|
HC Beta 2 Glycoprotein I Antibody - Glycoprotein Igg
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
Px03028614602
|
|
Hospital Revenue Code
|
302
|
| 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 Beta 2 Glycoprotein I Antibody - Glycoprotein Igg
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
Px03028614602
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.15 |
| 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 |
$32.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$34.64
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.07
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.07
|
| 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 |
$25.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.15
|
|
|
HC Beta 2 Glycoprotein I Antibody - Glycoprotein Igm
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
Px03028614604
|
|
Hospital Revenue Code
|
302
|
| 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 Beta 2 Glycoprotein I Antibody - Glycoprotein Igm
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
Px03028614604
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.15 |
| 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 |
$32.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$67.47
|
| Rate for Payer: Healthy Blue Medicaid |
$34.64
|
| Rate for Payer: Home State Health Plan Exchange |
$61.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.07
|
| Rate for Payer: Humana Medicare |
$80.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.07
|
| 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 |
$25.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.15
|
|
|
HC Beta-2 Protein - Beta 2 Microglobulin
|
Facility
|
OP
|
$261.45
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
Px03018223202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$209.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$184.32
|
| Rate for Payer: Aetna Workers' Compensation |
$184.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$201.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$206.02
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cigna Commercial |
$137.00
|
| Rate for Payer: Cigna Medicare Advantage |
$149.03
|
| Rate for Payer: Family Health Partners Medicaid |
$20.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$164.71
|
| Rate for Payer: Healthy Blue Medicaid |
$22.01
|
| Rate for Payer: Home State Health Plan Exchange |
$149.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.38
|
| Rate for Payer: Humana Medicare |
$196.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$172.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.35
|
|
|
HC Beta-2 Protein - Beta 2 Microglobulin
|
Facility
|
IP
|
$261.45
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
Px03018223202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$196.09 |
| 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 |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| 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 |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
|
|
HC Beta-2 Protein - Beta 2 Microglobulin CSF
|
Facility
|
OP
|
$261.45
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
Px03018223201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$209.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$184.32
|
| Rate for Payer: Aetna Workers' Compensation |
$184.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$201.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$206.02
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cigna Commercial |
$137.00
|
| Rate for Payer: Cigna Medicare Advantage |
$149.03
|
| Rate for Payer: Family Health Partners Medicaid |
$20.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$164.71
|
| Rate for Payer: Healthy Blue Medicaid |
$22.01
|
| Rate for Payer: Home State Health Plan Exchange |
$149.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.38
|
| Rate for Payer: Humana Medicare |
$196.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$172.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.35
|
|
|
HC Beta-2 Protein - Beta 2 Microglobulin CSF
|
Facility
|
IP
|
$261.45
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
Px03018223201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$196.09 |
| 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 |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| 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 |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
|
|
HC Beta-2 Protein - Beta 2 Microglobulin Urine
|
Facility
|
IP
|
$261.45
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
Px03018223203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$196.09 |
| 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 |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| 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 |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
|
|
HC Beta-2 Protein - Beta 2 Microglobulin Urine
|
Facility
|
OP
|
$261.45
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
Px03018223203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.35 |
| Max. Negotiated Rate |
$209.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$184.32
|
| Rate for Payer: Aetna Workers' Compensation |
$184.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$181.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$206.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$201.32
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$206.02
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cash Price |
$261.45
|
| Rate for Payer: Cigna Commercial |
$137.00
|
| Rate for Payer: Cigna Medicare Advantage |
$149.03
|
| Rate for Payer: Family Health Partners Medicaid |
$20.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$164.71
|
| Rate for Payer: Healthy Blue Medicaid |
$22.01
|
| Rate for Payer: Home State Health Plan Exchange |
$149.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$20.38
|
| Rate for Payer: Humana Medicare |
$196.09
|
| Rate for Payer: Mercy CarePlus Medicaid |
$20.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$196.09
|
| Rate for Payer: Provider Network of America Commercial |
$209.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$172.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$15.35
|
|
|
HC Bile Acids, Total - Bile Acids, Total
|
Facility
|
IP
|
$129.61
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
Px03018223901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$97.21 |
| 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 |
$129.61
|
| Rate for Payer: Cash Price |
$129.61
|
| 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 |
$97.21
|
| Rate for Payer: Provider Network of America Commercial |
$103.69
|
|
|
HC Bile Acids, Total - Bile Acids, Total
|
Facility
|
OP
|
$129.61
|
|
|
Service Code
|
CPT 82239
|
| Hospital Charge Code |
Px03018223901
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.24 |
| Max. Negotiated Rate |
$103.69 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$91.38
|
| Rate for Payer: Aetna Workers' Compensation |
$91.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$89.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$89.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$102.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$102.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$102.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$99.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$102.13
|
| Rate for Payer: Cash Price |
$129.61
|
| Rate for Payer: Cash Price |
$129.61
|
| Rate for Payer: Cigna Commercial |
$67.92
|
| Rate for Payer: Cigna Medicare Advantage |
$73.88
|
| Rate for Payer: Family Health Partners Medicaid |
$21.57
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$81.65
|
| Rate for Payer: Healthy Blue Medicaid |
$23.30
|
| Rate for Payer: Home State Health Plan Exchange |
$73.88
|
| Rate for Payer: Home State Health Plan Medicaid |
$21.57
|
| Rate for Payer: Humana Medicare |
$97.21
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21.57
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$97.21
|
| Rate for Payer: Provider Network of America Commercial |
$103.69
|
| Rate for Payer: UnitedHealthcare Commercial |
$85.54
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$17.12
|
| Rate for Payer: UnitedHealthcare Medicaid |
$16.24
|
|
|
HC Bilirubin Direct - Bilirubin Direct
|
Facility
|
IP
|
$88.20
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
Px03018224801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.15 |
| 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 |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| 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 |
$66.15
|
| Rate for Payer: Provider Network of America Commercial |
$70.56
|
|
|
HC Bilirubin Direct - Bilirubin Direct
|
Facility
|
OP
|
$88.20
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
Px03018224801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$70.56 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$62.18
|
| Rate for Payer: Aetna Workers' Compensation |
$62.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$61.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$69.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$69.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$69.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$67.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$69.50
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cigna Commercial |
$46.22
|
| Rate for Payer: Cigna Medicare Advantage |
$50.27
|
| Rate for Payer: Family Health Partners Medicaid |
$6.33
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$55.57
|
| Rate for Payer: Healthy Blue Medicaid |
$6.83
|
| Rate for Payer: Home State Health Plan Exchange |
$50.27
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.33
|
| Rate for Payer: Humana Medicare |
$66.15
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.33
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$66.15
|
| Rate for Payer: Provider Network of America Commercial |
$70.56
|
| Rate for Payer: UnitedHealthcare Commercial |
$58.21
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.76
|
|
|
HC Bilirubin Total - Bilirubin Body Fluid
|
Facility
|
OP
|
$90.30
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
Px03018224702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$72.24 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$63.66
|
| Rate for Payer: Aetna Workers' Compensation |
$63.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$62.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$62.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$71.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$71.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$71.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$69.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$71.16
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cigna Commercial |
$47.32
|
| Rate for Payer: Cigna Medicare Advantage |
$51.47
|
| Rate for Payer: Family Health Partners Medicaid |
$6.33
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$56.89
|
| Rate for Payer: Healthy Blue Medicaid |
$6.83
|
| Rate for Payer: Home State Health Plan Exchange |
$51.47
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.33
|
| Rate for Payer: Humana Medicare |
$67.72
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.33
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$67.72
|
| Rate for Payer: Provider Network of America Commercial |
$72.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.60
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.76
|
|
|
HC Bilirubin Total - Bilirubin Body Fluid
|
Facility
|
IP
|
$90.30
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
Px03018224702
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.72 |
| 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 |
$90.30
|
| Rate for Payer: Cash Price |
$90.30
|
| 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 |
$67.72
|
| Rate for Payer: Provider Network of America Commercial |
$72.24
|
|
|
HC Bilirubin Total - Bilirubin Total
|
Facility
|
OP
|
$90.30
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
Px03018224703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.76 |
| Max. Negotiated Rate |
$72.24 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$63.66
|
| Rate for Payer: Aetna Workers' Compensation |
$63.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$62.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$62.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$71.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$71.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$71.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$69.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$71.16
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cash Price |
$90.30
|
| Rate for Payer: Cigna Commercial |
$47.32
|
| Rate for Payer: Cigna Medicare Advantage |
$51.47
|
| Rate for Payer: Family Health Partners Medicaid |
$6.33
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$56.89
|
| Rate for Payer: Healthy Blue Medicaid |
$6.83
|
| Rate for Payer: Home State Health Plan Exchange |
$51.47
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.33
|
| Rate for Payer: Humana Medicare |
$67.72
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.33
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$67.72
|
| Rate for Payer: Provider Network of America Commercial |
$72.24
|
| Rate for Payer: UnitedHealthcare Commercial |
$59.60
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.02
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.76
|
|
|
HC Bilirubin Total - Bilirubin Total
|
Facility
|
IP
|
$90.30
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
Px03018224703
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.72 |
| 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 |
$90.30
|
| Rate for Payer: Cash Price |
$90.30
|
| 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 |
$67.72
|
| Rate for Payer: Provider Network of America Commercial |
$72.24
|
|
|
HC Bind 45-62 in Abd 9 in 3 Panel Univer Flannel Lined Elast Support W/Cont Closure
|
Facility
|
OP
|
$13.65
|
|
| Hospital Charge Code |
Px0272L062501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.78 |
| Max. Negotiated Rate |
$13.65 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$9.62
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$15.16
|
| Rate for Payer: Aetna Workers' Compensation |
$9.62
|
| Rate for Payer: Aetna Workers' Compensation |
$15.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$9.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$14.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$9.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$14.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$10.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$10.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$10.76
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$10.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$16.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$16.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$10.76
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cigna Commercial |
$8.35
|
| Rate for Payer: Cigna Commercial |
$13.16
|
| Rate for Payer: Cigna Medicare Advantage |
$7.78
|
| Rate for Payer: Cigna Medicare Advantage |
$12.26
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$8.60
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$13.54
|
| Rate for Payer: Home State Health Plan Exchange |
$7.78
|
| Rate for Payer: Home State Health Plan Exchange |
$12.26
|
| Rate for Payer: Humana Medicare |
$10.24
|
| Rate for Payer: Humana Medicare |
$16.12
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$10.24
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$16.12
|
| Rate for Payer: Provider Network of America Commercial |
$10.92
|
| Rate for Payer: Provider Network of America Commercial |
$17.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$9.01
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.19
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$13.65
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$21.50
|
|
|
HC Bind 45-62 in Abd 9 in 3 Panel Univer Flannel Lined Elast Support W/Cont Closure
|
Facility
|
IP
|
$21.50
|
|
| Hospital Charge Code |
Px0272L062501
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.12 |
| 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 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 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: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$10.24
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$16.12
|
| Rate for Payer: Provider Network of America Commercial |
$10.92
|
| Rate for Payer: Provider Network of America Commercial |
$17.20
|
|
|
HC Binder Lumbo Sacral Sm
|
Facility
|
OP
|
$93.84
|
|
| Hospital Charge Code |
Px02720000640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.49 |
| Max. Negotiated Rate |
$93.84 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$66.16
|
| Rate for Payer: Aetna Workers' Compensation |
$66.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$65.03
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$72.26
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.95
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cigna Commercial |
$57.43
|
| Rate for Payer: Cigna Medicare Advantage |
$53.49
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$59.12
|
| Rate for Payer: Home State Health Plan Exchange |
$53.49
|
| Rate for Payer: Humana Medicare |
$70.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.38
|
| Rate for Payer: Provider Network of America Commercial |
$75.07
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.93
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$93.84
|
|
|
HC Binder Lumbo Sacral Sm
|
Facility
|
IP
|
$93.84
|
|
| Hospital Charge Code |
Px02720000640
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$70.38 |
| 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 |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| 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 |
$70.38
|
| Rate for Payer: Provider Network of America Commercial |
$75.07
|
|
|
HC Biopsy Breast Open, Incisional
|
Facility
|
OP
|
$7,665.00
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
Px03601910101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,720.16 |
| Max. Negotiated Rate |
$7,665.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5,311.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5,311.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$6,040.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$6,040.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$6,040.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,902.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$6,040.02
|
| Rate for Payer: Cash Price |
$7,665.00
|
| Rate for Payer: Cash Price |
$7,665.00
|
| Rate for Payer: Cigna Commercial |
$5,081.90
|
| Rate for Payer: Cigna Medicare Advantage |
$4,369.05
|
| Rate for Payer: Family Health Partners Medicaid |
$4,941.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,828.95
|
| Rate for Payer: Healthy Blue Medicaid |
$5,336.69
|
| Rate for Payer: Home State Health Plan Exchange |
$4,369.05
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,941.38
|
| Rate for Payer: Humana Medicare |
$5,748.75
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,941.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$5,748.75
|
| Rate for Payer: Provider Network of America Commercial |
$6,132.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$5,058.90
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7,665.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,720.16
|
|
|
HC Biopsy Breast Open, Incisional
|
Facility
|
IP
|
$7,665.00
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
Px03601910101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$6,132.00 |
| 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 |
$7,665.00
|
| Rate for Payer: Cash Price |
$7,665.00
|
| 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 |
$5,748.75
|
| Rate for Payer: Provider Network of America Commercial |
$6,132.00
|
|
|
HC Biopsy, Each Added Lesion
|
Facility
|
OP
|
$157.50
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
Px07611110101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$89.78 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$111.04
|
| Rate for Payer: Aetna Workers' Compensation |
$111.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$109.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$109.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$124.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$124.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$124.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$121.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$124.11
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna Commercial |
$96.39
|
| Rate for Payer: Cigna Medicare Advantage |
$89.78
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$99.22
|
| Rate for Payer: Home State Health Plan Exchange |
$89.78
|
| Rate for Payer: Humana Medicare |
$118.12
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$118.12
|
| Rate for Payer: Provider Network of America Commercial |
$126.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$103.95
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$157.50
|
|
