|
HC Assay of Vitamin B-6 - Vitamin B6
|
Facility
|
IP
|
$202.65
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
Px03018420701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$151.99 |
| 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 |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| 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 |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
|
|
HC Assay of Vitamin B-6 - Vitamin B6
|
Facility
|
OP
|
$202.65
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
Px03018420701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.66 |
| Max. Negotiated Rate |
$162.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$142.87
|
| Rate for Payer: Aetna Workers' Compensation |
$142.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$156.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$159.69
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cigna Commercial |
$106.19
|
| Rate for Payer: Cigna Medicare Advantage |
$115.51
|
| Rate for Payer: Family Health Partners Medicaid |
$35.41
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$127.67
|
| Rate for Payer: Healthy Blue Medicaid |
$38.24
|
| Rate for Payer: Home State Health Plan Exchange |
$115.51
|
| Rate for Payer: Home State Health Plan Medicaid |
$35.41
|
| Rate for Payer: Humana Medicare |
$151.99
|
| Rate for Payer: Mercy CarePlus Medicaid |
$35.41
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$133.75
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$28.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$26.66
|
|
|
HC Assay of Vitamin E - Vitamin E (Tocopherol)
|
Facility
|
OP
|
$127.05
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
Px03018444601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.45 |
| Max. Negotiated Rate |
$101.64 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$89.57
|
| Rate for Payer: Aetna Workers' Compensation |
$89.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$88.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$88.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$100.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$100.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$100.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$97.83
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$100.12
|
| Rate for Payer: Cash Price |
$127.05
|
| Rate for Payer: Cash Price |
$127.05
|
| Rate for Payer: Cigna Commercial |
$66.57
|
| Rate for Payer: Cigna Medicare Advantage |
$72.42
|
| Rate for Payer: Family Health Partners Medicaid |
$17.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$80.04
|
| Rate for Payer: Healthy Blue Medicaid |
$19.29
|
| Rate for Payer: Home State Health Plan Exchange |
$72.42
|
| Rate for Payer: Home State Health Plan Medicaid |
$17.86
|
| Rate for Payer: Humana Medicare |
$95.29
|
| Rate for Payer: Mercy CarePlus Medicaid |
$17.86
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$95.29
|
| Rate for Payer: Provider Network of America Commercial |
$101.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$83.85
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.45
|
|
|
HC Assay of Vitamin E - Vitamin E (Tocopherol)
|
Facility
|
IP
|
$127.05
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
Px03018444601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$95.29 |
| 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 |
$127.05
|
| Rate for Payer: Cash Price |
$127.05
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$95.29
|
| Rate for Payer: Provider Network of America Commercial |
$101.64
|
|
|
HC Assay of Vitamin K - Vitamin K
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
Px03018459701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$157.50 |
| 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 |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| 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 |
$157.50
|
| Rate for Payer: Provider Network of America Commercial |
$168.00
|
|
|
HC Assay of Vitamin K - Vitamin K
|
Facility
|
OP
|
$210.00
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
Px03018459701
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.02 |
| Max. Negotiated Rate |
$168.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$148.05
|
| Rate for Payer: Aetna Workers' Compensation |
$148.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$145.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$145.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$165.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$165.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$165.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$161.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$165.48
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cash Price |
$210.00
|
| Rate for Payer: Cigna Commercial |
$110.04
|
| Rate for Payer: Cigna Medicare Advantage |
$119.70
|
| Rate for Payer: Family Health Partners Medicaid |
$17.29
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$132.30
|
| Rate for Payer: Healthy Blue Medicaid |
$18.67
|
| Rate for Payer: Home State Health Plan Exchange |
$119.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$17.29
|
| Rate for Payer: Humana Medicare |
$157.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$17.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$157.50
|
| Rate for Payer: Provider Network of America Commercial |
$168.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$138.60
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.72
|
| Rate for Payer: UnitedHealthcare Medicaid |
$13.02
|
|
|
HC Assay of Vit D,Calcifediol W Fractions, if Performed - Vitamin D 25
|
Facility
|
OP
|
$259.35
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
Px03018230601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.08 |
| Max. Negotiated Rate |
$207.48 |
| Rate for Payer: Cash Price |
$259.35
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$182.84
|
| Rate for Payer: Aetna Workers' Compensation |
$182.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$179.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$179.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$204.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$204.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$204.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$199.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$204.37
|
| Rate for Payer: Cash Price |
$259.35
|
| Rate for Payer: Cigna Commercial |
$135.90
|
| Rate for Payer: Cigna Medicare Advantage |
$147.83
|
| Rate for Payer: Family Health Partners Medicaid |
$37.30
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$163.39
|
| Rate for Payer: Healthy Blue Medicaid |
$40.28
|
| Rate for Payer: Home State Health Plan Exchange |
$147.83
|
| Rate for Payer: Home State Health Plan Medicaid |
$37.30
|
| Rate for Payer: Humana Medicare |
$194.51
|
| Rate for Payer: Mercy CarePlus Medicaid |
$37.30
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$194.51
|
| Rate for Payer: Provider Network of America Commercial |
$207.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$171.17
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$29.60
|
| Rate for Payer: UnitedHealthcare Medicaid |
$28.08
|
|
|
HC Assay of Vit D,Calcifediol W Fractions, if Performed - Vitamin D 25
|
Facility
|
IP
|
$259.35
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
Px03018230601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$194.51 |
| 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 |
$259.35
|
| Rate for Payer: Cash Price |
$259.35
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$194.51
|
| Rate for Payer: Provider Network of America Commercial |
$207.48
|
|
|
HC Assay of Zinc - Zinc
|
Facility
|
IP
|
$122.39
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
Px03018463001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.79 |
| 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 |
$122.39
|
| Rate for Payer: Cash Price |
$122.39
|
| 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 |
$91.79
|
| Rate for Payer: Provider Network of America Commercial |
$97.91
|
|
|
HC Assay of Zinc - Zinc
|
Facility
|
OP
|
$122.39
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
Px03018463001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$97.91 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$86.28
|
| Rate for Payer: Aetna Workers' Compensation |
$86.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$84.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$84.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$94.24
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$96.44
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cigna Commercial |
$64.13
|
| Rate for Payer: Cigna Medicare Advantage |
$69.76
|
| Rate for Payer: Family Health Partners Medicaid |
$14.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$77.11
|
| Rate for Payer: Healthy Blue Medicaid |
$15.50
|
| Rate for Payer: Home State Health Plan Exchange |
$69.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.35
|
| Rate for Payer: Humana Medicare |
$91.79
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$91.79
|
| Rate for Payer: Provider Network of America Commercial |
$97.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.78
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.80
|
|
|
HC Assay of Zinc - Zinc RBC
|
Facility
|
OP
|
$122.39
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
Px03018463003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$97.91 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$86.28
|
| Rate for Payer: Aetna Workers' Compensation |
$86.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$84.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$84.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$94.24
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$96.44
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cigna Commercial |
$64.13
|
| Rate for Payer: Cigna Medicare Advantage |
$69.76
|
| Rate for Payer: Family Health Partners Medicaid |
$14.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$77.11
|
| Rate for Payer: Healthy Blue Medicaid |
$15.50
|
| Rate for Payer: Home State Health Plan Exchange |
$69.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.35
|
| Rate for Payer: Humana Medicare |
$91.79
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$91.79
|
| Rate for Payer: Provider Network of America Commercial |
$97.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.78
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.80
|
|
|
HC Assay of Zinc - Zinc RBC
|
Facility
|
IP
|
$122.39
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
Px03018463003
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.79 |
| 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 |
$122.39
|
| Rate for Payer: Cash Price |
$122.39
|
| 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 |
$91.79
|
| Rate for Payer: Provider Network of America Commercial |
$97.91
|
|
|
HC Assay of Zinc - Zinc Urine
|
Facility
|
IP
|
$122.39
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
Px03018463002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.79 |
| 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 |
$122.39
|
| Rate for Payer: Cash Price |
$122.39
|
| 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 |
$91.79
|
| Rate for Payer: Provider Network of America Commercial |
$97.91
|
|
|
HC Assay of Zinc - Zinc Urine
|
Facility
|
OP
|
$122.39
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
Px03018463002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.80 |
| Max. Negotiated Rate |
$97.91 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$86.28
|
| Rate for Payer: Aetna Workers' Compensation |
$86.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$84.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$84.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$96.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$94.24
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$96.44
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cash Price |
$122.39
|
| Rate for Payer: Cigna Commercial |
$64.13
|
| Rate for Payer: Cigna Medicare Advantage |
$69.76
|
| Rate for Payer: Family Health Partners Medicaid |
$14.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$77.11
|
| Rate for Payer: Healthy Blue Medicaid |
$15.50
|
| Rate for Payer: Home State Health Plan Exchange |
$69.76
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.35
|
| Rate for Payer: Humana Medicare |
$91.79
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$91.79
|
| Rate for Payer: Provider Network of America Commercial |
$97.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.78
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.39
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.80
|
|
|
HC Assay Phosphatase Acid Prostatic - Prostatic Acid Phosphatase
|
Facility
|
IP
|
$134.40
|
|
|
Service Code
|
CPT 84066
|
| Hospital Charge Code |
Px03018406601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.80 |
| 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 |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| 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 |
$100.80
|
| Rate for Payer: Provider Network of America Commercial |
$107.52
|
|
|
HC Assay Phosphatase Acid Prostatic - Prostatic Acid Phosphatase
|
Facility
|
OP
|
$134.40
|
|
|
Service Code
|
CPT 84066
|
| Hospital Charge Code |
Px03018406601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$107.52 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$94.75
|
| Rate for Payer: Aetna Workers' Compensation |
$94.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$93.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$93.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$105.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$105.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$105.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$103.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$105.91
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cigna Commercial |
$70.43
|
| Rate for Payer: Cigna Medicare Advantage |
$76.61
|
| Rate for Payer: Family Health Partners Medicaid |
$12.17
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$84.67
|
| Rate for Payer: Healthy Blue Medicaid |
$13.14
|
| Rate for Payer: Home State Health Plan Exchange |
$76.61
|
| Rate for Payer: Home State Health Plan Medicaid |
$12.17
|
| Rate for Payer: Humana Medicare |
$100.80
|
| Rate for Payer: Mercy CarePlus Medicaid |
$12.17
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$100.80
|
| Rate for Payer: Provider Network of America Commercial |
$107.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$88.70
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.66
|
| Rate for Payer: UnitedHealthcare Medicaid |
$9.16
|
|
|
HC Assay Phosphatase Acid, Total - Acid Phosphatase, Total
|
Facility
|
IP
|
$58.80
|
|
|
Service Code
|
CPT 84060
|
| Hospital Charge Code |
Px03018406001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.10 |
| 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 |
$58.80
|
| Rate for Payer: Cash Price |
$58.80
|
| 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 |
$44.10
|
| Rate for Payer: Provider Network of America Commercial |
$47.04
|
|
|
HC Assay Phosphatase Acid, Total - Acid Phosphatase, Total
|
Facility
|
OP
|
$58.80
|
|
|
Service Code
|
CPT 84060
|
| Hospital Charge Code |
Px03018406001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$47.04 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$41.45
|
| Rate for Payer: Aetna Workers' Compensation |
$41.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$40.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$40.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$46.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$46.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$46.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$45.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$46.33
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: Cash Price |
$58.80
|
| Rate for Payer: Cigna Commercial |
$30.81
|
| Rate for Payer: Cigna Medicare Advantage |
$33.52
|
| Rate for Payer: Family Health Partners Medicaid |
$9.63
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$37.04
|
| Rate for Payer: Healthy Blue Medicaid |
$10.40
|
| Rate for Payer: Home State Health Plan Exchange |
$33.52
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.63
|
| Rate for Payer: Humana Medicare |
$44.10
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.63
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$44.10
|
| Rate for Payer: Provider Network of America Commercial |
$47.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$38.81
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.25
|
|
|
HC Assay Quantitative,Blood Glucose - Glucose Fasting
|
Facility
|
OP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$37.01
|
| Rate for Payer: Aetna Workers' Compensation |
$37.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$36.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$36.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$40.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$41.37
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$27.51
|
| Rate for Payer: Cigna Medicare Advantage |
$29.93
|
| Rate for Payer: Family Health Partners Medicaid |
$4.96
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$33.08
|
| Rate for Payer: Healthy Blue Medicaid |
$5.35
|
| Rate for Payer: Home State Health Plan Exchange |
$29.93
|
| Rate for Payer: Home State Health Plan Medicaid |
$4.96
|
| Rate for Payer: Humana Medicare |
$39.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4.96
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.65
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.73
|
|
|
HC Assay Quantitative,Blood Glucose - Glucose Fasting
|
Facility
|
IP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.38 |
| 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 |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| 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 |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
|
|
HC Assay Quantitative,Blood Glucose - Glucose Random
|
Facility
|
OP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$37.01
|
| Rate for Payer: Aetna Workers' Compensation |
$37.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$36.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$36.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$40.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$41.37
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$27.51
|
| Rate for Payer: Cigna Medicare Advantage |
$29.93
|
| Rate for Payer: Family Health Partners Medicaid |
$4.96
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$33.08
|
| Rate for Payer: Healthy Blue Medicaid |
$5.35
|
| Rate for Payer: Home State Health Plan Exchange |
$29.93
|
| Rate for Payer: Home State Health Plan Medicaid |
$4.96
|
| Rate for Payer: Humana Medicare |
$39.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4.96
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.65
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.73
|
|
|
HC Assay Quantitative,Blood Glucose - Glucose Random
|
Facility
|
IP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.38 |
| 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 |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| 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 |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
|
|
HC Assay Quantitative,Blood Glucose - Glucose Timed Urine
|
Facility
|
IP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.38 |
| 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 |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| 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 |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
|
|
HC Assay Quantitative,Blood Glucose - Glucose Timed Urine
|
Facility
|
OP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.73 |
| Max. Negotiated Rate |
$42.00 |
| Rate for Payer: Cigna Medicare Advantage |
$29.93
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$37.01
|
| Rate for Payer: Aetna Workers' Compensation |
$37.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$36.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$36.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$41.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$40.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$41.37
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| Rate for Payer: Cigna Commercial |
$27.51
|
| Rate for Payer: Family Health Partners Medicaid |
$4.96
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$33.08
|
| Rate for Payer: Healthy Blue Medicaid |
$5.35
|
| Rate for Payer: Home State Health Plan Exchange |
$29.93
|
| Rate for Payer: Home State Health Plan Medicaid |
$4.96
|
| Rate for Payer: Humana Medicare |
$39.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4.96
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$34.65
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.93
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.73
|
|
|
HC Assay Quantitative,Blood Glucose - Gtt Fasting
|
Facility
|
IP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294705
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.38 |
| 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 |
$52.50
|
| Rate for Payer: Cash Price |
$52.50
|
| 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 |
$39.38
|
| Rate for Payer: Provider Network of America Commercial |
$42.00
|
|
