|
HC Assay of Magnesium - Magnesium 24hr Urine
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373503
|
|
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 Fecal
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373505
|
|
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 Fecal
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373505
|
|
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 RBC
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373504
|
|
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 RBC
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373504
|
|
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 Urine
|
Facility
|
IP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373502
|
|
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 Urine
|
Facility
|
OP
|
$117.60
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
Px03018373502
|
|
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 Mercury - Heavy Metals, Blood
|
Facility
|
OP
|
$159.60
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
Px03018382502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$127.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$112.52
|
| Rate for Payer: Aetna Workers' Compensation |
$112.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$122.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$125.76
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cigna Commercial |
$83.63
|
| Rate for Payer: Cigna Medicare Advantage |
$90.97
|
| Rate for Payer: Family Health Partners Medicaid |
$20.48
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$100.55
|
| Rate for Payer: Healthy Blue Medicaid |
$22.12
|
| Rate for Payer: Home State Health Plan Exchange |
$90.97
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.48
|
| Rate for Payer: Humana Medicare |
$119.70
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.48
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$119.70
|
| Rate for Payer: Provider Network of America Commercial |
$127.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$105.34
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.42
|
|
|
HC Assay of Mercury - Heavy Metals, Blood
|
Facility
|
IP
|
$159.60
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
Px03018382502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.70 |
| 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 |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| 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 |
$119.70
|
| Rate for Payer: Provider Network of America Commercial |
$127.68
|
|
|
HC Assay of Mercury - Mercury 24 Hour Urine
|
Facility
|
OP
|
$159.60
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
Px03018382501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$127.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$112.52
|
| Rate for Payer: Aetna Workers' Compensation |
$112.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$122.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$125.76
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cigna Commercial |
$83.63
|
| Rate for Payer: Cigna Medicare Advantage |
$90.97
|
| Rate for Payer: Family Health Partners Medicaid |
$20.48
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$100.55
|
| Rate for Payer: Healthy Blue Medicaid |
$22.12
|
| Rate for Payer: Home State Health Plan Exchange |
$90.97
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.48
|
| Rate for Payer: Humana Medicare |
$119.70
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.48
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$119.70
|
| Rate for Payer: Provider Network of America Commercial |
$127.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$105.34
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.42
|
|
|
HC Assay of Mercury - Mercury 24 Hour Urine
|
Facility
|
IP
|
$159.60
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
Px03018382501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.70 |
| 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 |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| 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 |
$119.70
|
| Rate for Payer: Provider Network of America Commercial |
$127.68
|
|
|
HC Assay of Mercury - Mercury, Blood
|
Facility
|
OP
|
$159.60
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
Px03018382503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.42 |
| Max. Negotiated Rate |
$127.68 |
| Rate for Payer: Cigna Medicare Advantage |
$90.97
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$112.52
|
| Rate for Payer: Aetna Workers' Compensation |
$112.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$110.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$125.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$122.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$125.76
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| Rate for Payer: Cigna Commercial |
$83.63
|
| Rate for Payer: Family Health Partners Medicaid |
$20.48
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$100.55
|
| Rate for Payer: Healthy Blue Medicaid |
$22.12
|
| Rate for Payer: Home State Health Plan Exchange |
$90.97
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.48
|
| Rate for Payer: Humana Medicare |
$119.70
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.48
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$119.70
|
| Rate for Payer: Provider Network of America Commercial |
$127.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$105.34
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.26
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.42
|
|
|
HC Assay of Mercury - Mercury, Blood
|
Facility
|
IP
|
$159.60
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
Px03018382503
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$119.70 |
| 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 |
$159.60
|
| Rate for Payer: Cash Price |
$159.60
|
| 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 |
$119.70
|
| Rate for Payer: Provider Network of America Commercial |
$127.68
|
|
|
HC Assay of Metanephrines
|
Facility
|
OP
|
$378.16
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
Px03018383504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$302.53 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$266.60
|
| Rate for Payer: Aetna Workers' Compensation |
$266.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$291.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$297.99
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cigna Commercial |
$198.16
|
| Rate for Payer: Cigna Medicare Advantage |
$215.55
|
| Rate for Payer: Family Health Partners Medicaid |
$21.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$238.24
|
| Rate for Payer: Healthy Blue Medicaid |
$23.06
|
| Rate for Payer: Home State Health Plan Exchange |
$215.55
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.35
|
| Rate for Payer: Humana Medicare |
$283.62
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$283.62
|
| Rate for Payer: Provider Network of America Commercial |
$302.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$249.59
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.07
|
|
|
HC Assay of Metanephrines
|
Facility
|
IP
|
$378.16
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
Px03018383504
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$283.62 |
| 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 |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| 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 |
$283.62
|
| Rate for Payer: Provider Network of America Commercial |
$302.53
|
|
|
HC Assay of Metanephrines - Metanephrines 24hr Urine
|
Facility
|
IP
|
$378.16
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
Px03018383501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$283.62 |
| 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 |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| 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 |
$283.62
|
| Rate for Payer: Provider Network of America Commercial |
$302.53
|
|
|
HC Assay of Metanephrines - Metanephrines 24hr Urine
|
Facility
|
OP
|
$378.16
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
Px03018383501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$302.53 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$266.60
|
| Rate for Payer: Aetna Workers' Compensation |
$266.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$291.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$297.99
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cigna Commercial |
$198.16
|
| Rate for Payer: Cigna Medicare Advantage |
$215.55
|
| Rate for Payer: Family Health Partners Medicaid |
$21.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$238.24
|
| Rate for Payer: Healthy Blue Medicaid |
$23.06
|
| Rate for Payer: Home State Health Plan Exchange |
$215.55
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.35
|
| Rate for Payer: Humana Medicare |
$283.62
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$283.62
|
| Rate for Payer: Provider Network of America Commercial |
$302.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$249.59
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.07
|
|
|
HC Assay of Metanephrines - Metanephrines Plasma
|
Facility
|
OP
|
$378.16
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
Px03018383502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.07 |
| Max. Negotiated Rate |
$302.53 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$266.60
|
| Rate for Payer: Aetna Workers' Compensation |
$266.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$262.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$297.99
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$291.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$297.99
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| Rate for Payer: Cigna Commercial |
$198.16
|
| Rate for Payer: Cigna Medicare Advantage |
$215.55
|
| Rate for Payer: Family Health Partners Medicaid |
$21.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$238.24
|
| Rate for Payer: Healthy Blue Medicaid |
$23.06
|
| Rate for Payer: Home State Health Plan Exchange |
$215.55
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.35
|
| Rate for Payer: Humana Medicare |
$283.62
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$283.62
|
| Rate for Payer: Provider Network of America Commercial |
$302.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$249.59
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.94
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.07
|
|
|
HC Assay of Metanephrines - Metanephrines Plasma
|
Facility
|
IP
|
$378.16
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
Px03018383502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$283.62 |
| 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 |
$378.16
|
| Rate for Payer: Cash Price |
$378.16
|
| 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 |
$283.62
|
| Rate for Payer: Provider Network of America Commercial |
$302.53
|
|
|
HC Assay of Myoglobin - Myoglobin Serum
|
Facility
|
OP
|
$191.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
Px03018387401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$152.88 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$134.73
|
| Rate for Payer: Aetna Workers' Compensation |
$134.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$132.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$132.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$150.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$150.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$150.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$150.59
|
| Rate for Payer: Cash Price |
$191.10
|
| Rate for Payer: Cash Price |
$191.10
|
| Rate for Payer: Cigna Commercial |
$100.14
|
| Rate for Payer: Cigna Medicare Advantage |
$108.93
|
| Rate for Payer: Family Health Partners Medicaid |
$16.28
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$120.39
|
| Rate for Payer: Healthy Blue Medicaid |
$17.58
|
| Rate for Payer: Home State Health Plan Exchange |
$108.93
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.28
|
| Rate for Payer: Humana Medicare |
$143.32
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.28
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$143.32
|
| Rate for Payer: Provider Network of America Commercial |
$152.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.13
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.26
|
|
|
HC Assay of Myoglobin - Myoglobin Serum
|
Facility
|
IP
|
$191.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
Px03018387401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$143.32 |
| 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 |
$191.10
|
| Rate for Payer: Cash Price |
$191.10
|
| 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 |
$143.32
|
| Rate for Payer: Provider Network of America Commercial |
$152.88
|
|
|
HC Assay of Myoglobin - Myoglobin Urine Quantitative
|
Facility
|
OP
|
$191.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
Px03018387402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.26 |
| Max. Negotiated Rate |
$152.88 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$134.73
|
| Rate for Payer: Aetna Workers' Compensation |
$134.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$132.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$132.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$150.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$150.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$150.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$147.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$150.59
|
| Rate for Payer: Cash Price |
$191.10
|
| Rate for Payer: Cash Price |
$191.10
|
| Rate for Payer: Cigna Commercial |
$100.14
|
| Rate for Payer: Cigna Medicare Advantage |
$108.93
|
| Rate for Payer: Family Health Partners Medicaid |
$16.28
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$120.39
|
| Rate for Payer: Healthy Blue Medicaid |
$17.58
|
| Rate for Payer: Home State Health Plan Exchange |
$108.93
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.28
|
| Rate for Payer: Humana Medicare |
$143.32
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.28
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$143.32
|
| Rate for Payer: Provider Network of America Commercial |
$152.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$126.13
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.92
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.26
|
|
|
HC Assay of Myoglobin - Myoglobin Urine Quantitative
|
Facility
|
IP
|
$191.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
Px03018387402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$143.32 |
| 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 |
$191.10
|
| Rate for Payer: Cash Price |
$191.10
|
| 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 |
$143.32
|
| Rate for Payer: Provider Network of America Commercial |
$152.88
|
|
|
HC Assay of Nos Vitamin
|
Facility
|
OP
|
$261.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
Px03018459103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.18 |
| Max. Negotiated Rate |
$209.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$184.32
|
| Rate for Payer: Aetna Workers' Compensation |
$184.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$201.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$206.02
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cigna Commercial |
$137.00
|
| Rate for Payer: Cigna Medicare Advantage |
$149.03
|
| Rate for Payer: Family Health Partners Medicaid |
$21.49
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$164.71
|
| Rate for Payer: Healthy Blue Medicaid |
$23.21
|
| Rate for Payer: Home State Health Plan Exchange |
$149.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.49
|
| Rate for Payer: Humana Medicare |
$196.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.49
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$172.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.06
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.18
|
|
|
HC Assay of Nos Vitamin
|
Facility
|
IP
|
$261.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
Px03018459103
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$196.09 |
| 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 |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| 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 |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
|
