|
HC Athroscopy Shoulder Bicep Tenodesis
|
Facility
|
IP
|
$14,608.42
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
Px03602982801
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$11,686.74 |
| 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 |
$14,608.42
|
| Rate for Payer: Cash Price |
$14,608.42
|
| 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 |
$10,956.32
|
| Rate for Payer: Provider Network of America Commercial |
$11,686.74
|
|
|
HC Athroscopy Shoulder Bicep Tenodesis
|
Facility
|
OP
|
$14,608.42
|
|
|
Service Code
|
CPT 29828
|
| Hospital Charge Code |
Px03602982801
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,894.33 |
| Max. Negotiated Rate |
$14,608.42 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$10,123.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$10,123.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$11,511.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$11,511.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$11,511.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$11,248.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$11,511.43
|
| Rate for Payer: Cash Price |
$14,608.42
|
| Rate for Payer: Cash Price |
$14,608.42
|
| Rate for Payer: Cigna Commercial |
$9,685.38
|
| Rate for Payer: Cigna Medicare Advantage |
$8,326.80
|
| Rate for Payer: Family Health Partners Medicaid |
$9,157.55
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$9,203.30
|
| Rate for Payer: Healthy Blue Medicaid |
$9,890.16
|
| Rate for Payer: Home State Health Plan Exchange |
$8,326.80
|
| Rate for Payer: Home State Health Plan Medicaid |
$9,157.55
|
| Rate for Payer: Humana Medicare |
$10,956.32
|
| Rate for Payer: Mercy CarePlus Medicaid |
$9,157.55
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$10,956.32
|
| Rate for Payer: Provider Network of America Commercial |
$11,686.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$9,641.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$14,608.42
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6,894.33
|
|
|
HC Autograft Skin Split
|
Facility
|
OP
|
$3,994.64
|
|
|
Service Code
|
CPT 15100
|
| Hospital Charge Code |
Px03611510001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,960.38 |
| Max. Negotiated Rate |
$3,994.64 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,768.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,768.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$3,075.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$3,147.78
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cigna Commercial |
$2,648.45
|
| Rate for Payer: Cigna Medicare Advantage |
$2,276.94
|
| Rate for Payer: Family Health Partners Medicaid |
$2,603.92
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,516.62
|
| Rate for Payer: Healthy Blue Medicaid |
$2,812.23
|
| Rate for Payer: Home State Health Plan Exchange |
$2,276.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$2,603.92
|
| Rate for Payer: Humana Medicare |
$2,995.98
|
| Rate for Payer: Mercy CarePlus Medicaid |
$2,603.92
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,995.98
|
| Rate for Payer: Provider Network of America Commercial |
$3,195.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,636.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,994.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,960.38
|
|
|
HC Autograft Skin Split
|
Facility
|
IP
|
$3,994.64
|
|
|
Service Code
|
CPT 15100
|
| Hospital Charge Code |
Px03611510001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cash Price |
$3,994.64
|
| 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 |
$2,995.98
|
| Rate for Payer: Provider Network of America Commercial |
$3,195.71
|
|
|
HC Babesia Species by Pcr / 2nd Test
|
Facility
|
IP
|
$354.90
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
Px03068779822
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$266.18 |
| 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 |
$354.90
|
| Rate for Payer: Cash Price |
$354.90
|
| 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 |
$266.18
|
| Rate for Payer: Provider Network of America Commercial |
$283.92
|
|
|
HC Babesia Species by Pcr / 2nd Test
|
Facility
|
OP
|
$354.90
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
Px03068779822
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.29 |
| Max. Negotiated Rate |
$283.92 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$250.20
|
| Rate for Payer: Aetna Workers' Compensation |
$250.20
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$245.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$245.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$279.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$279.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$279.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$273.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$279.66
|
| Rate for Payer: Cash Price |
$354.90
|
| Rate for Payer: Cash Price |
$354.90
|
| Rate for Payer: Cigna Commercial |
$185.97
|
| Rate for Payer: Cigna Medicare Advantage |
$202.29
|
| Rate for Payer: Family Health Partners Medicaid |
$44.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$223.59
|
| Rate for Payer: Healthy Blue Medicaid |
$47.75
|
| Rate for Payer: Home State Health Plan Exchange |
$202.29
|
| Rate for Payer: Home State Health Plan Medicaid |
$44.21
|
| Rate for Payer: Humana Medicare |
$266.18
|
| Rate for Payer: Mercy CarePlus Medicaid |
$44.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$266.18
|
| Rate for Payer: Provider Network of America Commercial |
$283.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$234.23
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$35.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.29
|
|
|
HC Babesia Species by Pcr Arup
|
Facility
|
OP
|
$110.25
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
Px03068779824
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.29 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$77.73
|
| Rate for Payer: Aetna Workers' Compensation |
$77.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$84.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$86.88
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cigna Commercial |
$57.77
|
| Rate for Payer: Cigna Medicare Advantage |
$62.84
|
| Rate for Payer: Family Health Partners Medicaid |
$44.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$69.46
|
| Rate for Payer: Healthy Blue Medicaid |
$47.75
|
| Rate for Payer: Home State Health Plan Exchange |
$62.84
|
| Rate for Payer: Home State Health Plan Medicaid |
$44.21
|
| Rate for Payer: Humana Medicare |
$82.69
|
| Rate for Payer: Mercy CarePlus Medicaid |
$44.21
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.77
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$35.09
|
| Rate for Payer: UnitedHealthcare Medicaid |
$33.29
|
|
|
HC Babesia Species by Pcr Arup
|
Facility
|
IP
|
$110.25
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
Px03068779824
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$82.69 |
| 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 |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| 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 |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
|
|
HC Bacteria Culture Screen - Nasal Mrsa
|
Facility
|
OP
|
$189.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
Px03068708104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.29 |
| 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 |
$8.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$119.07
|
| Rate for Payer: Healthy Blue Medicaid |
$9.03
|
| Rate for Payer: Home State Health Plan Exchange |
$107.73
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.36
|
| Rate for Payer: Humana Medicare |
$141.75
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.36
|
| 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 |
$6.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.29
|
|
|
HC Bacteria Culture Screen - Nasal Mrsa
|
Facility
|
IP
|
$189.00
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
Px03068708104
|
|
Hospital Revenue Code
|
306
|
| 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
|
|
|
HC Bacteria Culture Screen - Strep Culture Grp B
|
Facility
|
IP
|
$202.65
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
Px03068708106
|
|
Hospital Revenue Code
|
306
|
| 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 Bacteria Culture Screen - Strep Culture Grp B
|
Facility
|
OP
|
$202.65
|
|
|
Service Code
|
CPT 87081
|
| Hospital Charge Code |
Px03068708106
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.29 |
| 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 |
$8.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$127.67
|
| Rate for Payer: Healthy Blue Medicaid |
$9.03
|
| Rate for Payer: Home State Health Plan Exchange |
$115.51
|
| Rate for Payer: Home State Health Plan Medicaid |
$8.36
|
| Rate for Payer: Humana Medicare |
$151.99
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8.36
|
| 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 |
$6.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$6.29
|
|
|
HC Bacteria Identification, Aerobic Isolate - Organism ID Culture
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707702
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.33 |
| 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 |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
|
|
HC Bacteria Identification, Aerobic Isolate - Organism ID Culture
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707702
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$75.51
|
| Rate for Payer: Aetna Workers' Compensation |
$75.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$82.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$84.39
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Cigna Medicare Advantage |
$61.05
|
| Rate for Payer: Family Health Partners Medicaid |
$10.18
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$10.99
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.18
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.18
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.69
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.66
|
|
|
HC Bacteria Identification, Aerobic Isolate - Perform ID R/M
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707704
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.33 |
| 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 |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
|
|
HC Bacteria Identification, Aerobic Isolate - Perform ID R/M
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707704
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$75.51
|
| Rate for Payer: Aetna Workers' Compensation |
$75.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$82.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$84.39
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Cigna Medicare Advantage |
$61.05
|
| Rate for Payer: Family Health Partners Medicaid |
$10.18
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$10.99
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.18
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.18
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.69
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.66
|
|
|
HC Bacteria Identification, Aerobic Isolate - Perform ID V/M
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707703
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.33 |
| 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 |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
|
|
HC Bacteria Identification, Aerobic Isolate - Perform ID V/M
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707703
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$75.51
|
| Rate for Payer: Aetna Workers' Compensation |
$75.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$82.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$84.39
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Cigna Medicare Advantage |
$61.05
|
| Rate for Payer: Family Health Partners Medicaid |
$10.18
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$10.99
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.18
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.18
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.69
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.66
|
|
|
HC Bacteria Identification, Aerobic Isolate - Perform ID V/M/R
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707705
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.33 |
| 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 |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
|
|
HC Bacteria Identification, Aerobic Isolate - Perform ID V/M/R
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707705
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$75.51
|
| Rate for Payer: Aetna Workers' Compensation |
$75.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$82.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$84.39
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Cigna Medicare Advantage |
$61.05
|
| Rate for Payer: Family Health Partners Medicaid |
$10.18
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$10.99
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.18
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.18
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.69
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.66
|
|
|
HC Bacteria Identification, Aerobic Isolate - POCT H. Pylori
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707701
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$80.33 |
| 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 |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
|
|
HC Bacteria Identification, Aerobic Isolate - POCT H. Pylori
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
Px03068707701
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.66 |
| Max. Negotiated Rate |
$85.68 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$75.51
|
| Rate for Payer: Aetna Workers' Compensation |
$75.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$74.22
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$84.39
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$82.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$84.39
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cash Price |
$107.10
|
| Rate for Payer: Cigna Commercial |
$56.12
|
| Rate for Payer: Cigna Medicare Advantage |
$61.05
|
| Rate for Payer: Family Health Partners Medicaid |
$10.18
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$10.99
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$10.18
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$10.18
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$80.33
|
| Rate for Payer: Provider Network of America Commercial |
$85.68
|
| Rate for Payer: UnitedHealthcare Commercial |
$70.69
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.08
|
| Rate for Payer: UnitedHealthcare Medicaid |
$7.66
|
|
|
HC Bacterium, Antibody
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660903
|
|
Hospital Revenue Code
|
302
|
| 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 Bacterium, Antibody
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660903
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.22 |
| 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 |
$16.23
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$44.98
|
| Rate for Payer: Healthy Blue Medicaid |
$17.52
|
| Rate for Payer: Home State Health Plan Exchange |
$40.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$16.23
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$16.23
|
| 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 |
$12.88
|
| Rate for Payer: UnitedHealthcare Medicaid |
$12.22
|
|
|
HC Bacterium, Antibody - Burkholderia Pseudomallei Antibody
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660901
|
|
Hospital Revenue Code
|
302
|
| 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
|
|
