|
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
|
|
|
HC Assay Quantitative,Blood Glucose - POCT Glucometer
|
Facility
|
IP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294701
|
|
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 - POCT Glucometer
|
Facility
|
OP
|
$52.50
|
|
|
Service Code
|
CPT 82947
|
| Hospital Charge Code |
Px03018294701
|
|
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, Serum Cholinesterase - Pseudocholinesterase
|
Facility
|
IP
|
$90.83
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
Px03018248001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.12 |
| 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 |
$90.83
|
| Rate for Payer: Cash Price |
$90.83
|
| 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 |
$68.12
|
| Rate for Payer: Provider Network of America Commercial |
$72.66
|
|
|
HC Assay, Serum Cholinesterase - Pseudocholinesterase
|
Facility
|
OP
|
$90.83
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
Px03018248001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$72.66 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$64.04
|
| Rate for Payer: Aetna Workers' Compensation |
$64.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$62.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$62.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$71.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$71.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$71.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$69.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$71.57
|
| Rate for Payer: Cash Price |
$90.83
|
| Rate for Payer: Cash Price |
$90.83
|
| Rate for Payer: Cigna Commercial |
$47.59
|
| Rate for Payer: Cigna Medicare Advantage |
$51.77
|
| Rate for Payer: Family Health Partners Medicaid |
$9.91
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$57.22
|
| Rate for Payer: Healthy Blue Medicaid |
$10.70
|
| Rate for Payer: Home State Health Plan Exchange |
$51.77
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.91
|
| Rate for Payer: Humana Medicare |
$68.12
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.91
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$68.12
|
| Rate for Payer: Provider Network of America Commercial |
$72.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.95
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.46
|
|
|
HC Assay, Serum Cholinesterase - Pseudocholinesterase Phenotype
|
Facility
|
OP
|
$90.83
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
Px03018248002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.46 |
| Max. Negotiated Rate |
$72.66 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$64.04
|
| Rate for Payer: Aetna Workers' Compensation |
$64.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$62.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$62.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$71.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$71.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$71.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$69.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$71.57
|
| Rate for Payer: Cash Price |
$90.83
|
| Rate for Payer: Cash Price |
$90.83
|
| Rate for Payer: Cigna Commercial |
$47.59
|
| Rate for Payer: Cigna Medicare Advantage |
$51.77
|
| Rate for Payer: Family Health Partners Medicaid |
$9.91
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$57.22
|
| Rate for Payer: Healthy Blue Medicaid |
$10.70
|
| Rate for Payer: Home State Health Plan Exchange |
$51.77
|
| Rate for Payer: Home State Health Plan Medicaid |
$9.91
|
| Rate for Payer: Humana Medicare |
$68.12
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9.91
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$68.12
|
| Rate for Payer: Provider Network of America Commercial |
$72.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.95
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7.87
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.46
|
|
|
HC Assay, Serum Cholinesterase - Pseudocholinesterase Phenotype
|
Facility
|
IP
|
$90.83
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
Px03018248002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.12 |
| 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 |
$90.83
|
| Rate for Payer: Cash Price |
$90.83
|
| 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 |
$68.12
|
| Rate for Payer: Provider Network of America Commercial |
$72.66
|
|
|
HC Assay, Three Catecholamines - Catecholamine 24 Hr Urine
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
Px03018238401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$173.25 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| 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 |
$173.25
|
| Rate for Payer: Provider Network of America Commercial |
$184.80
|
|
|
HC Assay, Three Catecholamines - Catecholamine 24 Hr Urine
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
Px03018238401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$184.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$162.85
|
| Rate for Payer: Aetna Workers' Compensation |
$162.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$160.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$160.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$177.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$182.03
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cigna Commercial |
$121.04
|
| Rate for Payer: Cigna Medicare Advantage |
$131.67
|
| Rate for Payer: Family Health Partners Medicaid |
$31.82
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$145.53
|
| Rate for Payer: Healthy Blue Medicaid |
$34.37
|
| Rate for Payer: Home State Health Plan Exchange |
$131.67
|
| Rate for Payer: Home State Health Plan Medicaid |
$31.82
|
| Rate for Payer: Humana Medicare |
$173.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$31.82
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$173.25
|
| Rate for Payer: Provider Network of America Commercial |
$184.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$152.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.96
|
|
|
HC Assay, Three Catecholamines - Catecholamines Fractionated
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
Px03018238403
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$184.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$162.85
|
| Rate for Payer: Aetna Workers' Compensation |
$162.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$160.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$160.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$177.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$182.03
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cigna Commercial |
$121.04
|
| Rate for Payer: Cigna Medicare Advantage |
$131.67
|
| Rate for Payer: Family Health Partners Medicaid |
$31.82
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$145.53
|
| Rate for Payer: Healthy Blue Medicaid |
$34.37
|
| Rate for Payer: Home State Health Plan Exchange |
$131.67
|
| Rate for Payer: Home State Health Plan Medicaid |
$31.82
|
| Rate for Payer: Humana Medicare |
$173.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$31.82
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$173.25
|
| Rate for Payer: Provider Network of America Commercial |
$184.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$152.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.96
|
|
|
HC Assay, Three Catecholamines - Catecholamines Fractionated
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
Px03018238403
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$173.25 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| 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 |
$173.25
|
| Rate for Payer: Provider Network of America Commercial |
$184.80
|
|
|
HC Assay, Three Catecholamines - Catecholamines Fractionated Pl
|
Facility
|
IP
|
$231.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
Px03018238402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$173.25 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| 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 |
$173.25
|
| Rate for Payer: Provider Network of America Commercial |
$184.80
|
|
|
HC Assay, Three Catecholamines - Catecholamines Fractionated Pl
|
Facility
|
OP
|
$231.00
|
|
|
Service Code
|
CPT 82384
|
| Hospital Charge Code |
Px03018238402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.96 |
| Max. Negotiated Rate |
$184.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$162.85
|
| Rate for Payer: Aetna Workers' Compensation |
$162.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$160.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$160.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$182.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$177.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$182.03
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cash Price |
$231.00
|
| Rate for Payer: Cigna Commercial |
$121.04
|
| Rate for Payer: Cigna Medicare Advantage |
$131.67
|
| Rate for Payer: Family Health Partners Medicaid |
$31.82
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$145.53
|
| Rate for Payer: Healthy Blue Medicaid |
$34.37
|
| Rate for Payer: Home State Health Plan Exchange |
$131.67
|
| Rate for Payer: Home State Health Plan Medicaid |
$31.82
|
| Rate for Payer: Humana Medicare |
$173.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$31.82
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$173.25
|
| Rate for Payer: Provider Network of America Commercial |
$184.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$152.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$23.96
|
|
|
HC Assay Thyroid Stim Hormone - POCT Thyroid Stimulating Hormone (Tsh)
|
Facility
|
OP
|
$183.75
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
Px03018444302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.94 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$129.54
|
| Rate for Payer: Aetna Workers' Compensation |
$129.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$127.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$127.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$144.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$144.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$144.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$141.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$144.79
|
| Rate for Payer: Cash Price |
$183.75
|
| Rate for Payer: Cash Price |
$183.75
|
| Rate for Payer: Cigna Commercial |
$96.28
|
| Rate for Payer: Cigna Medicare Advantage |
$104.74
|
| Rate for Payer: Family Health Partners Medicaid |
$21.17
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$115.76
|
| Rate for Payer: Healthy Blue Medicaid |
$22.86
|
| Rate for Payer: Home State Health Plan Exchange |
$104.74
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.17
|
| Rate for Payer: Humana Medicare |
$137.81
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.17
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$137.81
|
| Rate for Payer: Provider Network of America Commercial |
$147.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$121.28
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.94
|
|
|
HC Assay Thyroid Stim Hormone - POCT Thyroid Stimulating Hormone (Tsh)
|
Facility
|
IP
|
$183.75
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
Px03018444302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$137.81 |
| 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 |
$183.75
|
| Rate for Payer: Cash Price |
$183.75
|
| 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 |
$137.81
|
| Rate for Payer: Provider Network of America Commercial |
$147.00
|
|
|
HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone
|
Facility
|
OP
|
$183.75
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
Px03018444301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.94 |
| Max. Negotiated Rate |
$147.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$129.54
|
| Rate for Payer: Aetna Workers' Compensation |
$129.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$127.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$127.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$144.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$144.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$144.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$141.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$144.79
|
| Rate for Payer: Cash Price |
$183.75
|
| Rate for Payer: Cash Price |
$183.75
|
| Rate for Payer: Cigna Commercial |
$96.28
|
| Rate for Payer: Cigna Medicare Advantage |
$104.74
|
| Rate for Payer: Family Health Partners Medicaid |
$21.17
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$115.76
|
| Rate for Payer: Healthy Blue Medicaid |
$22.86
|
| Rate for Payer: Home State Health Plan Exchange |
$104.74
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.17
|
| Rate for Payer: Humana Medicare |
$137.81
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.17
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$137.81
|
| Rate for Payer: Provider Network of America Commercial |
$147.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$121.28
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.94
|
|
|
HC Assay Thyroid Stim Hormone - Thyroid Stimulating Hormone
|
Facility
|
IP
|
$183.75
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
Px03018444301
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$137.81 |
| 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 |
$183.75
|
| Rate for Payer: Cash Price |
$183.75
|
| 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 |
$137.81
|
| Rate for Payer: Provider Network of America Commercial |
$147.00
|
|
|
HC Assay, Toxin or Antitoxin - Clostridium Difficile Toxins Tissue Cult
|
Facility
|
OP
|
$215.25
|
|
|
Service Code
|
CPT 87230
|
| Hospital Charge Code |
Px03068723001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.73 |
| Max. Negotiated Rate |
$172.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$151.75
|
| Rate for Payer: Aetna Workers' Compensation |
$151.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$149.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$149.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$169.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$169.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$169.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$165.74
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$169.62
|
| Rate for Payer: Cash Price |
$215.25
|
| Rate for Payer: Cash Price |
$215.25
|
| Rate for Payer: Cigna Commercial |
$112.79
|
| Rate for Payer: Cigna Medicare Advantage |
$122.69
|
| Rate for Payer: Family Health Partners Medicaid |
$24.88
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$135.61
|
| Rate for Payer: Healthy Blue Medicaid |
$26.87
|
| Rate for Payer: Home State Health Plan Exchange |
$122.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$24.88
|
| Rate for Payer: Humana Medicare |
$161.44
|
| Rate for Payer: Mercy CarePlus Medicaid |
$24.88
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$161.44
|
| Rate for Payer: Provider Network of America Commercial |
$172.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$142.06
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$19.74
|
| Rate for Payer: UnitedHealthcare Medicaid |
$18.73
|
|
|
HC Assay, Toxin or Antitoxin - Clostridium Difficile Toxins Tissue Cult
|
Facility
|
IP
|
$215.25
|
|
|
Service Code
|
CPT 87230
|
| Hospital Charge Code |
Px03068723001
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$161.44 |
| 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 |
$215.25
|
| Rate for Payer: Cash Price |
$215.25
|
| 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 |
$161.44
|
| Rate for Payer: Provider Network of America Commercial |
$172.20
|
|
|
HC Assay Urea Nitrogen, Quan - Blood Urea Nitrogen
|
Facility
|
OP
|
$92.40
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
Px03018452001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$73.92 |
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.14
|
| Rate for Payer: Aetna Workers' Compensation |
$65.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$72.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$72.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$72.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$72.81
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$48.42
|
| Rate for Payer: Cigna Medicare Advantage |
$52.67
|
| Rate for Payer: Family Health Partners Medicaid |
$4.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.21
|
| Rate for Payer: Healthy Blue Medicaid |
$5.38
|
| Rate for Payer: Home State Health Plan Exchange |
$52.67
|
| Rate for Payer: Home State Health Plan Medicaid |
$4.98
|
| Rate for Payer: Humana Medicare |
$69.30
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$69.30
|
| Rate for Payer: Provider Network of America Commercial |
$73.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$60.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.75
|
|
|
HC Assay Urea Nitrogen, Quan - Blood Urea Nitrogen
|
Facility
|
IP
|
$92.40
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
Px03018452001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.30 |
| 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 |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| 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 |
$69.30
|
| Rate for Payer: Provider Network of America Commercial |
$73.92
|
|
|
HC Assay Urea Nitrogen, Quan - POCT Urea (Bun)
|
Facility
|
IP
|
$92.40
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
Px03018452004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.30 |
| 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 |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| 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 |
$69.30
|
| Rate for Payer: Provider Network of America Commercial |
$73.92
|
|
|
HC Assay Urea Nitrogen, Quan - POCT Urea (Bun)
|
Facility
|
OP
|
$92.40
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
Px03018452004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.75 |
| Max. Negotiated Rate |
$73.92 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.14
|
| Rate for Payer: Aetna Workers' Compensation |
$65.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$72.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$72.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$72.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$72.81
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cigna Commercial |
$48.42
|
| Rate for Payer: Cigna Medicare Advantage |
$52.67
|
| Rate for Payer: Family Health Partners Medicaid |
$4.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.21
|
| Rate for Payer: Healthy Blue Medicaid |
$5.38
|
| Rate for Payer: Home State Health Plan Exchange |
$52.67
|
| Rate for Payer: Home State Health Plan Medicaid |
$4.98
|
| Rate for Payer: Humana Medicare |
$69.30
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$69.30
|
| Rate for Payer: Provider Network of America Commercial |
$73.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$60.98
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.75
|
|
|
HC Assay, Urine Catecholamines - Catecholamines, Urine, Total
|
Facility
|
OP
|
$189.00
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
Px03018238201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.90 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$133.25
|
| Rate for Payer: Aetna Workers' Compensation |
$133.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$130.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$130.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$148.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$148.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$148.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$145.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$148.93
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cigna Commercial |
$99.04
|
| Rate for Payer: Cigna Medicare Advantage |
$107.73
|
| Rate for Payer: Family Health Partners Medicaid |
$34.40
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$119.07
|
| Rate for Payer: Healthy Blue Medicaid |
$37.15
|
| Rate for Payer: Home State Health Plan Exchange |
$107.73
|
| Rate for Payer: Home State Health Plan Medicaid |
$34.40
|
| Rate for Payer: Humana Medicare |
$141.75
|
| Rate for Payer: Mercy CarePlus Medicaid |
$34.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$141.75
|
| Rate for Payer: Provider Network of America Commercial |
$151.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$124.74
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$27.30
|
| Rate for Payer: UnitedHealthcare Medicaid |
$25.90
|
|
|
HC Assay, Urine Catecholamines - Catecholamines, Urine, Total
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
CPT 82382
|
| Hospital Charge Code |
Px03018238201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$141.75 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$189.00
|
| Rate for Payer: Cash Price |
$189.00
|
| 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 |
$141.75
|
| Rate for Payer: Provider Network of America Commercial |
$151.20
|
|
