|
HC Assay of Total Testosterone - Testosterone
|
Facility
|
OP
|
$199.50
|
|
|
Service Code
|
CPT 84403
|
| Hospital Charge Code |
Px03018440301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.48 |
| Max. Negotiated Rate |
$159.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$140.65
|
| Rate for Payer: Aetna Workers' Compensation |
$140.65
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$138.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$138.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$157.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$157.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$157.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$153.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$157.21
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cigna Commercial |
$104.54
|
| Rate for Payer: Cigna Medicare Advantage |
$113.72
|
| Rate for Payer: Family Health Partners Medicaid |
$32.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$125.69
|
| Rate for Payer: Healthy Blue Medicaid |
$35.12
|
| Rate for Payer: Home State Health Plan Exchange |
$113.72
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.52
|
| Rate for Payer: Humana Medicare |
$149.62
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$149.62
|
| Rate for Payer: Provider Network of America Commercial |
$159.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$131.67
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.81
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.48
|
|
|
HC Assay of Total Thyroxine - T4 (Thyroid Hormone)
|
Facility
|
OP
|
$119.70
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
Px03018443601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$95.76 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$84.39
|
| Rate for Payer: Aetna Workers' Compensation |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$82.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$82.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$94.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$94.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$94.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$92.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$94.32
|
| Rate for Payer: Cash Price |
$119.70
|
| Rate for Payer: Cash Price |
$119.70
|
| Rate for Payer: Cigna Commercial |
$62.72
|
| Rate for Payer: Cigna Medicare Advantage |
$68.23
|
| Rate for Payer: Family Health Partners Medicaid |
$8.65
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$75.41
|
| Rate for Payer: Healthy Blue Medicaid |
$9.34
|
| Rate for Payer: Home State Health Plan Exchange |
$68.23
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.65
|
| Rate for Payer: Humana Medicare |
$89.78
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.65
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$89.78
|
| Rate for Payer: Provider Network of America Commercial |
$95.76
|
| Rate for Payer: UnitedHealthcare Commercial |
$79.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.51
|
|
|
HC Assay of Total Thyroxine - T4 (Thyroid Hormone)
|
Facility
|
IP
|
$119.70
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
Px03018443601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$89.78 |
| 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 |
$119.70
|
| Rate for Payer: Cash Price |
$119.70
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$89.78
|
| Rate for Payer: Provider Network of America Commercial |
$95.76
|
|
|
HC Assay of Transferrin - Transferrin
|
Facility
|
IP
|
$102.90
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
Px03018446601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.17 |
| 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 |
$102.90
|
| Rate for Payer: Cash Price |
$102.90
|
| 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 |
$77.17
|
| Rate for Payer: Provider Network of America Commercial |
$82.32
|
|
|
HC Assay of Transferrin - Transferrin
|
Facility
|
OP
|
$102.90
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
Px03018446601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.10 |
| Max. Negotiated Rate |
$82.32 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$72.54
|
| Rate for Payer: Aetna Workers' Compensation |
$72.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$71.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$71.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$81.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$79.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$81.09
|
| Rate for Payer: Cash Price |
$102.90
|
| Rate for Payer: Cash Price |
$102.90
|
| Rate for Payer: Cigna Commercial |
$53.92
|
| Rate for Payer: Cigna Medicare Advantage |
$58.65
|
| Rate for Payer: Family Health Partners Medicaid |
$16.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$64.83
|
| Rate for Payer: Healthy Blue Medicaid |
$17.36
|
| Rate for Payer: Home State Health Plan Exchange |
$58.65
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.07
|
| Rate for Payer: Humana Medicare |
$77.17
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.07
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$77.17
|
| Rate for Payer: Provider Network of America Commercial |
$82.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$67.91
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.76
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.10
|
|
|
HC Assay of Triglycerides - POCT Triglyceride
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
Px03018447803
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$7.24
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$7.82
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$7.24
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$7.24
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.45
|
|
|
HC Assay of Triglycerides - POCT Triglyceride
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
Px03018447803
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.38 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Assay of Triglycerides - Triglycerides
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
Px03018447801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.38 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Assay of Triglycerides - Triglycerides
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
Px03018447801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$7.24
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$7.82
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$7.24
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$7.24
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.45
|
|
|
HC Assay of Triglycerides - Triglycerides Body Fluid
|
Facility
|
OP
|
$136.50
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
Px03018447802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.45 |
| Max. Negotiated Rate |
$109.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$96.23
|
| Rate for Payer: Aetna Workers' Compensation |
$96.23
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$94.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$107.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$105.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$107.56
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Commercial |
$71.53
|
| Rate for Payer: Cigna Medicare Advantage |
$77.81
|
| Rate for Payer: Family Health Partners Medicaid |
$7.24
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$86.00
|
| Rate for Payer: Healthy Blue Medicaid |
$7.82
|
| Rate for Payer: Home State Health Plan Exchange |
$77.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$7.24
|
| Rate for Payer: Humana Medicare |
$102.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$7.24
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$90.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.45
|
|
|
HC Assay of Triglycerides - Triglycerides Body Fluid
|
Facility
|
IP
|
$136.50
|
|
|
Service Code
|
CPT 84478
|
| Hospital Charge Code |
Px03018447802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.38 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cash Price |
$136.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$102.38
|
| Rate for Payer: Provider Network of America Commercial |
$109.20
|
|
|
HC Assay of Troponin, Quant - Troponin I
|
Facility
|
IP
|
$288.75
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
Px03018448402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$216.56 |
| 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 |
$288.75
|
| Rate for Payer: Cash Price |
$288.75
|
| 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 |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
|
|
HC Assay of Troponin, Quant - Troponin I
|
Facility
|
OP
|
$288.75
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
Px03018448402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.83 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$203.57
|
| Rate for Payer: Aetna Workers' Compensation |
$203.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$222.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$227.53
|
| Rate for Payer: Cash Price |
$288.75
|
| Rate for Payer: Cash Price |
$288.75
|
| Rate for Payer: Cigna Commercial |
$151.31
|
| Rate for Payer: Cigna Medicare Advantage |
$164.59
|
| Rate for Payer: Family Health Partners Medicaid |
$15.71
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$181.91
|
| Rate for Payer: Healthy Blue Medicaid |
$16.96
|
| Rate for Payer: Home State Health Plan Exchange |
$164.59
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.71
|
| Rate for Payer: Humana Medicare |
$216.56
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.71
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.57
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.83
|
|
|
HC Assay of Troponin, Quant - Troponin T
|
Facility
|
IP
|
$288.75
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
Px03018448401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$216.56 |
| 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 |
$288.75
|
| Rate for Payer: Cash Price |
$288.75
|
| 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 |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
|
|
HC Assay of Troponin, Quant - Troponin T
|
Facility
|
OP
|
$288.75
|
|
|
Service Code
|
CPT 84484
|
| Hospital Charge Code |
Px03018448401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.83 |
| Max. Negotiated Rate |
$231.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$203.57
|
| Rate for Payer: Aetna Workers' Compensation |
$203.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$222.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$227.53
|
| Rate for Payer: Cash Price |
$288.75
|
| Rate for Payer: Cash Price |
$288.75
|
| Rate for Payer: Cigna Commercial |
$151.31
|
| Rate for Payer: Cigna Medicare Advantage |
$164.59
|
| Rate for Payer: Family Health Partners Medicaid |
$15.71
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$181.91
|
| Rate for Payer: Healthy Blue Medicaid |
$16.96
|
| Rate for Payer: Home State Health Plan Exchange |
$164.59
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.71
|
| Rate for Payer: Humana Medicare |
$216.56
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.71
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.57
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.47
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.83
|
|
|
HC Assay of Uric Acid, Blood, Other Source - Uric Acid Body Fluid
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
Px03018456002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$57.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$50.34
|
| Rate for Payer: Aetna Workers' Compensation |
$50.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$49.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$49.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$54.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$56.26
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$37.41
|
| Rate for Payer: Cigna Medicare Advantage |
$40.70
|
| Rate for Payer: Family Health Partners Medicaid |
$6.40
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$44.98
|
| Rate for Payer: Healthy Blue Medicaid |
$6.91
|
| Rate for Payer: Home State Health Plan Exchange |
$40.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.40
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$53.55
|
| Rate for Payer: Provider Network of America Commercial |
$57.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.12
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.82
|
|
|
HC Assay of Uric Acid, Blood, Other Source - Uric Acid Body Fluid
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
Px03018456002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.55 |
| 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 |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| 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 |
$53.55
|
| Rate for Payer: Provider Network of America Commercial |
$57.12
|
|
|
HC Assay of Uric Acid, Blood, Other Source - Uric Acid, Urine
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
Px03018456004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$57.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$50.34
|
| Rate for Payer: Aetna Workers' Compensation |
$50.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$49.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$49.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$54.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$56.26
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$37.41
|
| Rate for Payer: Cigna Medicare Advantage |
$40.70
|
| Rate for Payer: Family Health Partners Medicaid |
$6.40
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$44.98
|
| Rate for Payer: Healthy Blue Medicaid |
$6.91
|
| Rate for Payer: Home State Health Plan Exchange |
$40.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.40
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$53.55
|
| Rate for Payer: Provider Network of America Commercial |
$57.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.12
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.82
|
|
|
HC Assay of Uric Acid, Blood, Other Source - Uric Acid, Urine
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
Px03018456004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.55 |
| 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 |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| 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 |
$53.55
|
| Rate for Payer: Provider Network of America Commercial |
$57.12
|
|
|
HC Assay of Uric Acid, Blood, Other Source - Uric Acid, Urine, 24 Hour
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
Px03018456003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$57.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$50.34
|
| Rate for Payer: Aetna Workers' Compensation |
$50.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$49.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$49.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$56.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$54.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$56.26
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| Rate for Payer: Cigna Commercial |
$37.41
|
| Rate for Payer: Cigna Medicare Advantage |
$40.70
|
| Rate for Payer: Family Health Partners Medicaid |
$6.40
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$44.98
|
| Rate for Payer: Healthy Blue Medicaid |
$6.91
|
| Rate for Payer: Home State Health Plan Exchange |
$40.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.40
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$53.55
|
| Rate for Payer: Provider Network of America Commercial |
$57.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.12
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.82
|
|
|
HC Assay of Uric Acid, Blood, Other Source - Uric Acid, Urine, 24 Hour
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
Px03018456003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.55 |
| 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 |
$71.40
|
| Rate for Payer: Cash Price |
$71.40
|
| 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 |
$53.55
|
| Rate for Payer: Provider Network of America Commercial |
$57.12
|
|
|
HC Assay of Uric Acid, Blood - POCT Uric Acid
|
Facility
|
OP
|
$95.55
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
Px03018455002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$76.44 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$67.36
|
| Rate for Payer: Aetna Workers' Compensation |
$67.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$66.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$66.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$73.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$75.29
|
| Rate for Payer: Cash Price |
$95.55
|
| Rate for Payer: Cash Price |
$95.55
|
| Rate for Payer: Cigna Commercial |
$50.07
|
| Rate for Payer: Cigna Medicare Advantage |
$54.46
|
| Rate for Payer: Family Health Partners Medicaid |
$5.70
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$60.20
|
| Rate for Payer: Healthy Blue Medicaid |
$6.15
|
| Rate for Payer: Home State Health Plan Exchange |
$54.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.70
|
| Rate for Payer: Humana Medicare |
$71.66
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.70
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$71.66
|
| Rate for Payer: Provider Network of America Commercial |
$76.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.06
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.29
|
|
|
HC Assay of Uric Acid, Blood - POCT Uric Acid
|
Facility
|
IP
|
$95.55
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
Px03018455002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.66 |
| 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 |
$95.55
|
| Rate for Payer: Cash Price |
$95.55
|
| 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 |
$71.66
|
| Rate for Payer: Provider Network of America Commercial |
$76.44
|
|
|
HC Assay of Uric Acid, Blood - Uric Acid
|
Facility
|
OP
|
$95.55
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
Px03018455001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$76.44 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$67.36
|
| Rate for Payer: Aetna Workers' Compensation |
$67.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$66.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$66.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$75.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$73.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$75.29
|
| Rate for Payer: Cash Price |
$95.55
|
| Rate for Payer: Cash Price |
$95.55
|
| Rate for Payer: Cigna Commercial |
$50.07
|
| Rate for Payer: Cigna Medicare Advantage |
$54.46
|
| Rate for Payer: Family Health Partners Medicaid |
$5.70
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$60.20
|
| Rate for Payer: Healthy Blue Medicaid |
$6.15
|
| Rate for Payer: Home State Health Plan Exchange |
$54.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.70
|
| Rate for Payer: Humana Medicare |
$71.66
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.70
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$71.66
|
| Rate for Payer: Provider Network of America Commercial |
$76.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$63.06
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.52
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.29
|
|
|
HC Assay of Uric Acid, Blood - Uric Acid
|
Facility
|
IP
|
$95.55
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
Px03018455001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.66 |
| 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 |
$95.55
|
| Rate for Payer: Cash Price |
$95.55
|
| 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 |
$71.66
|
| Rate for Payer: Provider Network of America Commercial |
$76.44
|
|
