|
HC Assay of Ldh Isoenzymes - Lactate Dehydrogenase Isoenzms
|
Facility
|
OP
|
$232.05
|
|
|
Service Code
|
CPT 83625
|
| Hospital Charge Code |
Px03018362501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.13 |
| Max. Negotiated Rate |
$185.64 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$163.60
|
| Rate for Payer: Aetna Workers' Compensation |
$163.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$160.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$160.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$182.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$182.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$182.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$178.68
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$182.86
|
| Rate for Payer: Cash Price |
$232.05
|
| Rate for Payer: Cash Price |
$232.05
|
| Rate for Payer: Cigna Commercial |
$121.59
|
| Rate for Payer: Cigna Medicare Advantage |
$132.27
|
| Rate for Payer: Family Health Partners Medicaid |
$16.11
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$146.19
|
| Rate for Payer: Healthy Blue Medicaid |
$17.40
|
| Rate for Payer: Home State Health Plan Exchange |
$132.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.11
|
| Rate for Payer: Humana Medicare |
$174.04
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.11
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$174.04
|
| Rate for Payer: Provider Network of America Commercial |
$185.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$153.15
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.79
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.13
|
|
|
HC Assay of Ldh Isoenzymes - Lactate Dehydrogenase Isoenzms
|
Facility
|
IP
|
$232.05
|
|
|
Service Code
|
CPT 83625
|
| Hospital Charge Code |
Px03018362501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$174.04 |
| 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 |
$232.05
|
| Rate for Payer: Cash Price |
$232.05
|
| 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 |
$174.04
|
| Rate for Payer: Provider Network of America Commercial |
$185.64
|
|
|
HC Assay of Lead - Lead 24hr Urine
|
Facility
|
OP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$80.69
|
| Rate for Payer: Aetna Workers' Compensation |
$80.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$88.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$90.19
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cigna Commercial |
$59.97
|
| Rate for Payer: Cigna Medicare Advantage |
$65.24
|
| Rate for Payer: Family Health Partners Medicaid |
$15.26
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$72.10
|
| Rate for Payer: Healthy Blue Medicaid |
$16.48
|
| Rate for Payer: Home State Health Plan Exchange |
$65.24
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.26
|
| Rate for Payer: Humana Medicare |
$85.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.26
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.49
|
|
|
HC Assay of Lead - Lead 24hr Urine
|
Facility
|
IP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| 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 |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
|
|
HC Assay of Lead - Lead Blood
|
Facility
|
OP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$80.69
|
| Rate for Payer: Aetna Workers' Compensation |
$80.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$88.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$90.19
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cigna Commercial |
$59.97
|
| Rate for Payer: Cigna Medicare Advantage |
$65.24
|
| Rate for Payer: Family Health Partners Medicaid |
$15.26
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$72.10
|
| Rate for Payer: Healthy Blue Medicaid |
$16.48
|
| Rate for Payer: Home State Health Plan Exchange |
$65.24
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.26
|
| Rate for Payer: Humana Medicare |
$85.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.26
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.49
|
|
|
HC Assay of Lead - Lead Blood
|
Facility
|
IP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| 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 |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
|
|
HC Assay of Lead - Lead, Capillary Blood
|
Facility
|
OP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$80.69
|
| Rate for Payer: Aetna Workers' Compensation |
$80.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$88.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$90.19
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cigna Commercial |
$59.97
|
| Rate for Payer: Cigna Medicare Advantage |
$65.24
|
| Rate for Payer: Family Health Partners Medicaid |
$15.26
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$72.10
|
| Rate for Payer: Healthy Blue Medicaid |
$16.48
|
| Rate for Payer: Home State Health Plan Exchange |
$65.24
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.26
|
| Rate for Payer: Humana Medicare |
$85.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.26
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.49
|
|
|
HC Assay of Lead - Lead, Capillary Blood
|
Facility
|
IP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| 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 |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
|
|
HC Assay of Lead - POCT Blood Lead
|
Facility
|
IP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$85.84 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| 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 |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
|
|
HC Assay of Lead - POCT Blood Lead
|
Facility
|
OP
|
$114.45
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
Px03018365502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.49 |
| Max. Negotiated Rate |
$91.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$80.69
|
| Rate for Payer: Aetna Workers' Compensation |
$80.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$79.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$90.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$88.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$90.19
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cash Price |
$114.45
|
| Rate for Payer: Cigna Commercial |
$59.97
|
| Rate for Payer: Cigna Medicare Advantage |
$65.24
|
| Rate for Payer: Family Health Partners Medicaid |
$15.26
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$72.10
|
| Rate for Payer: Healthy Blue Medicaid |
$16.48
|
| Rate for Payer: Home State Health Plan Exchange |
$65.24
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.26
|
| Rate for Payer: Humana Medicare |
$85.84
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.26
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$85.84
|
| Rate for Payer: Provider Network of America Commercial |
$91.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$75.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.11
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.49
|
|
|
HC Assay of Levetiracetam
|
Facility
|
OP
|
$147.00
|
|
|
Service Code
|
CPT 80177
|
| Hospital Charge Code |
Px03018017701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$117.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$103.64
|
| Rate for Payer: Aetna Workers' Compensation |
$103.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$101.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$101.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$115.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$115.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$115.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$113.19
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$115.84
|
| Rate for Payer: Cash Price |
$147.00
|
| Rate for Payer: Cash Price |
$147.00
|
| Rate for Payer: Cigna Commercial |
$77.03
|
| Rate for Payer: Cigna Medicare Advantage |
$83.79
|
| Rate for Payer: Family Health Partners Medicaid |
$16.70
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$92.61
|
| Rate for Payer: Healthy Blue Medicaid |
$18.04
|
| Rate for Payer: Home State Health Plan Exchange |
$83.79
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.70
|
| Rate for Payer: Humana Medicare |
$110.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.70
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$110.25
|
| Rate for Payer: Provider Network of America Commercial |
$117.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$97.02
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.57
|
|
|
HC Assay of Levetiracetam
|
Facility
|
IP
|
$147.00
|
|
|
Service Code
|
CPT 80177
|
| Hospital Charge Code |
Px03018017701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$110.25 |
| 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 |
$147.00
|
| Rate for Payer: Cash Price |
$147.00
|
| 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 |
$110.25
|
| Rate for Payer: Provider Network of America Commercial |
$117.60
|
|
|
HC Assay of Lidocaine - Lidocaine Level
|
Facility
|
IP
|
$61.95
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
Px03018017601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.46 |
| 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 |
$61.95
|
| Rate for Payer: Cash Price |
$61.95
|
| 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 |
$46.46
|
| Rate for Payer: Provider Network of America Commercial |
$49.56
|
|
|
HC Assay of Lidocaine - Lidocaine Level
|
Facility
|
OP
|
$61.95
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
Px03018017601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.93 |
| Max. Negotiated Rate |
$49.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$43.67
|
| Rate for Payer: Aetna Workers' Compensation |
$43.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$42.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$48.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$48.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$48.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$47.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$48.82
|
| Rate for Payer: Cash Price |
$61.95
|
| Rate for Payer: Cash Price |
$61.95
|
| Rate for Payer: Cigna Commercial |
$32.46
|
| Rate for Payer: Cigna Medicare Advantage |
$35.31
|
| Rate for Payer: Family Health Partners Medicaid |
$18.51
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$39.03
|
| Rate for Payer: Healthy Blue Medicaid |
$19.99
|
| Rate for Payer: Home State Health Plan Exchange |
$35.31
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.51
|
| Rate for Payer: Humana Medicare |
$46.46
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.51
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$46.46
|
| Rate for Payer: Provider Network of America Commercial |
$49.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$40.89
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.69
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.93
|
|
|
HC Assay of Lipase - Lipase
|
Facility
|
IP
|
$171.15
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
Px03018369001
|
|
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 Lipase - Lipase
|
Facility
|
OP
|
$171.15
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
Px03018369001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.53 |
| 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 |
$8.68
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$107.82
|
| Rate for Payer: Healthy Blue Medicaid |
$9.37
|
| Rate for Payer: Home State Health Plan Exchange |
$97.56
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.68
|
| Rate for Payer: Humana Medicare |
$128.36
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.68
|
| 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 |
$6.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.53
|
|
|
HC Assay of Lipase - Lipase Body Fluid
|
Facility
|
OP
|
$171.15
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
Px03018369002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.53 |
| 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 |
$8.68
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$107.82
|
| Rate for Payer: Healthy Blue Medicaid |
$9.37
|
| Rate for Payer: Home State Health Plan Exchange |
$97.56
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.68
|
| Rate for Payer: Humana Medicare |
$128.36
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.68
|
| 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 |
$6.89
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.53
|
|
|
HC Assay of Lipase - Lipase Body Fluid
|
Facility
|
IP
|
$171.15
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
Px03018369002
|
|
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 Lipoprotein (A)
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
Px03018369501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.59 |
| Max. Negotiated Rate |
$84.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$74.03
|
| Rate for Payer: Aetna Workers' Compensation |
$74.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$72.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$72.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$82.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$82.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$82.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$80.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$82.74
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| Rate for Payer: Cigna Commercial |
$55.02
|
| Rate for Payer: Cigna Medicare Advantage |
$59.85
|
| Rate for Payer: Family Health Partners Medicaid |
$18.05
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$66.15
|
| Rate for Payer: Healthy Blue Medicaid |
$19.49
|
| Rate for Payer: Home State Health Plan Exchange |
$59.85
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.05
|
| Rate for Payer: Humana Medicare |
$78.75
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.05
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$78.75
|
| Rate for Payer: Provider Network of America Commercial |
$84.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$69.30
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.59
|
|
|
HC Assay of Lipoprotein (A)
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
Px03018369501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.75 |
| 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 |
$105.00
|
| Rate for Payer: Cash Price |
$105.00
|
| 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 |
$78.75
|
| Rate for Payer: Provider Network of America Commercial |
$84.00
|
|
|
HC Assay of Lithium - Lithium
|
Facility
|
OP
|
$112.35
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
Px03018017801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$89.88 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$79.21
|
| Rate for Payer: Aetna Workers' Compensation |
$79.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$77.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$77.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$88.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$88.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$88.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$86.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$88.53
|
| Rate for Payer: Cash Price |
$112.35
|
| Rate for Payer: Cash Price |
$112.35
|
| Rate for Payer: Cigna Commercial |
$58.87
|
| Rate for Payer: Cigna Medicare Advantage |
$64.04
|
| Rate for Payer: Family Health Partners Medicaid |
$8.33
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$70.78
|
| Rate for Payer: Healthy Blue Medicaid |
$9.00
|
| Rate for Payer: Home State Health Plan Exchange |
$64.04
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.33
|
| Rate for Payer: Humana Medicare |
$84.26
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.33
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$84.26
|
| Rate for Payer: Provider Network of America Commercial |
$89.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$74.15
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.61
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.27
|
|
|
HC Assay of Lithium - Lithium
|
Facility
|
IP
|
$112.35
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
Px03018017801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.26 |
| 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 |
$112.35
|
| Rate for Payer: Cash Price |
$112.35
|
| 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 |
$84.26
|
| Rate for Payer: Provider Network of America Commercial |
$89.88
|
|
|
HC Assay of Magnesium - Magnesium
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$94.08 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$82.91
|
| Rate for Payer: Aetna Workers' Compensation |
$82.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$81.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$81.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$92.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$92.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$92.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$90.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$92.67
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| Rate for Payer: Cigna Commercial |
$61.62
|
| Rate for Payer: Cigna Medicare Advantage |
$67.03
|
| Rate for Payer: Family Health Partners Medicaid |
$8.44
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$74.09
|
| Rate for Payer: Healthy Blue Medicaid |
$9.12
|
| Rate for Payer: Home State Health Plan Exchange |
$67.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.44
|
| Rate for Payer: Humana Medicare |
$88.20
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.44
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$88.20
|
| Rate for Payer: Provider Network of America Commercial |
$94.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$77.62
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.70
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.36
|
|
|
HC Assay of Magnesium - Magnesium
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$88.20 |
| 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 |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| 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 |
$88.20
|
| Rate for Payer: Provider Network of America Commercial |
$94.08
|
|
|
HC Assay of Magnesium - Magnesium 24hr Urine
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$88.20 |
| 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 |
$117.60
|
| Rate for Payer: Cash Price |
$117.60
|
| 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 |
$88.20
|
| Rate for Payer: Provider Network of America Commercial |
$94.08
|
|
