|
HC Assay of Calcium, Total - Calcium
|
Facility
|
IP
|
$86.10
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
Px03018231001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.58 |
| 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 |
$86.10
|
| Rate for Payer: Cash Price |
$86.10
|
| 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 |
$64.58
|
| Rate for Payer: Provider Network of America Commercial |
$68.88
|
|
|
HC Assay of Calcium, Total - POCT Calcium, Total
|
Facility
|
OP
|
$86.10
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
Px03018231002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$68.88 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$60.70
|
| Rate for Payer: Aetna Workers' Compensation |
$60.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$59.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$59.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$67.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$67.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$67.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$66.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$67.85
|
| Rate for Payer: Cash Price |
$86.10
|
| Rate for Payer: Cash Price |
$86.10
|
| Rate for Payer: Cigna Commercial |
$45.12
|
| Rate for Payer: Cigna Medicare Advantage |
$49.08
|
| Rate for Payer: Family Health Partners Medicaid |
$6.50
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$54.24
|
| Rate for Payer: Healthy Blue Medicaid |
$7.02
|
| Rate for Payer: Home State Health Plan Exchange |
$49.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.50
|
| Rate for Payer: Humana Medicare |
$64.58
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.50
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$64.58
|
| Rate for Payer: Provider Network of America Commercial |
$68.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.83
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.89
|
|
|
HC Assay of Calcium, Total - POCT Calcium, Total
|
Facility
|
IP
|
$86.10
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
Px03018231002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.58 |
| 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 |
$86.10
|
| Rate for Payer: Cash Price |
$86.10
|
| 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 |
$64.58
|
| Rate for Payer: Provider Network of America Commercial |
$68.88
|
|
|
HC Assay of Calcium, Total - Pth, Intact and Calcium
|
Facility
|
OP
|
$86.10
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
Px03018231003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$68.88 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$60.70
|
| Rate for Payer: Aetna Workers' Compensation |
$60.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$59.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$59.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$67.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$67.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$67.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$66.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$67.85
|
| Rate for Payer: Cash Price |
$86.10
|
| Rate for Payer: Cash Price |
$86.10
|
| Rate for Payer: Cigna Commercial |
$45.12
|
| Rate for Payer: Cigna Medicare Advantage |
$49.08
|
| Rate for Payer: Family Health Partners Medicaid |
$6.50
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$54.24
|
| Rate for Payer: Healthy Blue Medicaid |
$7.02
|
| Rate for Payer: Home State Health Plan Exchange |
$49.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.50
|
| Rate for Payer: Humana Medicare |
$64.58
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.50
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$64.58
|
| Rate for Payer: Provider Network of America Commercial |
$68.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$56.83
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.16
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.89
|
|
|
HC Assay of Calcium, Total - Pth, Intact and Calcium
|
Facility
|
IP
|
$86.10
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
Px03018231003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$64.58 |
| 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 |
$86.10
|
| Rate for Payer: Cash Price |
$86.10
|
| 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 |
$64.58
|
| Rate for Payer: Provider Network of America Commercial |
$68.88
|
|
|
HC Assay of Calprotectin Fecal
|
Facility
|
IP
|
$291.90
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
Px03018399301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$218.93 |
| 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 |
$291.90
|
| Rate for Payer: Cash Price |
$291.90
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$218.93
|
| Rate for Payer: Provider Network of America Commercial |
$233.52
|
|
|
HC Assay of Calprotectin Fecal
|
Facility
|
OP
|
$291.90
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
Px03018399301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.62 |
| Max. Negotiated Rate |
$233.52 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$205.79
|
| Rate for Payer: Aetna Workers' Compensation |
$205.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$202.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$202.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$230.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$230.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$230.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$224.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$230.02
|
| Rate for Payer: Cash Price |
$291.90
|
| Rate for Payer: Cash Price |
$291.90
|
| Rate for Payer: Cigna Commercial |
$152.96
|
| Rate for Payer: Cigna Medicare Advantage |
$166.38
|
| Rate for Payer: Family Health Partners Medicaid |
$24.74
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$183.90
|
| Rate for Payer: Healthy Blue Medicaid |
$26.72
|
| Rate for Payer: Home State Health Plan Exchange |
$166.38
|
| Rate for Payer: Home State Health Plan Medicaid |
$24.74
|
| Rate for Payer: Humana Medicare |
$218.93
|
| Rate for Payer: Mercy CarePlus Medicaid |
$24.74
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$218.93
|
| Rate for Payer: Provider Network of America Commercial |
$233.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$192.65
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$19.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.62
|
|
|
HC Assay of Carbamazepine Total - Carbamazepine Total
|
Facility
|
OP
|
$172.20
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
Px03018015601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.82 |
| Max. Negotiated Rate |
$137.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$121.40
|
| Rate for Payer: Aetna Workers' Compensation |
$121.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$119.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$119.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$135.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$132.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$135.69
|
| Rate for Payer: Cash Price |
$172.20
|
| Rate for Payer: Cash Price |
$172.20
|
| Rate for Payer: Cigna Commercial |
$90.23
|
| Rate for Payer: Cigna Medicare Advantage |
$98.15
|
| Rate for Payer: Family Health Partners Medicaid |
$18.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$108.49
|
| Rate for Payer: Healthy Blue Medicaid |
$19.82
|
| Rate for Payer: Home State Health Plan Exchange |
$98.15
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.35
|
| Rate for Payer: Humana Medicare |
$129.15
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$129.15
|
| Rate for Payer: Provider Network of America Commercial |
$137.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$113.65
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.82
|
|
|
HC Assay of Carbamazepine Total - Carbamazepine Total
|
Facility
|
IP
|
$172.20
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
Px03018015601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$129.15 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$172.20
|
| Rate for Payer: Cash Price |
$172.20
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$129.15
|
| Rate for Payer: Provider Network of America Commercial |
$137.76
|
|
|
HC Assay of Ceruloplasmin - Ceruloplasmin
|
Facility
|
OP
|
$116.55
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
Px03018239001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.19 |
| Max. Negotiated Rate |
$93.24 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$82.17
|
| Rate for Payer: Aetna Workers' Compensation |
$82.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$80.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$80.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$91.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$91.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$91.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$89.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$91.84
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cigna Commercial |
$61.07
|
| Rate for Payer: Cigna Medicare Advantage |
$66.43
|
| Rate for Payer: Family Health Partners Medicaid |
$13.54
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$73.43
|
| Rate for Payer: Healthy Blue Medicaid |
$14.62
|
| Rate for Payer: Home State Health Plan Exchange |
$66.43
|
| Rate for Payer: Home State Health Plan Medicaid |
$13.54
|
| Rate for Payer: Humana Medicare |
$87.41
|
| Rate for Payer: Mercy CarePlus Medicaid |
$13.54
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$87.41
|
| Rate for Payer: Provider Network of America Commercial |
$93.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$76.92
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$10.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.19
|
|
|
HC Assay of Ceruloplasmin - Ceruloplasmin
|
Facility
|
IP
|
$116.55
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
Px03018239001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$87.41 |
| 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 |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| 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 |
$87.41
|
| Rate for Payer: Provider Network of America Commercial |
$93.24
|
|
|
HC Assay of Citrate - Citrate 24 Hour Urine
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
Px03018250701
|
|
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 Citrate - Citrate 24 Hour Urine
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
Px03018250701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.37 |
| 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 |
$35.03
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$37.83
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$35.03
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$35.03
|
| 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 |
$27.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.37
|
|
|
HC Assay of Citrate - Citrate Random Urine
|
Facility
|
OP
|
$212.10
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
Px03018250703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.37 |
| 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 |
$35.03
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$133.62
|
| Rate for Payer: Healthy Blue Medicaid |
$37.83
|
| Rate for Payer: Home State Health Plan Exchange |
$120.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$35.03
|
| Rate for Payer: Humana Medicare |
$159.07
|
| Rate for Payer: Mercy CarePlus Medicaid |
$35.03
|
| 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 |
$27.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.37
|
|
|
HC Assay of Citrate - Citrate Random Urine
|
Facility
|
IP
|
$212.10
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
Px03018250703
|
|
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 CK (Cpk) - CK
|
Facility
|
IP
|
$126.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
Px03018255001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.50 |
| 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 |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| 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 |
$94.50
|
| Rate for Payer: Provider Network of America Commercial |
$100.80
|
|
|
HC Assay of CK (Cpk) - CK
|
Facility
|
OP
|
$126.00
|
|
|
Service Code
|
CPT 82550
|
| Hospital Charge Code |
Px03018255001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$100.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$88.83
|
| Rate for Payer: Aetna Workers' Compensation |
$88.83
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$87.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$87.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$99.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$99.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$99.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$97.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$99.29
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cash Price |
$126.00
|
| Rate for Payer: Cigna Commercial |
$66.02
|
| Rate for Payer: Cigna Medicare Advantage |
$71.82
|
| Rate for Payer: Family Health Partners Medicaid |
$8.20
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$79.38
|
| Rate for Payer: Healthy Blue Medicaid |
$8.86
|
| Rate for Payer: Home State Health Plan Exchange |
$71.82
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.20
|
| Rate for Payer: Humana Medicare |
$94.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.20
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$94.50
|
| Rate for Payer: Provider Network of America Commercial |
$100.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$83.16
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.51
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.18
|
|
|
HC Assay of CK (Cpk) Isoenzymes
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
Px03018255201
|
|
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 CK (Cpk) Isoenzymes
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 82552
|
| Hospital Charge Code |
Px03018255201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.70 |
| 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 |
$16.87
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$105.84
|
| Rate for Payer: Healthy Blue Medicaid |
$18.22
|
| Rate for Payer: Home State Health Plan Exchange |
$95.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.87
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.87
|
| 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 |
$13.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.70
|
|
|
HC Assay of Clozapine - Clozapine
|
Facility
|
OP
|
$149.72
|
|
|
Service Code
|
CPT 80159
|
| Hospital Charge Code |
Px03018015901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.12 |
| Max. Negotiated Rate |
$119.78 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$105.55
|
| Rate for Payer: Aetna Workers' Compensation |
$105.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$103.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$103.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$117.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$117.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$117.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$115.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$117.98
|
| Rate for Payer: Cash Price |
$149.72
|
| Rate for Payer: Cash Price |
$149.72
|
| Rate for Payer: Cigna Commercial |
$78.45
|
| Rate for Payer: Cigna Medicare Advantage |
$85.34
|
| Rate for Payer: Family Health Partners Medicaid |
$25.40
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$94.32
|
| Rate for Payer: Healthy Blue Medicaid |
$27.43
|
| Rate for Payer: Home State Health Plan Exchange |
$85.34
|
| Rate for Payer: Home State Health Plan Medicaid |
$25.40
|
| Rate for Payer: Humana Medicare |
$112.29
|
| Rate for Payer: Mercy CarePlus Medicaid |
$25.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$112.29
|
| Rate for Payer: Provider Network of America Commercial |
$119.78
|
| Rate for Payer: UnitedHealthcare Commercial |
$98.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$20.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$19.12
|
|
|
HC Assay of Clozapine - Clozapine
|
Facility
|
IP
|
$149.72
|
|
|
Service Code
|
CPT 80159
|
| Hospital Charge Code |
Px03018015901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.29 |
| 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 |
$149.72
|
| Rate for Payer: Cash Price |
$149.72
|
| 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 |
$112.29
|
| Rate for Payer: Provider Network of America Commercial |
$119.78
|
|
|
HC Assay of Copper
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252505
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$15.64
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$16.89
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.64
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.64
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.77
|
|
|
HC Assay of Copper
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252505
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$102.38 |
| 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 |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| 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 |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Assay of Copper - Copper 24hr Urine
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.38 |
| 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 |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| 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 |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Assay of Copper - Copper 24hr Urine
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$15.64
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$16.89
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.64
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.64
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.41
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.77
|
|
