|
HC Assay of Copper - Copper Random Urine
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252503
|
|
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
|
|
|
HC Assay of Copper - Copper Random Urine
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252503
|
|
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, Serum
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252504
|
|
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, Serum
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 82525
|
| Hospital Charge Code |
Px03018252504
|
|
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
|
|
|
HC Assay of C-Peptide - C-Peptide
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
Px03018468101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.74 |
| 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 |
$26.22
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$105.84
|
| Rate for Payer: Healthy Blue Medicaid |
$28.32
|
| Rate for Payer: Home State Health Plan Exchange |
$95.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$26.22
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$26.22
|
| 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 |
$20.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$19.74
|
|
|
HC Assay of C-Peptide - C-Peptide
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 84681
|
| Hospital Charge Code |
Px03018468101
|
|
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 Creatinine - Creatinine Blood
|
Facility
|
OP
|
$100.80
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
Px03018256503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$80.64 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$71.06
|
| Rate for Payer: Aetna Workers' Compensation |
$71.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$77.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$79.43
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cigna Commercial |
$52.82
|
| Rate for Payer: Cigna Medicare Advantage |
$57.46
|
| Rate for Payer: Family Health Partners Medicaid |
$6.45
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$63.50
|
| Rate for Payer: Healthy Blue Medicaid |
$6.97
|
| Rate for Payer: Home State Health Plan Exchange |
$57.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.45
|
| Rate for Payer: Humana Medicare |
$75.60
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.45
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$75.60
|
| Rate for Payer: Provider Network of America Commercial |
$80.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.53
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.86
|
|
|
HC Assay of Creatinine - Creatinine Blood
|
Facility
|
IP
|
$100.80
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
Px03018256503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.60 |
| 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 |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| 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 |
$75.60
|
| Rate for Payer: Provider Network of America Commercial |
$80.64
|
|
|
HC Assay of Creatinine - Creatinine Fluid
|
Facility
|
OP
|
$100.80
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
Px03018256502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$80.64 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$71.06
|
| Rate for Payer: Aetna Workers' Compensation |
$71.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$77.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$79.43
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cigna Commercial |
$52.82
|
| Rate for Payer: Cigna Medicare Advantage |
$57.46
|
| Rate for Payer: Family Health Partners Medicaid |
$6.45
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$63.50
|
| Rate for Payer: Healthy Blue Medicaid |
$6.97
|
| Rate for Payer: Home State Health Plan Exchange |
$57.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.45
|
| Rate for Payer: Humana Medicare |
$75.60
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.45
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$75.60
|
| Rate for Payer: Provider Network of America Commercial |
$80.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.53
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.86
|
|
|
HC Assay of Creatinine - Creatinine Fluid
|
Facility
|
IP
|
$100.80
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
Px03018256502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.60 |
| 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 |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| 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 |
$75.60
|
| Rate for Payer: Provider Network of America Commercial |
$80.64
|
|
|
HC Assay of Creatinine - Creatinine Serum
|
Facility
|
OP
|
$100.80
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
Px03018256501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$80.64 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$71.06
|
| Rate for Payer: Aetna Workers' Compensation |
$71.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$69.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$79.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$77.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$79.43
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| Rate for Payer: Cigna Commercial |
$52.82
|
| Rate for Payer: Cigna Medicare Advantage |
$57.46
|
| Rate for Payer: Family Health Partners Medicaid |
$6.45
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$63.50
|
| Rate for Payer: Healthy Blue Medicaid |
$6.97
|
| Rate for Payer: Home State Health Plan Exchange |
$57.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.45
|
| Rate for Payer: Humana Medicare |
$75.60
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.45
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$75.60
|
| Rate for Payer: Provider Network of America Commercial |
$80.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.53
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.86
|
|
|
HC Assay of Creatinine - Creatinine Serum
|
Facility
|
IP
|
$100.80
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
Px03018256501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.60 |
| 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 |
$100.80
|
| Rate for Payer: Cash Price |
$100.80
|
| 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 |
$75.60
|
| Rate for Payer: Provider Network of America Commercial |
$80.64
|
|
|
HC Assay of Cryoglobulin - Cryoglobulin
|
Facility
|
OP
|
$126.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
Px03018259501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.13 |
| 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 |
$8.15
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$79.38
|
| Rate for Payer: Healthy Blue Medicaid |
$8.80
|
| Rate for Payer: Home State Health Plan Exchange |
$71.82
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.15
|
| Rate for Payer: Humana Medicare |
$94.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.15
|
| 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 |
$6.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.13
|
|
|
HC Assay of Cryoglobulin - Cryoglobulin
|
Facility
|
IP
|
$126.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
Px03018259501
|
|
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 Cyclosporine - Cyclosporine
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
Px03018015801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.13 |
| Max. Negotiated Rate |
$201.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$177.66
|
| Rate for Payer: Aetna Workers' Compensation |
$177.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$174.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$174.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$198.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$198.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$198.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$194.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$198.58
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| Rate for Payer: Cigna Commercial |
$132.05
|
| Rate for Payer: Cigna Medicare Advantage |
$143.64
|
| Rate for Payer: Family Health Partners Medicaid |
$22.75
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$158.76
|
| Rate for Payer: Healthy Blue Medicaid |
$24.57
|
| Rate for Payer: Home State Health Plan Exchange |
$143.64
|
| Rate for Payer: Home State Health Plan Medicaid |
$22.75
|
| Rate for Payer: Humana Medicare |
$189.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$22.75
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$189.00
|
| Rate for Payer: Provider Network of America Commercial |
$201.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$166.32
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.13
|
|
|
HC Assay of Cyclosporine - Cyclosporine
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
Px03018015801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$189.00 |
| 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 |
$252.00
|
| Rate for Payer: Cash Price |
$252.00
|
| 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 |
$189.00
|
| Rate for Payer: Provider Network of America Commercial |
$201.60
|
|
|
HC Assay of Cystatin C
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
Px03018261001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.57 |
| Max. Negotiated Rate |
$80.00 |
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$70.50
|
| Rate for Payer: Aetna Workers' Compensation |
$70.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$69.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$69.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$78.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$78.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$78.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$77.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$78.80
|
| Rate for Payer: Cash Price |
$100.00
|
| Rate for Payer: Cigna Commercial |
$52.40
|
| Rate for Payer: Cigna Medicare Advantage |
$57.00
|
| Rate for Payer: Family Health Partners Medicaid |
$23.34
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$63.00
|
| Rate for Payer: Healthy Blue Medicaid |
$25.21
|
| Rate for Payer: Home State Health Plan Exchange |
$57.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.34
|
| Rate for Payer: Humana Medicare |
$75.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.34
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$75.00
|
| Rate for Payer: Provider Network of America Commercial |
$80.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$66.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.57
|
|
|
HC Assay of Cystatin C
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
Px03018261001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$75.00 |
| 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 |
$100.00
|
| Rate for Payer: Cash Price |
$100.00
|
| 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 |
$75.00
|
| Rate for Payer: Provider Network of America Commercial |
$80.00
|
|
|
HC Assay of Erythropoietin - Erythropoietin
|
Facility
|
IP
|
$244.65
|
|
|
Service Code
|
CPT 82668
|
| Hospital Charge Code |
Px03018266801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$183.49 |
| 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 |
$244.65
|
| Rate for Payer: Cash Price |
$244.65
|
| 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 |
$183.49
|
| Rate for Payer: Provider Network of America Commercial |
$195.72
|
|
|
HC Assay of Erythropoietin - Erythropoietin
|
Facility
|
OP
|
$244.65
|
|
|
Service Code
|
CPT 82668
|
| Hospital Charge Code |
Px03018266801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.82 |
| Max. Negotiated Rate |
$195.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$172.48
|
| Rate for Payer: Aetna Workers' Compensation |
$172.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$169.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$169.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$192.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$192.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$192.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$188.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$192.78
|
| Rate for Payer: Cash Price |
$244.65
|
| Rate for Payer: Cash Price |
$244.65
|
| Rate for Payer: Cigna Commercial |
$128.20
|
| Rate for Payer: Cigna Medicare Advantage |
$139.45
|
| Rate for Payer: Family Health Partners Medicaid |
$23.67
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$154.13
|
| Rate for Payer: Healthy Blue Medicaid |
$25.57
|
| Rate for Payer: Home State Health Plan Exchange |
$139.45
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.67
|
| Rate for Payer: Humana Medicare |
$183.49
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.67
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$183.49
|
| Rate for Payer: Provider Network of America Commercial |
$195.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$161.47
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.82
|
|
|
HC Assay of Estradiol - Estradiol
|
Facility
|
IP
|
$198.45
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
Px03018267001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.84 |
| 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 |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| 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 |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
|
|
HC Assay of Estradiol - Estradiol
|
Facility
|
OP
|
$198.45
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
Px03018267001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$158.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$139.91
|
| Rate for Payer: Aetna Workers' Compensation |
$139.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$156.38
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cigna Commercial |
$103.99
|
| Rate for Payer: Cigna Medicare Advantage |
$113.12
|
| Rate for Payer: Family Health Partners Medicaid |
$35.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$125.02
|
| Rate for Payer: Healthy Blue Medicaid |
$38.03
|
| Rate for Payer: Home State Health Plan Exchange |
$113.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$35.21
|
| Rate for Payer: Humana Medicare |
$148.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$35.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$27.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.51
|
|
|
HC Assay of Estradiol - Estradiol High Sensitive
|
Facility
|
IP
|
$198.45
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
Px03018267002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$148.84 |
| 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 |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| 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 |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
|
|
HC Assay of Estradiol - Estradiol High Sensitive
|
Facility
|
OP
|
$198.45
|
|
|
Service Code
|
CPT 82670
|
| Hospital Charge Code |
Px03018267002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$158.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$139.91
|
| Rate for Payer: Aetna Workers' Compensation |
$139.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$137.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$156.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$156.38
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cash Price |
$198.45
|
| Rate for Payer: Cigna Commercial |
$103.99
|
| Rate for Payer: Cigna Medicare Advantage |
$113.12
|
| Rate for Payer: Family Health Partners Medicaid |
$35.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$125.02
|
| Rate for Payer: Healthy Blue Medicaid |
$38.03
|
| Rate for Payer: Home State Health Plan Exchange |
$113.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$35.21
|
| Rate for Payer: Humana Medicare |
$148.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$35.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.84
|
| Rate for Payer: Provider Network of America Commercial |
$158.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$130.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$27.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.51
|
|
|
HC Assay of Estrogen - Estrogens, Total
|
Facility
|
IP
|
$277.73
|
|
|
Service Code
|
CPT 82672
|
| Hospital Charge Code |
Px03018267201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$208.30 |
| 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 |
$277.73
|
| Rate for Payer: Cash Price |
$277.73
|
| 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 |
$208.30
|
| Rate for Payer: Provider Network of America Commercial |
$222.18
|
|
