|
HC Assay of Nos Vitamin
|
Facility
|
OP
|
$261.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
Px03018459102
|
|
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 |
Px03018459102
|
|
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
|
|
|
HC Assay of Nos Vitamin - Niacin (Vitamin B3)
|
Facility
|
OP
|
$261.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
Px03018459101
|
|
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 - Niacin (Vitamin B3)
|
Facility
|
IP
|
$261.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
Px03018459101
|
|
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
|
|
|
HC Assay of Oxalate - Oxalate 24hr Urine
|
Facility
|
OP
|
$93.45
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
Px03018394501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$74.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.88
|
| Rate for Payer: Aetna Workers' Compensation |
$65.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.64
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cigna Commercial |
$48.97
|
| Rate for Payer: Cigna Medicare Advantage |
$53.27
|
| Rate for Payer: Family Health Partners Medicaid |
$18.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.87
|
| Rate for Payer: Healthy Blue Medicaid |
$19.67
|
| Rate for Payer: Home State Health Plan Exchange |
$53.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.21
|
| Rate for Payer: Humana Medicare |
$70.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.71
|
|
|
HC Assay of Oxalate - Oxalate 24hr Urine
|
Facility
|
IP
|
$93.45
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
Px03018394501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.09 |
| 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 |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| 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 |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
|
|
HC Assay of Oxalate - Oxalate Serum
|
Facility
|
OP
|
$93.45
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
Px03018394502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.71 |
| Max. Negotiated Rate |
$74.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.88
|
| Rate for Payer: Aetna Workers' Compensation |
$65.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.64
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| Rate for Payer: Cigna Commercial |
$48.97
|
| Rate for Payer: Cigna Medicare Advantage |
$53.27
|
| Rate for Payer: Family Health Partners Medicaid |
$18.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.87
|
| Rate for Payer: Healthy Blue Medicaid |
$19.67
|
| Rate for Payer: Home State Health Plan Exchange |
$53.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.21
|
| Rate for Payer: Humana Medicare |
$70.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.71
|
|
|
HC Assay of Oxalate - Oxalate Serum
|
Facility
|
IP
|
$93.45
|
|
|
Service Code
|
CPT 83945
|
| Hospital Charge Code |
Px03018394502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.09 |
| 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 |
$93.45
|
| Rate for Payer: Cash Price |
$93.45
|
| 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 |
$70.09
|
| Rate for Payer: Provider Network of America Commercial |
$74.76
|
|
|
HC Assay of Parathormone
|
Facility
|
IP
|
$321.30
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
Px03018397003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$240.97 |
| 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 |
$321.30
|
| Rate for Payer: Cash Price |
$321.30
|
| 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 |
$240.97
|
| Rate for Payer: Provider Network of America Commercial |
$257.04
|
|
|
HC Assay of Parathormone
|
Facility
|
OP
|
$321.30
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
Px03018397003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$257.04 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$226.52
|
| Rate for Payer: Aetna Workers' Compensation |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$222.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$222.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$247.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$253.18
|
| Rate for Payer: Cash Price |
$321.30
|
| Rate for Payer: Cash Price |
$321.30
|
| Rate for Payer: Cigna Commercial |
$168.36
|
| Rate for Payer: Cigna Medicare Advantage |
$183.14
|
| Rate for Payer: Family Health Partners Medicaid |
$52.01
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$202.42
|
| Rate for Payer: Healthy Blue Medicaid |
$56.17
|
| Rate for Payer: Home State Health Plan Exchange |
$183.14
|
| Rate for Payer: Home State Health Plan Medicaid |
$52.01
|
| Rate for Payer: Humana Medicare |
$240.97
|
| Rate for Payer: Mercy CarePlus Medicaid |
$52.01
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$240.97
|
| Rate for Payer: Provider Network of America Commercial |
$257.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$212.06
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$41.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$39.16
|
|
|
HC Assay of Parathormone
|
Facility
|
IP
|
$321.30
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
Px03018397002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$240.97 |
| 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 |
$321.30
|
| Rate for Payer: Cash Price |
$321.30
|
| 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 |
$240.97
|
| Rate for Payer: Provider Network of America Commercial |
$257.04
|
|
|
HC Assay of Parathormone
|
Facility
|
OP
|
$321.30
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
Px03018397002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$257.04 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$226.52
|
| Rate for Payer: Aetna Workers' Compensation |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$222.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$222.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$247.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$253.18
|
| Rate for Payer: Cash Price |
$321.30
|
| Rate for Payer: Cash Price |
$321.30
|
| Rate for Payer: Cigna Commercial |
$168.36
|
| Rate for Payer: Cigna Medicare Advantage |
$183.14
|
| Rate for Payer: Family Health Partners Medicaid |
$52.01
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$202.42
|
| Rate for Payer: Healthy Blue Medicaid |
$56.17
|
| Rate for Payer: Home State Health Plan Exchange |
$183.14
|
| Rate for Payer: Home State Health Plan Medicaid |
$52.01
|
| Rate for Payer: Humana Medicare |
$240.97
|
| Rate for Payer: Mercy CarePlus Medicaid |
$52.01
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$240.97
|
| Rate for Payer: Provider Network of America Commercial |
$257.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$212.06
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$41.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$39.16
|
|
|
HC Assay of Parathormone - Pth Intact
|
Facility
|
IP
|
$321.30
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
Px03018397001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$240.97 |
| 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 |
$321.30
|
| Rate for Payer: Cash Price |
$321.30
|
| 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 |
$240.97
|
| Rate for Payer: Provider Network of America Commercial |
$257.04
|
|
|
HC Assay of Parathormone - Pth Intact
|
Facility
|
OP
|
$321.30
|
|
|
Service Code
|
CPT 83970
|
| Hospital Charge Code |
Px03018397001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.16 |
| Max. Negotiated Rate |
$257.04 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$226.52
|
| Rate for Payer: Aetna Workers' Compensation |
$226.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$222.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$222.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$253.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$247.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$253.18
|
| Rate for Payer: Cash Price |
$321.30
|
| Rate for Payer: Cash Price |
$321.30
|
| Rate for Payer: Cigna Commercial |
$168.36
|
| Rate for Payer: Cigna Medicare Advantage |
$183.14
|
| Rate for Payer: Family Health Partners Medicaid |
$52.01
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$202.42
|
| Rate for Payer: Healthy Blue Medicaid |
$56.17
|
| Rate for Payer: Home State Health Plan Exchange |
$183.14
|
| Rate for Payer: Home State Health Plan Medicaid |
$52.01
|
| Rate for Payer: Humana Medicare |
$240.97
|
| Rate for Payer: Mercy CarePlus Medicaid |
$52.01
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$240.97
|
| Rate for Payer: Provider Network of America Commercial |
$257.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$212.06
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$41.28
|
| Rate for Payer: UnitedHealthcare Medicaid |
$39.16
|
|
|
HC Assay of Phenobarbital - Phenobarbital
|
Facility
|
IP
|
$124.95
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
Px03018018401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.71 |
| 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 |
$124.95
|
| Rate for Payer: Cash Price |
$124.95
|
| 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 |
$93.71
|
| Rate for Payer: Provider Network of America Commercial |
$99.96
|
|
|
HC Assay of Phenobarbital - Phenobarbital
|
Facility
|
OP
|
$124.95
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
Px03018018401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.51 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$88.09
|
| Rate for Payer: Aetna Workers' Compensation |
$88.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$86.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$86.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$98.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$98.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$98.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$96.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$98.46
|
| Rate for Payer: Cash Price |
$124.95
|
| Rate for Payer: Cash Price |
$124.95
|
| Rate for Payer: Cigna Commercial |
$65.47
|
| Rate for Payer: Cigna Medicare Advantage |
$71.22
|
| Rate for Payer: Family Health Partners Medicaid |
$19.28
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$78.72
|
| Rate for Payer: Healthy Blue Medicaid |
$20.82
|
| Rate for Payer: Home State Health Plan Exchange |
$71.22
|
| Rate for Payer: Home State Health Plan Medicaid |
$19.28
|
| Rate for Payer: Humana Medicare |
$93.71
|
| Rate for Payer: Mercy CarePlus Medicaid |
$19.28
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$93.71
|
| Rate for Payer: Provider Network of America Commercial |
$99.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$82.47
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$15.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$14.51
|
|
|
HC Assay of Phenytoin, Total - Phenytoin Total
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 80185
|
| Hospital Charge Code |
Px03018018502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.00 |
| 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 |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| 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 |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
|
|
HC Assay of Phenytoin, Total - Phenytoin Total
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 80185
|
| Hospital Charge Code |
Px03018018502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$118.44
|
| Rate for Payer: Aetna Workers' Compensation |
$118.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$129.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$132.38
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cigna Commercial |
$88.03
|
| Rate for Payer: Cigna Medicare Advantage |
$95.76
|
| Rate for Payer: Family Health Partners Medicaid |
$16.70
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$105.84
|
| Rate for Payer: Healthy Blue Medicaid |
$18.04
|
| Rate for Payer: Home State Health Plan Exchange |
$95.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.70
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.70
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.88
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.57
|
|
|
HC Assay of Phenytoin, Total - Phenytoin Total and Free
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 80185
|
| Hospital Charge Code |
Px03018018501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$134.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$118.44
|
| Rate for Payer: Aetna Workers' Compensation |
$118.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$116.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$132.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$129.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$132.38
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| Rate for Payer: Cigna Commercial |
$88.03
|
| Rate for Payer: Cigna Medicare Advantage |
$95.76
|
| Rate for Payer: Family Health Partners Medicaid |
$16.70
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$105.84
|
| Rate for Payer: Healthy Blue Medicaid |
$18.04
|
| Rate for Payer: Home State Health Plan Exchange |
$95.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.70
|
| Rate for Payer: Humana Medicare |
$126.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.70
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$110.88
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.57
|
|
|
HC Assay of Phenytoin, Total - Phenytoin Total and Free
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 80185
|
| Hospital Charge Code |
Px03018018501
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$126.00 |
| 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 |
$168.00
|
| Rate for Payer: Cash Price |
$168.00
|
| 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 |
$126.00
|
| Rate for Payer: Provider Network of America Commercial |
$134.40
|
|
|
HC Assay of Phosphorus Inorganic Urine
|
Facility
|
IP
|
$66.15
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
Px03018410502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.61 |
| 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 |
$66.15
|
| Rate for Payer: Cash Price |
$66.15
|
| 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 |
$49.61
|
| Rate for Payer: Provider Network of America Commercial |
$52.92
|
|
|
HC Assay of Phosphorus Inorganic Urine
|
Facility
|
OP
|
$66.15
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
Px03018410502
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.48 |
| Max. Negotiated Rate |
$52.92 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$46.64
|
| Rate for Payer: Aetna Workers' Compensation |
$46.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$45.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$45.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$52.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$52.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$52.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$50.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$52.13
|
| Rate for Payer: Cash Price |
$66.15
|
| Rate for Payer: Cash Price |
$66.15
|
| Rate for Payer: Cigna Commercial |
$34.66
|
| Rate for Payer: Cigna Medicare Advantage |
$37.71
|
| Rate for Payer: Family Health Partners Medicaid |
$7.28
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$41.67
|
| Rate for Payer: Healthy Blue Medicaid |
$7.86
|
| Rate for Payer: Home State Health Plan Exchange |
$37.71
|
| Rate for Payer: Home State Health Plan Medicaid |
$7.28
|
| Rate for Payer: Humana Medicare |
$49.61
|
| Rate for Payer: Mercy CarePlus Medicaid |
$7.28
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$49.61
|
| Rate for Payer: Provider Network of America Commercial |
$52.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$43.66
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.78
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.48
|
|
|
HC Assay of Prealbumin - Prealbumin
|
Facility
|
IP
|
$139.65
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
Px03018413401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.74 |
| 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 |
$139.65
|
| Rate for Payer: Cash Price |
$139.65
|
| 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 |
$104.74
|
| Rate for Payer: Provider Network of America Commercial |
$111.72
|
|
|
HC Assay of Prealbumin - Prealbumin
|
Facility
|
OP
|
$139.65
|
|
|
Service Code
|
CPT 84134
|
| Hospital Charge Code |
Px03018413401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.84 |
| Max. Negotiated Rate |
$111.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$98.45
|
| Rate for Payer: Aetna Workers' Compensation |
$98.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$96.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$96.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$110.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$110.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$110.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$107.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$110.04
|
| Rate for Payer: Cash Price |
$139.65
|
| Rate for Payer: Cash Price |
$139.65
|
| Rate for Payer: Cigna Commercial |
$73.18
|
| Rate for Payer: Cigna Medicare Advantage |
$79.60
|
| Rate for Payer: Family Health Partners Medicaid |
$18.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$87.98
|
| Rate for Payer: Healthy Blue Medicaid |
$19.85
|
| Rate for Payer: Home State Health Plan Exchange |
$79.60
|
| Rate for Payer: Home State Health Plan Medicaid |
$18.38
|
| Rate for Payer: Humana Medicare |
$104.74
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$104.74
|
| Rate for Payer: Provider Network of America Commercial |
$111.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$92.17
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.59
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.84
|
|
|
HC Assay of Procainamide
|
Facility
|
OP
|
$55.65
|
|
|
Service Code
|
CPT 80190
|
| Hospital Charge Code |
Px03018019001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.16 |
| Max. Negotiated Rate |
$81.65 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$39.23
|
| Rate for Payer: Aetna Workers' Compensation |
$39.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$38.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$43.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$43.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$43.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$42.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$43.85
|
| Rate for Payer: Cash Price |
$55.65
|
| Rate for Payer: Cash Price |
$55.65
|
| Rate for Payer: Cigna Commercial |
$29.16
|
| Rate for Payer: Cigna Medicare Advantage |
$31.72
|
| Rate for Payer: Family Health Partners Medicaid |
$75.60
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$35.06
|
| Rate for Payer: Healthy Blue Medicaid |
$81.65
|
| Rate for Payer: Home State Health Plan Exchange |
$31.72
|
| Rate for Payer: Home State Health Plan Medicaid |
$75.60
|
| Rate for Payer: Humana Medicare |
$41.74
|
| Rate for Payer: Mercy CarePlus Medicaid |
$75.60
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$41.74
|
| Rate for Payer: Provider Network of America Commercial |
$44.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$36.73
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$60.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$56.92
|
|
