|
HC Assay of Ammonia - Ammonia
|
Facility
|
IP
|
$196.35
|
|
|
Service Code
|
CPT 82140
|
| Hospital Charge Code |
Px03018214001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$147.26 |
| 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 |
$196.35
|
| Rate for Payer: Cash Price |
$196.35
|
| 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 |
$147.26
|
| Rate for Payer: Provider Network of America Commercial |
$157.08
|
|
|
HC Assay of Amylase - Amylase
|
Facility
|
IP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215005
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.61 |
| 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 |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
|
|
HC Assay of Amylase - Amylase
|
Facility
|
OP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215005
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.14 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$105.86
|
| Rate for Payer: Aetna Workers' Compensation |
$105.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$115.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$118.32
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Commercial |
$78.68
|
| Rate for Payer: Cigna Medicare Advantage |
$85.59
|
| Rate for Payer: Family Health Partners Medicaid |
$8.16
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$94.59
|
| Rate for Payer: Healthy Blue Medicaid |
$8.81
|
| Rate for Payer: Home State Health Plan Exchange |
$85.59
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.16
|
| Rate for Payer: Humana Medicare |
$112.61
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.16
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.10
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.14
|
|
|
HC Assay of Amylase - Amylase,24 Hour Urine
|
Facility
|
IP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.61 |
| 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 |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
|
|
HC Assay of Amylase - Amylase,24 Hour Urine
|
Facility
|
OP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.14 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$105.86
|
| Rate for Payer: Aetna Workers' Compensation |
$105.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$115.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$118.32
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Commercial |
$78.68
|
| Rate for Payer: Cigna Medicare Advantage |
$85.59
|
| Rate for Payer: Family Health Partners Medicaid |
$8.16
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$94.59
|
| Rate for Payer: Healthy Blue Medicaid |
$8.81
|
| Rate for Payer: Home State Health Plan Exchange |
$85.59
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.16
|
| Rate for Payer: Humana Medicare |
$112.61
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.16
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.10
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.14
|
|
|
HC Assay of Amylase - Amylase Blood
|
Facility
|
OP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215007
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.14 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$105.86
|
| Rate for Payer: Aetna Workers' Compensation |
$105.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$115.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$118.32
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Commercial |
$78.68
|
| Rate for Payer: Cigna Medicare Advantage |
$85.59
|
| Rate for Payer: Family Health Partners Medicaid |
$8.16
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$94.59
|
| Rate for Payer: Healthy Blue Medicaid |
$8.81
|
| Rate for Payer: Home State Health Plan Exchange |
$85.59
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.16
|
| Rate for Payer: Humana Medicare |
$112.61
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.16
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.10
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.14
|
|
|
HC Assay of Amylase - Amylase Blood
|
Facility
|
IP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215007
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.61 |
| 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 |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
|
|
HC Assay of Amylase - Amylase Body Fluid
|
Facility
|
IP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.61 |
| 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 |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
|
|
HC Assay of Amylase - Amylase Body Fluid
|
Facility
|
OP
|
$150.15
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
Px03018215001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.14 |
| Max. Negotiated Rate |
$120.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$105.86
|
| Rate for Payer: Aetna Workers' Compensation |
$105.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$104.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$118.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$115.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$118.32
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cash Price |
$150.15
|
| Rate for Payer: Cigna Commercial |
$78.68
|
| Rate for Payer: Cigna Medicare Advantage |
$85.59
|
| Rate for Payer: Family Health Partners Medicaid |
$8.16
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$94.59
|
| Rate for Payer: Healthy Blue Medicaid |
$8.81
|
| Rate for Payer: Home State Health Plan Exchange |
$85.59
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.16
|
| Rate for Payer: Humana Medicare |
$112.61
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.16
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.61
|
| Rate for Payer: Provider Network of America Commercial |
$120.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$99.10
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.48
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.14
|
|
|
HC Assay of Anti-Mullerian Hormone
|
Facility
|
OP
|
$131.25
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
Px03018216601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$105.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$92.53
|
| Rate for Payer: Aetna Workers' Compensation |
$92.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$90.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$90.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$103.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$103.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$103.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$101.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$103.42
|
| Rate for Payer: Cash Price |
$131.25
|
| Rate for Payer: Cash Price |
$131.25
|
| Rate for Payer: Cigna Commercial |
$68.78
|
| Rate for Payer: Cigna Medicare Advantage |
$74.81
|
| Rate for Payer: Family Health Partners Medicaid |
$48.66
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$82.69
|
| Rate for Payer: Healthy Blue Medicaid |
$52.56
|
| Rate for Payer: Home State Health Plan Exchange |
$74.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$48.66
|
| Rate for Payer: Humana Medicare |
$98.44
|
| Rate for Payer: Mercy CarePlus Medicaid |
$48.66
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$98.44
|
| Rate for Payer: Provider Network of America Commercial |
$105.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$86.62
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$38.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.64
|
|
|
HC Assay of Anti-Mullerian Hormone
|
Facility
|
IP
|
$131.25
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
Px03018216601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$98.44 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$131.25
|
| Rate for Payer: Cash Price |
$131.25
|
| 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 |
$98.44
|
| Rate for Payer: Provider Network of America Commercial |
$105.00
|
|
|
HC Assay of Apolipoprotein Each
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
Px03018217202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$118.44
|
| Rate for Payer: Aetna Workers' Compensation |
$118.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$129.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$132.38
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cigna Commercial |
$88.03
|
| Rate for Payer: Cigna Medicare Advantage |
$95.76
|
| Rate for Payer: Family Health Partners Medicaid |
$26.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$105.84
|
| Rate for Payer: Healthy Blue Medicaid |
$28.70
|
| Rate for Payer: Home State Health Plan Exchange |
$95.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$26.57
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$26.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.88
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$21.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.00
|
|
|
HC Assay of Apolipoprotein Each
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
Px03018217202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.00 |
| 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 |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| 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 |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
|
|
HC Assay of Apolipoprotein - Lipoprotein a (Lpa)
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
Px03018217201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$118.44
|
| Rate for Payer: Aetna Workers' Compensation |
$118.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$129.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$132.38
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cigna Commercial |
$88.03
|
| Rate for Payer: Cigna Medicare Advantage |
$95.76
|
| Rate for Payer: Family Health Partners Medicaid |
$26.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$105.84
|
| Rate for Payer: Healthy Blue Medicaid |
$28.70
|
| Rate for Payer: Home State Health Plan Exchange |
$95.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$26.57
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$26.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.88
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$21.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.00
|
|
|
HC Assay of Apolipoprotein - Lipoprotein a (Lpa)
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
Px03018217201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.00 |
| 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 |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| 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 |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
|
|
HC Assay of Arsenic
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217506
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$169.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$149.53
|
| Rate for Payer: Aetna Workers' Compensation |
$149.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$167.13
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cigna Commercial |
$111.14
|
| Rate for Payer: Cigna Medicare Advantage |
$120.90
|
| Rate for Payer: Family Health Partners Medicaid |
$23.90
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$25.81
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.90
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.90
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.99
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.99
|
|
|
HC Assay of Arsenic
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217506
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$159.07 |
| 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 |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| 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 |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
|
|
HC Assay of Arsenic - Arsenic 24 Hour Urine
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$159.07 |
| 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 |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| 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 |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
|
|
HC Assay of Arsenic - Arsenic 24 Hour Urine
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$169.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$149.53
|
| Rate for Payer: Aetna Workers' Compensation |
$149.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$167.13
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cigna Commercial |
$111.14
|
| Rate for Payer: Cigna Medicare Advantage |
$120.90
|
| Rate for Payer: Family Health Partners Medicaid |
$23.90
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$25.81
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.90
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.90
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.99
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.99
|
|
|
HC Assay of Arsenic - Arsenic,Fractionation,UR
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$169.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$149.53
|
| Rate for Payer: Aetna Workers' Compensation |
$149.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$167.13
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cigna Commercial |
$111.14
|
| Rate for Payer: Cigna Medicare Advantage |
$120.90
|
| Rate for Payer: Family Health Partners Medicaid |
$23.90
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$25.81
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.90
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.90
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.99
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.99
|
|
|
HC Assay of Arsenic - Arsenic,Fractionation,UR
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$159.07 |
| 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 |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| 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 |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
|
|
HC Assay of Arsenic - Arsenic Random Urine
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$159.07 |
| 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 |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| 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 |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
|
|
HC Assay of Arsenic - Arsenic Random Urine
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$169.68 |
| Rate for Payer: Cigna Commercial |
$111.14
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$149.53
|
| Rate for Payer: Aetna Workers' Compensation |
$149.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$167.13
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cigna Medicare Advantage |
$120.90
|
| Rate for Payer: Family Health Partners Medicaid |
$23.90
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$25.81
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.90
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.90
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.99
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.99
|
|
|
HC Assay of Arsenic - Arsenic Serum
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$159.07 |
| 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 |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| 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 |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
|
|
HC Assay of Arsenic - Arsenic Serum
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
Px03018217505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$169.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$149.53
|
| Rate for Payer: Aetna Workers' Compensation |
$149.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$146.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$167.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$163.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$167.13
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cash Price |
$212.10
|
| Rate for Payer: Cigna Commercial |
$111.14
|
| Rate for Payer: Cigna Medicare Advantage |
$120.90
|
| Rate for Payer: Family Health Partners Medicaid |
$23.90
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$25.81
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.90
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.90
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$159.07
|
| Rate for Payer: Provider Network of America Commercial |
$169.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$139.99
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.97
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.99
|
|
