|
HC Assay of Gammaglobulin Iga, Igd, Igg, Igm, Each - Igg Serum
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278411
|
|
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 |
Px03018278411
|
|
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 - Igm
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278403
|
|
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 - Igm
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278403
|
|
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 - Immunoglobulins
|
Facility
|
IP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278401
|
|
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 - Immunoglobulins
|
Facility
|
OP
|
$180.60
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
Px03018278401
|
|
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 Ige - Humoral Immunity Status Survey
|
Facility
|
OP
|
$110.25
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
Px03018278502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$77.73
|
| Rate for Payer: Aetna Workers' Compensation |
$77.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$84.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$86.88
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cigna Commercial |
$57.77
|
| Rate for Payer: Cigna Medicare Advantage |
$62.84
|
| Rate for Payer: Family Health Partners Medicaid |
$20.73
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$69.46
|
| Rate for Payer: Healthy Blue Medicaid |
$22.39
|
| Rate for Payer: Home State Health Plan Exchange |
$62.84
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.73
|
| Rate for Payer: Humana Medicare |
$82.69
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.73
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.77
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.61
|
|
|
HC Assay of Gammaglobulin Ige - Humoral Immunity Status Survey
|
Facility
|
IP
|
$110.25
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
Px03018278502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.69 |
| 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 |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| 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 |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
|
|
HC Assay of Gammaglobulin Ige - Immunoglobulin Ige
|
Facility
|
IP
|
$110.25
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
Px03018278501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.69 |
| 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 |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| 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 |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
|
|
HC Assay of Gammaglobulin Ige - Immunoglobulin Ige
|
Facility
|
OP
|
$110.25
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
Px03018278501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.61 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$77.73
|
| Rate for Payer: Aetna Workers' Compensation |
$77.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$84.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$86.88
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cigna Commercial |
$57.77
|
| Rate for Payer: Cigna Medicare Advantage |
$62.84
|
| Rate for Payer: Family Health Partners Medicaid |
$20.73
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$69.46
|
| Rate for Payer: Healthy Blue Medicaid |
$22.39
|
| Rate for Payer: Home State Health Plan Exchange |
$62.84
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.73
|
| Rate for Payer: Humana Medicare |
$82.69
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.73
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.77
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.46
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.61
|
|
|
HC Assay of Gastrin - Gastrin
|
Facility
|
OP
|
$175.35
|
|
|
Service Code
|
CPT 82941
|
| Hospital Charge Code |
Px03018294101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.73 |
| Max. Negotiated Rate |
$140.28 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$123.62
|
| Rate for Payer: Aetna Workers' Compensation |
$123.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$121.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$121.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$138.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$138.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$138.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$135.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$138.18
|
| Rate for Payer: Cash Price |
$175.35
|
| Rate for Payer: Cash Price |
$175.35
|
| Rate for Payer: Cigna Commercial |
$91.88
|
| Rate for Payer: Cigna Medicare Advantage |
$99.95
|
| Rate for Payer: Family Health Partners Medicaid |
$22.22
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$110.47
|
| Rate for Payer: Healthy Blue Medicaid |
$24.00
|
| Rate for Payer: Home State Health Plan Exchange |
$99.95
|
| Rate for Payer: Home State Health Plan Medicaid |
$22.22
|
| Rate for Payer: Humana Medicare |
$131.51
|
| Rate for Payer: Mercy CarePlus Medicaid |
$22.22
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$131.51
|
| Rate for Payer: Provider Network of America Commercial |
$140.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$115.73
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.73
|
|
|
HC Assay of Gastrin - Gastrin
|
Facility
|
IP
|
$175.35
|
|
|
Service Code
|
CPT 82941
|
| Hospital Charge Code |
Px03018294101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$131.51 |
| 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 |
$175.35
|
| Rate for Payer: Cash Price |
$175.35
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$131.51
|
| Rate for Payer: Provider Network of America Commercial |
$140.28
|
|
|
HC Assay of Gentamicin - Gentamicin Peak
|
Facility
|
OP
|
$220.50
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
Px03018017003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$155.45
|
| Rate for Payer: Aetna Workers' Compensation |
$155.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$169.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$173.75
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cigna Commercial |
$115.54
|
| Rate for Payer: Cigna Medicare Advantage |
$125.69
|
| Rate for Payer: Family Health Partners Medicaid |
$20.64
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$138.91
|
| Rate for Payer: Healthy Blue Medicaid |
$22.29
|
| Rate for Payer: Home State Health Plan Exchange |
$125.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.64
|
| Rate for Payer: Humana Medicare |
$165.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.64
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$165.38
|
| Rate for Payer: Provider Network of America Commercial |
$176.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$145.53
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.54
|
|
|
HC Assay of Gentamicin - Gentamicin Peak
|
Facility
|
IP
|
$220.50
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
Px03018017003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$165.38 |
| 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 |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| 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 |
$165.38
|
| Rate for Payer: Provider Network of America Commercial |
$176.40
|
|
|
HC Assay of Gentamicin - Gentamicin Trough
|
Facility
|
IP
|
$220.50
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
Px03018017001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$165.38 |
| 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 |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| 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 |
$165.38
|
| Rate for Payer: Provider Network of America Commercial |
$176.40
|
|
|
HC Assay of Gentamicin - Gentamicin Trough
|
Facility
|
OP
|
$220.50
|
|
|
Service Code
|
CPT 80170
|
| Hospital Charge Code |
Px03018017001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.54 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$155.45
|
| Rate for Payer: Aetna Workers' Compensation |
$155.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$169.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$173.75
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cigna Commercial |
$115.54
|
| Rate for Payer: Cigna Medicare Advantage |
$125.69
|
| Rate for Payer: Family Health Partners Medicaid |
$20.64
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$138.91
|
| Rate for Payer: Healthy Blue Medicaid |
$22.29
|
| Rate for Payer: Home State Health Plan Exchange |
$125.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.64
|
| Rate for Payer: Humana Medicare |
$165.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.64
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$165.38
|
| Rate for Payer: Provider Network of America Commercial |
$176.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$145.53
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.54
|
|
|
HC Assay of Ggt - Gamma Gt
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
Px03018297701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$63.00 |
| 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 |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| 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 |
$63.00
|
| Rate for Payer: Provider Network of America Commercial |
$67.20
|
|
|
HC Assay of Ggt - Gamma Gt
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 82977
|
| Hospital Charge Code |
Px03018297701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.83 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$59.22
|
| Rate for Payer: Aetna Workers' Compensation |
$59.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$58.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$58.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$66.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$66.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$66.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$64.68
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$66.19
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cigna Commercial |
$44.02
|
| Rate for Payer: Cigna Medicare Advantage |
$47.88
|
| Rate for Payer: Family Health Partners Medicaid |
$9.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$52.92
|
| Rate for Payer: Healthy Blue Medicaid |
$9.80
|
| Rate for Payer: Home State Health Plan Exchange |
$47.88
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.07
|
| Rate for Payer: Humana Medicare |
$63.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.07
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$63.00
|
| Rate for Payer: Provider Network of America Commercial |
$67.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$55.44
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7.20
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.83
|
|
|
HC Assay of Haptoglobin, Quant - Haptoglobin
|
Facility
|
OP
|
$178.50
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
Px03018301001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$125.84
|
| Rate for Payer: Aetna Workers' Compensation |
$125.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$137.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$140.66
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cigna Commercial |
$93.53
|
| Rate for Payer: Cigna Medicare Advantage |
$101.75
|
| Rate for Payer: Family Health Partners Medicaid |
$15.85
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$112.45
|
| Rate for Payer: Healthy Blue Medicaid |
$17.12
|
| Rate for Payer: Home State Health Plan Exchange |
$101.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.85
|
| Rate for Payer: Humana Medicare |
$133.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.85
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.81
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.58
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.93
|
|
|
HC Assay of Haptoglobin, Quant - Haptoglobin
|
Facility
|
IP
|
$178.50
|
|
|
Service Code
|
CPT 83010
|
| Hospital Charge Code |
Px03018301001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$133.88 |
| 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 |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| 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 |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
|
|
HC Assay of Homocystine - Homocysteine
|
Facility
|
OP
|
$219.45
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
Px03018309002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$175.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$154.71
|
| Rate for Payer: Aetna Workers' Compensation |
$154.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$172.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$172.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$172.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$168.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$172.93
|
| Rate for Payer: Cash Price |
$219.45
|
| Rate for Payer: Cash Price |
$219.45
|
| Rate for Payer: Cigna Commercial |
$114.99
|
| Rate for Payer: Cigna Medicare Advantage |
$125.09
|
| Rate for Payer: Family Health Partners Medicaid |
$22.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$138.25
|
| Rate for Payer: Healthy Blue Medicaid |
$24.39
|
| Rate for Payer: Home State Health Plan Exchange |
$125.09
|
| Rate for Payer: Home State Health Plan Medicaid |
$22.58
|
| Rate for Payer: Humana Medicare |
$164.59
|
| Rate for Payer: Mercy CarePlus Medicaid |
$22.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$164.59
|
| Rate for Payer: Provider Network of America Commercial |
$175.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$144.84
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.00
|
|
|
HC Assay of Homocystine - Homocysteine
|
Facility
|
IP
|
$219.45
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
Px03018309002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$164.59 |
| 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 |
$219.45
|
| Rate for Payer: Cash Price |
$219.45
|
| 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 |
$164.59
|
| Rate for Payer: Provider Network of America Commercial |
$175.56
|
|
|
HC Assay of Homocystine - Homocysteine Total
|
Facility
|
OP
|
$219.45
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
Px03018309001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.00 |
| Max. Negotiated Rate |
$175.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$154.71
|
| Rate for Payer: Aetna Workers' Compensation |
$154.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$152.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$172.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$172.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$172.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$168.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$172.93
|
| Rate for Payer: Cash Price |
$219.45
|
| Rate for Payer: Cash Price |
$219.45
|
| Rate for Payer: Cigna Commercial |
$114.99
|
| Rate for Payer: Cigna Medicare Advantage |
$125.09
|
| Rate for Payer: Family Health Partners Medicaid |
$22.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$138.25
|
| Rate for Payer: Healthy Blue Medicaid |
$24.39
|
| Rate for Payer: Home State Health Plan Exchange |
$125.09
|
| Rate for Payer: Home State Health Plan Medicaid |
$22.58
|
| Rate for Payer: Humana Medicare |
$164.59
|
| Rate for Payer: Mercy CarePlus Medicaid |
$22.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$164.59
|
| Rate for Payer: Provider Network of America Commercial |
$175.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$144.84
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.00
|
|
|
HC Assay of Homocystine - Homocysteine Total
|
Facility
|
IP
|
$219.45
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
Px03018309001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$164.59 |
| 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 |
$219.45
|
| Rate for Payer: Cash Price |
$219.45
|
| 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 |
$164.59
|
| Rate for Payer: Provider Network of America Commercial |
$175.56
|
|
|
HC Assay of Inorganic Phosphorus - Organophosphate Pesticides
|
Facility
|
IP
|
$98.70
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
Px03018410003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.03 |
| 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 |
$98.70
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$74.03
|
| Rate for Payer: Provider Network of America Commercial |
$78.96
|
|
