|
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
|
|
|
HC Assay of Inorganic Phosphorus - Phosphorus
|
Facility
|
IP
|
$98.70
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
Px03018410004
|
|
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
|
|
|
HC Assay of Inorganic Phosphorus - Phosphorus
|
Facility
|
OP
|
$98.70
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
Px03018410004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$69.58
|
| Rate for Payer: Aetna Workers' Compensation |
$69.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$68.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$68.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$76.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$77.78
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cigna Commercial |
$51.72
|
| Rate for Payer: Cigna Medicare Advantage |
$56.26
|
| Rate for Payer: Family Health Partners Medicaid |
$5.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$62.18
|
| Rate for Payer: Healthy Blue Medicaid |
$6.46
|
| Rate for Payer: Home State Health Plan Exchange |
$56.26
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.98
|
| Rate for Payer: Humana Medicare |
$74.03
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$74.03
|
| Rate for Payer: Provider Network of America Commercial |
$78.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.14
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.50
|
|
|
HC Assay of Inorganic Phosphorus - Phosphorus Body Fluid
|
Facility
|
OP
|
$98.70
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
Px03018410001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$78.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$69.58
|
| Rate for Payer: Aetna Workers' Compensation |
$69.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$68.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$68.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$77.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$76.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$77.78
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cash Price |
$98.70
|
| Rate for Payer: Cigna Commercial |
$51.72
|
| Rate for Payer: Cigna Medicare Advantage |
$56.26
|
| Rate for Payer: Family Health Partners Medicaid |
$5.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$62.18
|
| Rate for Payer: Healthy Blue Medicaid |
$6.46
|
| Rate for Payer: Home State Health Plan Exchange |
$56.26
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.98
|
| Rate for Payer: Humana Medicare |
$74.03
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$74.03
|
| Rate for Payer: Provider Network of America Commercial |
$78.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$65.14
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.50
|
|
|
HC Assay of Inorganic Phosphorus - Phosphorus Body Fluid
|
Facility
|
IP
|
$98.70
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
Px03018410001
|
|
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
|
|
|
HC Assay of Insulin,Total - Insulin, Fasting
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
Px03018352501
|
|
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 Insulin,Total - Insulin, Fasting
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
Px03018352501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| 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 |
$14.41
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$52.92
|
| Rate for Payer: Healthy Blue Medicaid |
$15.56
|
| Rate for Payer: Home State Health Plan Exchange |
$47.88
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.41
|
| Rate for Payer: Humana Medicare |
$63.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.41
|
| 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 |
$11.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.85
|
|
|
HC Assay of Insulin,Total - Insulin, Random
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
Px03018352502
|
|
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 Insulin,Total - Insulin, Random
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
Px03018352502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| 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 |
$14.41
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$52.92
|
| Rate for Payer: Healthy Blue Medicaid |
$15.56
|
| Rate for Payer: Home State Health Plan Exchange |
$47.88
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.41
|
| Rate for Payer: Humana Medicare |
$63.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.41
|
| 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 |
$11.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.85
|
|
|
HC Assay of Insulin,Total - Insulin, Total
|
Facility
|
IP
|
$84.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
Px03018352503
|
|
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 Insulin,Total - Insulin, Total
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 83525
|
| Hospital Charge Code |
Px03018352503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.85 |
| 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 |
$14.41
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$52.92
|
| Rate for Payer: Healthy Blue Medicaid |
$15.56
|
| Rate for Payer: Home State Health Plan Exchange |
$47.88
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.41
|
| Rate for Payer: Humana Medicare |
$63.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.41
|
| 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 |
$11.43
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.85
|
|
|
HC Assay of Interleukin 6, Plasma
|
Facility
|
OP
|
$154.35
|
|
|
Service Code
|
CPT 83529
|
| Hospital Charge Code |
Px03008352901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.38 |
| Max. Negotiated Rate |
$123.48 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$108.82
|
| Rate for Payer: Aetna Workers' Compensation |
$108.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$106.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$106.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$121.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$121.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$121.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$118.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$121.63
|
| Rate for Payer: Cash Price |
$154.35
|
| Rate for Payer: Cash Price |
$154.35
|
| Rate for Payer: Cigna Commercial |
$80.88
|
| Rate for Payer: Cigna Medicare Advantage |
$87.98
|
| Rate for Payer: Family Health Partners Medicaid |
$21.76
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$97.24
|
| Rate for Payer: Healthy Blue Medicaid |
$23.50
|
| Rate for Payer: Home State Health Plan Exchange |
$87.98
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.76
|
| Rate for Payer: Humana Medicare |
$115.76
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.76
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$115.76
|
| Rate for Payer: Provider Network of America Commercial |
$123.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$101.87
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.27
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.38
|
|
|
HC Assay of Interleukin 6, Plasma
|
Facility
|
IP
|
$154.35
|
|
|
Service Code
|
CPT 83529
|
| Hospital Charge Code |
Px03008352901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$115.76 |
| 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 |
$154.35
|
| Rate for Payer: Cash Price |
$154.35
|
| 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 |
$115.76
|
| Rate for Payer: Provider Network of America Commercial |
$123.48
|
|
|
HC Assay of Iron - Iron
|
Facility
|
IP
|
$96.60
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
Px03018354002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.45 |
| 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 |
$96.60
|
| Rate for Payer: Cash Price |
$96.60
|
| 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 |
$72.45
|
| Rate for Payer: Provider Network of America Commercial |
$77.28
|
|
|
HC Assay of Iron - Iron
|
Facility
|
OP
|
$96.60
|
|
|
Service Code
|
CPT 83540
|
| Hospital Charge Code |
Px03018354002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.13 |
| Max. Negotiated Rate |
$77.28 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$68.10
|
| Rate for Payer: Aetna Workers' Compensation |
$68.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$66.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$66.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$76.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$76.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$76.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$74.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$76.12
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Cash Price |
$96.60
|
| Rate for Payer: Cigna Commercial |
$50.62
|
| Rate for Payer: Cigna Medicare Advantage |
$55.06
|
| Rate for Payer: Family Health Partners Medicaid |
$8.15
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$60.86
|
| Rate for Payer: Healthy Blue Medicaid |
$8.80
|
| Rate for Payer: Home State Health Plan Exchange |
$55.06
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.15
|
| Rate for Payer: Humana Medicare |
$72.45
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.15
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$72.45
|
| Rate for Payer: Provider Network of America Commercial |
$77.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.76
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.13
|
|
|
HC Assay of Lactic Acid - Lactate
|
Facility
|
OP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$135.47
|
| Rate for Payer: Aetna Workers' Compensation |
$135.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$151.41
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cigna Commercial |
$100.69
|
| Rate for Payer: Cigna Medicare Advantage |
$109.53
|
| Rate for Payer: Family Health Partners Medicaid |
$14.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$121.05
|
| Rate for Payer: Healthy Blue Medicaid |
$15.74
|
| Rate for Payer: Home State Health Plan Exchange |
$109.53
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.57
|
| Rate for Payer: Humana Medicare |
$144.11
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.97
|
|
|
HC Assay of Lactic Acid - Lactate
|
Facility
|
IP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.11 |
| 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 |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| 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 |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
|
|
HC Assay of Lactic Acid - Lactic Acid, Arterial, Whole Blood
|
Facility
|
OP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$135.47
|
| Rate for Payer: Aetna Workers' Compensation |
$135.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$151.41
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cigna Commercial |
$100.69
|
| Rate for Payer: Cigna Medicare Advantage |
$109.53
|
| Rate for Payer: Family Health Partners Medicaid |
$14.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$121.05
|
| Rate for Payer: Healthy Blue Medicaid |
$15.74
|
| Rate for Payer: Home State Health Plan Exchange |
$109.53
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.57
|
| Rate for Payer: Humana Medicare |
$144.11
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.97
|
|
|
HC Assay of Lactic Acid - Lactic Acid, Arterial, Whole Blood
|
Facility
|
IP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360505
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.11 |
| 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 |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| 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 |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
|
|
HC Assay of Lactic Acid - Lactic Acid Body Fluid
|
Facility
|
OP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$135.47
|
| Rate for Payer: Aetna Workers' Compensation |
$135.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$151.41
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cigna Commercial |
$100.69
|
| Rate for Payer: Cigna Medicare Advantage |
$109.53
|
| Rate for Payer: Family Health Partners Medicaid |
$14.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$121.05
|
| Rate for Payer: Healthy Blue Medicaid |
$15.74
|
| Rate for Payer: Home State Health Plan Exchange |
$109.53
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.57
|
| Rate for Payer: Humana Medicare |
$144.11
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.97
|
|
|
HC Assay of Lactic Acid - Lactic Acid Body Fluid
|
Facility
|
IP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.11 |
| 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 |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| 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 |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
|
|
HC Assay of Lactic Acid - Lactic Acid, Venous, Whole Blood
|
Facility
|
IP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360506
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.11 |
| 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 |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| 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 |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
|
|
HC Assay of Lactic Acid - Lactic Acid, Venous, Whole Blood
|
Facility
|
OP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360506
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$135.47
|
| Rate for Payer: Aetna Workers' Compensation |
$135.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$151.41
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cigna Commercial |
$100.69
|
| Rate for Payer: Cigna Medicare Advantage |
$109.53
|
| Rate for Payer: Family Health Partners Medicaid |
$14.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$121.05
|
| Rate for Payer: Healthy Blue Medicaid |
$15.74
|
| Rate for Payer: Home State Health Plan Exchange |
$109.53
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.57
|
| Rate for Payer: Humana Medicare |
$144.11
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.97
|
|
|
HC Assay of Lactic Acid - POCT Lactic Acid (Lactate)
|
Facility
|
IP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$144.11 |
| 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 |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| 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 |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
|
|
HC Assay of Lactic Acid - POCT Lactic Acid (Lactate)
|
Facility
|
OP
|
$192.15
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
Px03018360503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$153.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$135.47
|
| Rate for Payer: Aetna Workers' Compensation |
$135.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$133.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$151.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$151.41
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cash Price |
$192.15
|
| Rate for Payer: Cigna Commercial |
$100.69
|
| Rate for Payer: Cigna Medicare Advantage |
$109.53
|
| Rate for Payer: Family Health Partners Medicaid |
$14.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$121.05
|
| Rate for Payer: Healthy Blue Medicaid |
$15.74
|
| Rate for Payer: Home State Health Plan Exchange |
$109.53
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.57
|
| Rate for Payer: Humana Medicare |
$144.11
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$144.11
|
| Rate for Payer: Provider Network of America Commercial |
$153.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.97
|
|
