|
HC Bacterium, Antibody - Burkholderia Pseudomallei Antibody
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660901
|
|
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 - Listeria Antibody Total
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660909
|
|
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 - Listeria Antibody Total
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660909
|
|
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 - Saccharopolyspora Rectivirgula
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660904
|
|
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 - Saccharopolyspora Rectivirgula
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660904
|
|
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 - Thermoactinomyces Candidus
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660907
|
|
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 - Thermoactinomyces Candidus
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660907
|
|
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 - Thermoactinomyces Sacchari
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660906
|
|
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 - Thermoactinomyces Sacchari
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660906
|
|
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 - Thermoactinomyces Vulgaris
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660905
|
|
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 - Thermoactinomyces Vulgaris
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660905
|
|
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 - Toxic Shock Syndrome Antibody
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660902
|
|
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 - Toxic Shock Syndrome Antibody
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660902
|
|
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 - Trichoderm Viride Igg
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660908
|
|
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 - Trichoderm Viride Igg
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
Px03028660908
|
|
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 Bag Flatus
|
Facility
|
IP
|
$3.41
|
|
| Hospital Charge Code |
Px02700002701
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cash Price |
$3.41
|
| 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 |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
|
|
HC Bag Flatus
|
Facility
|
OP
|
$3.41
|
|
| Hospital Charge Code |
Px02700002701
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$3.41 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2.40
|
| Rate for Payer: Aetna Workers' Compensation |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2.69
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cigna Commercial |
$2.09
|
| Rate for Payer: Cigna Medicare Advantage |
$1.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2.15
|
| Rate for Payer: Home State Health Plan Exchange |
$1.94
|
| Rate for Payer: Humana Medicare |
$2.56
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.25
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.41
|
|
|
HC Bag Vaginal Irrig
|
Facility
|
IP
|
$4.39
|
|
| Hospital Charge Code |
Px02700002676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.29 |
| 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 |
$4.39
|
| Rate for Payer: Cash Price |
$4.39
|
| 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 |
$3.29
|
| Rate for Payer: Provider Network of America Commercial |
$3.51
|
|
|
HC Bag Vaginal Irrig
|
Facility
|
OP
|
$4.39
|
|
| Hospital Charge Code |
Px02700002676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$4.39 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$3.09
|
| Rate for Payer: Aetna Workers' Compensation |
$3.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$3.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$3.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$3.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$3.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$3.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$3.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$3.46
|
| Rate for Payer: Cash Price |
$4.39
|
| Rate for Payer: Cigna Commercial |
$2.69
|
| Rate for Payer: Cigna Medicare Advantage |
$2.50
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2.77
|
| Rate for Payer: Home State Health Plan Exchange |
$2.50
|
| Rate for Payer: Humana Medicare |
$3.29
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$3.29
|
| Rate for Payer: Provider Network of America Commercial |
$3.51
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.90
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.39
|
|
|
HC Bandage Comp Lopress 2.3 X5.4yd
|
Facility
|
IP
|
$11.75
|
|
| Hospital Charge Code |
Px02720000586
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.81 |
| 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 |
$11.75
|
| Rate for Payer: Cash Price |
$11.75
|
| 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 |
$8.81
|
| Rate for Payer: Provider Network of America Commercial |
$9.40
|
|
|
HC Bandage Comp Lopress 2.3 X5.4yd
|
Facility
|
OP
|
$11.75
|
|
| Hospital Charge Code |
Px02720000586
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.70 |
| Max. Negotiated Rate |
$11.75 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$8.28
|
| Rate for Payer: Aetna Workers' Compensation |
$8.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$8.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$8.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$9.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$9.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$9.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$9.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$9.26
|
| Rate for Payer: Cash Price |
$11.75
|
| Rate for Payer: Cigna Commercial |
$7.19
|
| Rate for Payer: Cigna Medicare Advantage |
$6.70
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$7.40
|
| Rate for Payer: Home State Health Plan Exchange |
$6.70
|
| Rate for Payer: Humana Medicare |
$8.81
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$8.81
|
| Rate for Payer: Provider Network of America Commercial |
$9.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$7.75
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.75
|
|
|
HC Bandage Comp Lopress 3.1 X5.4yd
|
Facility
|
IP
|
$15.60
|
|
| Hospital Charge Code |
Px02720000587
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.70 |
| 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 |
$15.60
|
| Rate for Payer: Cash Price |
$15.60
|
| 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 |
$11.70
|
| Rate for Payer: Provider Network of America Commercial |
$12.48
|
|
|
HC Bandage Comp Lopress 3.1 X5.4yd
|
Facility
|
OP
|
$15.60
|
|
| Hospital Charge Code |
Px02720000587
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$15.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$11.00
|
| Rate for Payer: Aetna Workers' Compensation |
$11.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$10.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$12.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$12.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$12.29
|
| Rate for Payer: Cash Price |
$15.60
|
| Rate for Payer: Cigna Commercial |
$9.55
|
| Rate for Payer: Cigna Medicare Advantage |
$8.89
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$9.83
|
| Rate for Payer: Home State Health Plan Exchange |
$8.89
|
| Rate for Payer: Humana Medicare |
$11.70
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$11.70
|
| Rate for Payer: Provider Network of America Commercial |
$12.48
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.30
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$15.60
|
|
|
HC Bandage Comp Lopress 3.9 X5.4yd
|
Facility
|
OP
|
$18.16
|
|
| Hospital Charge Code |
Px02720000588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.35 |
| Max. Negotiated Rate |
$18.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$12.80
|
| Rate for Payer: Aetna Workers' Compensation |
$12.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$12.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$12.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$14.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$14.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$14.31
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$13.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$14.31
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cigna Commercial |
$11.11
|
| Rate for Payer: Cigna Medicare Advantage |
$10.35
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$11.44
|
| Rate for Payer: Home State Health Plan Exchange |
$10.35
|
| Rate for Payer: Humana Medicare |
$13.62
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$13.62
|
| Rate for Payer: Provider Network of America Commercial |
$14.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$11.99
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.16
|
|
|
HC Bandage Comp Lopress 3.9 X5.4yd
|
Facility
|
IP
|
$18.16
|
|
| Hospital Charge Code |
Px02720000588
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.62 |
| 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 |
$18.16
|
| Rate for Payer: Cash Price |
$18.16
|
| 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 |
$13.62
|
| Rate for Payer: Provider Network of America Commercial |
$14.53
|
|
