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$57.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$57.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$57.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$55.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$57.09
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Cigna Commercial |
$37.96
|
| Rate for Payer: Cigna Medicare Advantage |
$41.30
|
| Rate for Payer: Family Health Partners Medicaid |
$5.49
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$45.64
|
| Rate for Payer: Healthy Blue Medicaid |
$5.93
|
| Rate for Payer: Home State Health Plan Exchange |
$41.30
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.49
|
| Rate for Payer: Humana Medicare |
$54.34
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.49
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$54.34
|
| Rate for Payer: Provider Network of America Commercial |
$57.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.13
|
|
|
HC Assay, Bld/Serum Cholesterol - Cholesterol Total
|
Facility
|
IP
|
$72.45
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
Px03018246502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.34 |
| 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 |
$72.45
|
| Rate for Payer: Cash Price |
$72.45
|
| 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 |
$54.34
|
| Rate for Payer: Provider Network of America Commercial |
$57.96
|
|
|
HC Assay, Bld/Serum Cholesterol - Cholesterol Total
|
Facility
|
OP
|
$72.45
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
Px03018246502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$57.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$51.08
|
| Rate for Payer: Aetna Workers' Compensation |
$51.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$50.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$50.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$57.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$57.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$57.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$55.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$57.09
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Cash Price |
$72.45
|
| Rate for Payer: Cigna Commercial |
$37.96
|
| Rate for Payer: Cigna Medicare Advantage |
$41.30
|
| Rate for Payer: Family Health Partners Medicaid |
$5.49
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$45.64
|
| Rate for Payer: Healthy Blue Medicaid |
$5.93
|
| Rate for Payer: Home State Health Plan Exchange |
$41.30
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.49
|
| Rate for Payer: Humana Medicare |
$54.34
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.49
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$54.34
|
| Rate for Payer: Provider Network of America Commercial |
$57.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.13
|
|
|
HC Assay Blood Carbon Dioxide - Co2 Total
|
Facility
|
IP
|
$51.98
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
Px03018237401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.98 |
| 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 |
$51.98
|
| Rate for Payer: Cash Price |
$51.98
|
| 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 |
$38.98
|
| Rate for Payer: Provider Network of America Commercial |
$41.58
|
|
|
HC Assay Blood Carbon Dioxide - Co2 Total
|
Facility
|
OP
|
$51.98
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
Px03018237401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.63 |
| Max. Negotiated Rate |
$41.58 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$36.65
|
| Rate for Payer: Aetna Workers' Compensation |
$36.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$36.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$36.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$40.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$40.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$40.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$40.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$40.96
|
| Rate for Payer: Cash Price |
$51.98
|
| Rate for Payer: Cash Price |
$51.98
|
| Rate for Payer: Cigna Commercial |
$27.24
|
| Rate for Payer: Cigna Medicare Advantage |
$29.63
|
| Rate for Payer: Family Health Partners Medicaid |
$6.15
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$32.75
|
| Rate for Payer: Healthy Blue Medicaid |
$6.64
|
| Rate for Payer: Home State Health Plan Exchange |
$29.63
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.15
|
| Rate for Payer: Humana Medicare |
$38.98
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.15
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$38.98
|
| Rate for Payer: Provider Network of America Commercial |
$41.58
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.31
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.63
|
|
|
HC Assay Blood Carbon Monoxide - Carboxyhemoglobin
|
Facility
|
OP
|
$122.85
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
Px03018237501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$98.28 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$86.61
|
| Rate for Payer: Aetna Workers' Compensation |
$86.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$85.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$85.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$96.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$96.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$96.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$96.81
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cigna Commercial |
$64.37
|
| Rate for Payer: Cigna Medicare Advantage |
$70.02
|
| Rate for Payer: Family Health Partners Medicaid |
$15.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$77.40
|
| Rate for Payer: Healthy Blue Medicaid |
$16.77
|
| Rate for Payer: Home State Health Plan Exchange |
$70.02
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.53
|
| Rate for Payer: Humana Medicare |
$92.14
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$92.14
|
| Rate for Payer: Provider Network of America Commercial |
$98.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$81.08
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.69
|
|
|
HC Assay Blood Carbon Monoxide - Carboxyhemoglobin
|
Facility
|
IP
|
$122.85
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
Px03018237501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.14 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| 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 |
$122.85
|
| Rate for Payer: Cash Price |
$122.85
|
| Rate for Payer: Cigna Medicare Advantage |
$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: Oscar Health EPO/HMO/POS/PPO |
$92.14
|
| Rate for Payer: Provider Network of America Commercial |
$98.28
|
|
|
HC Assay Everolimus
|
Facility
|
OP
|
$273.00
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
Px03018016901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$218.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$192.47
|
| Rate for Payer: Aetna Workers' Compensation |
$192.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$189.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$189.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$215.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$215.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$215.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$210.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$215.12
|
| Rate for Payer: Cash Price |
$273.00
|
| Rate for Payer: Cash Price |
$273.00
|
| Rate for Payer: Cigna Commercial |
$143.05
|
| Rate for Payer: Cigna Medicare Advantage |
$155.61
|
| Rate for Payer: Family Health Partners Medicaid |
$17.30
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$171.99
|
| Rate for Payer: Healthy Blue Medicaid |
$18.69
|
| Rate for Payer: Home State Health Plan Exchange |
$155.61
|
| Rate for Payer: Home State Health Plan Medicaid |
$17.30
|
| Rate for Payer: Humana Medicare |
$204.75
|
| Rate for Payer: Mercy CarePlus Medicaid |
$17.30
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$204.75
|
| Rate for Payer: Provider Network of America Commercial |
$218.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$180.18
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.73
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.03
|
|
|
HC Assay Everolimus
|
Facility
|
IP
|
$273.00
|
|
|
Service Code
|
CPT 80169
|
| Hospital Charge Code |
Px03018016901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$204.75 |
| 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 |
$273.00
|
| Rate for Payer: Cash Price |
$273.00
|
| 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 |
$204.75
|
| Rate for Payer: Provider Network of America Commercial |
$218.40
|
|
|
HC Assay for Collagen Cross Links - N-Telopeptide, Urine
|
Facility
|
IP
|
$247.80
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
Px03018252302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$185.85 |
| 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 |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$185.85
|
| Rate for Payer: Provider Network of America Commercial |
$198.24
|
|
|
HC Assay for Collagen Cross Links - N-Telopeptide, Urine
|
Facility
|
OP
|
$247.80
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
Px03018252302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.72 |
| Max. Negotiated Rate |
$198.24 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$174.70
|
| Rate for Payer: Aetna Workers' Compensation |
$174.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$171.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$171.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$195.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$195.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$195.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$190.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$195.27
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cigna Commercial |
$129.85
|
| Rate for Payer: Cigna Medicare Advantage |
$141.25
|
| Rate for Payer: Family Health Partners Medicaid |
$23.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$156.11
|
| Rate for Payer: Healthy Blue Medicaid |
$25.42
|
| Rate for Payer: Home State Health Plan Exchange |
$141.25
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.53
|
| Rate for Payer: Humana Medicare |
$185.85
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$185.85
|
| Rate for Payer: Provider Network of America Commercial |
$198.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$163.55
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.72
|
|
|
HC Assay for Collagen Cross Links - POCT Collagen Type I Crosslink
|
Facility
|
OP
|
$247.80
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
Px03018252301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.72 |
| Max. Negotiated Rate |
$198.24 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$174.70
|
| Rate for Payer: Aetna Workers' Compensation |
$174.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$171.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$171.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$195.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$195.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$195.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$190.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$195.27
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cigna Commercial |
$129.85
|
| Rate for Payer: Cigna Medicare Advantage |
$141.25
|
| Rate for Payer: Family Health Partners Medicaid |
$23.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$156.11
|
| Rate for Payer: Healthy Blue Medicaid |
$25.42
|
| Rate for Payer: Home State Health Plan Exchange |
$141.25
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.53
|
| Rate for Payer: Humana Medicare |
$185.85
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$185.85
|
| Rate for Payer: Provider Network of America Commercial |
$198.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$163.55
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.68
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.72
|
|
|
HC Assay for Collagen Cross Links - POCT Collagen Type I Crosslink
|
Facility
|
IP
|
$247.80
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
Px03018252301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$185.85 |
| 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 |
$247.80
|
| Rate for Payer: Cash Price |
$247.80
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$185.85
|
| Rate for Payer: Provider Network of America Commercial |
$198.24
|
|
