|
HC Assay of Estrogen - Estrogens, Total
|
Facility
|
OP
|
$277.73
|
|
|
Service Code
|
CPT 82672
|
| Hospital Charge Code |
Px03018267201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.58 |
| Max. Negotiated Rate |
$222.18 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$195.80
|
| Rate for Payer: Aetna Workers' Compensation |
$195.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$192.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$192.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$218.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$218.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$218.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$213.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$218.85
|
| Rate for Payer: Cash Price |
$277.73
|
| Rate for Payer: Cash Price |
$277.73
|
| Rate for Payer: Cigna Commercial |
$145.53
|
| Rate for Payer: Cigna Medicare Advantage |
$158.31
|
| Rate for Payer: Family Health Partners Medicaid |
$27.34
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$174.97
|
| Rate for Payer: Healthy Blue Medicaid |
$29.53
|
| Rate for Payer: Home State Health Plan Exchange |
$158.31
|
| Rate for Payer: Home State Health Plan Medicaid |
$27.34
|
| Rate for Payer: Humana Medicare |
$208.30
|
| Rate for Payer: Mercy CarePlus Medicaid |
$27.34
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$208.30
|
| Rate for Payer: Provider Network of America Commercial |
$222.18
|
| Rate for Payer: UnitedHealthcare Commercial |
$183.30
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$21.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$20.58
|
|
|
HC Assay of Ferritin - Ferritin
|
Facility
|
IP
|
$171.15
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
Px03018272801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$128.36 |
| 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 |
$171.15
|
| Rate for Payer: Cash Price |
$171.15
|
| 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 |
$128.36
|
| Rate for Payer: Provider Network of America Commercial |
$136.92
|
|
|
HC Assay of Ferritin - Ferritin
|
Facility
|
OP
|
$171.15
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
Px03018272801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.93 |
| Max. Negotiated Rate |
$136.92 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$120.66
|
| Rate for Payer: Aetna Workers' Compensation |
$120.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$118.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$118.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$134.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$134.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$134.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$131.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$134.87
|
| Rate for Payer: Cash Price |
$171.15
|
| Rate for Payer: Cash Price |
$171.15
|
| Rate for Payer: Cigna Commercial |
$89.68
|
| Rate for Payer: Cigna Medicare Advantage |
$97.56
|
| Rate for Payer: Family Health Partners Medicaid |
$17.18
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$107.82
|
| Rate for Payer: Healthy Blue Medicaid |
$18.55
|
| Rate for Payer: Home State Health Plan Exchange |
$97.56
|
| Rate for Payer: Home State Health Plan Medicaid |
$17.18
|
| Rate for Payer: Humana Medicare |
$128.36
|
| Rate for Payer: Mercy CarePlus Medicaid |
$17.18
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$128.36
|
| Rate for Payer: Provider Network of America Commercial |
$136.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$112.96
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.93
|
|
|
HC Assay of Folic Acid, RBC - Folate RBC
|
Facility
|
IP
|
$264.60
|
|
|
Service Code
|
CPT 82747
|
| Hospital Charge Code |
Px03018274701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$198.45 |
| 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 |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| 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 |
$198.45
|
| Rate for Payer: Provider Network of America Commercial |
$211.68
|
|
|
HC Assay of Folic Acid, RBC - Folate RBC
|
Facility
|
OP
|
$264.60
|
|
|
Service Code
|
CPT 82747
|
| Hospital Charge Code |
Px03018274701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.75 |
| Max. Negotiated Rate |
$211.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$186.54
|
| Rate for Payer: Aetna Workers' Compensation |
$186.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$183.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$183.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$208.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$203.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$208.50
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cash Price |
$264.60
|
| Rate for Payer: Cigna Commercial |
$138.65
|
| Rate for Payer: Cigna Medicare Advantage |
$150.82
|
| Rate for Payer: Family Health Partners Medicaid |
$22.25
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$166.70
|
| Rate for Payer: Healthy Blue Medicaid |
$24.03
|
| Rate for Payer: Home State Health Plan Exchange |
$150.82
|
| Rate for Payer: Home State Health Plan Medicaid |
$22.25
|
| Rate for Payer: Humana Medicare |
$198.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$22.25
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$198.45
|
| Rate for Payer: Provider Network of America Commercial |
$211.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$174.64
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.65
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.75
|
|
|
HC Assay of Free Thyroxine - T4 Free
|
Facility
|
IP
|
$157.50
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
Px03018443901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.12 |
| 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 |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| 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 |
$118.12
|
| Rate for Payer: Provider Network of America Commercial |
$126.00
|
|
|
HC Assay of Free Thyroxine - T4 Free
|
Facility
|
OP
|
$157.50
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
Px03018443901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.56 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$111.04
|
| Rate for Payer: Aetna Workers' Compensation |
$111.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$109.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$109.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$124.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$124.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$124.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$121.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$124.11
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna Commercial |
$82.53
|
| Rate for Payer: Cigna Medicare Advantage |
$89.78
|
| Rate for Payer: Family Health Partners Medicaid |
$11.37
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$99.22
|
| Rate for Payer: Healthy Blue Medicaid |
$12.28
|
| Rate for Payer: Home State Health Plan Exchange |
$89.78
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.37
|
| Rate for Payer: Humana Medicare |
$118.12
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.37
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$118.12
|
| Rate for Payer: Provider Network of America Commercial |
$126.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.95
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.56
|
|
|
HC Assay of G6pd Enzyme - Glucose 6 Phosphate Dehydrogenase
|
Facility
|
IP
|
$89.25
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
Px03018295501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.94 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$89.25
|
| Rate for Payer: Cash Price |
$89.25
|
| 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 |
$66.94
|
| Rate for Payer: Provider Network of America Commercial |
$71.40
|
|
|
HC Assay of G6pd Enzyme - Glucose 6 Phosphate Dehydrogenase
|
Facility
|
OP
|
$89.25
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
Px03018295501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.20 |
| Max. Negotiated Rate |
$71.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$62.92
|
| Rate for Payer: Aetna Workers' Compensation |
$62.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$61.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$61.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$70.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$70.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$70.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$68.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$70.33
|
| Rate for Payer: Cash Price |
$89.25
|
| Rate for Payer: Cash Price |
$89.25
|
| Rate for Payer: Cigna Commercial |
$46.77
|
| Rate for Payer: Cigna Medicare Advantage |
$50.87
|
| Rate for Payer: Family Health Partners Medicaid |
$12.22
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$56.23
|
| Rate for Payer: Healthy Blue Medicaid |
$13.20
|
| Rate for Payer: Home State Health Plan Exchange |
$50.87
|
| Rate for Payer: Home State Health Plan Medicaid |
$12.22
|
| Rate for Payer: Humana Medicare |
$66.94
|
| Rate for Payer: Mercy CarePlus Medicaid |
$12.22
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$66.94
|
| Rate for Payer: Provider Network of America Commercial |
$71.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.91
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.20
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each Celiac Disease Comp Cascade-Mayo Clinic
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each Celiac Disease Comp Cascade-Mayo Clinic
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Celiac Panel Rfx
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Celiac Panel Rfx
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278406
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Celiac Reflex Pnl
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Celiac Reflex Pnl
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Iga
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Iga
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Iga Serum
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278409
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Iga Serum
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278409
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg 1, 2, 3, and 4
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg 1, 2, 3, and 4
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg Serum
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$144.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$127.32
|
| Rate for Payer: Aetna Workers' Compensation |
$127.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$125.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$142.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$139.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$142.31
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cigna Commercial |
$94.63
|
| Rate for Payer: Cigna Medicare Advantage |
$102.94
|
| Rate for Payer: Family Health Partners Medicaid |
$11.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$113.78
|
| Rate for Payer: Healthy Blue Medicaid |
$12.66
|
| Rate for Payer: Home State Health Plan Exchange |
$102.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$11.72
|
| Rate for Payer: Humana Medicare |
$135.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$11.72
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$119.20
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$8.82
|
|
|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg Serum
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278408
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.45 |
| 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 |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| 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 |
$135.45
|
| Rate for Payer: Provider Network of America Commercial |
$144.48
|
|
