|
HC Biopsy, Each Added Lesion
|
Facility
|
IP
|
$157.50
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
Px07611110101
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$118.12
|
| Rate for Payer: Provider Network of America Commercial |
$126.00
|
|
|
HC Biopsy/Excision Lesion
|
Facility
|
IP
|
$1,575.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
Px03615750001
|
|
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 |
$1,575.00
|
| Rate for Payer: Cash Price |
$1,575.00
|
| 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 |
$1,181.25
|
| Rate for Payer: Provider Network of America Commercial |
$1,260.00
|
|
|
HC Biopsy/Excision Lesion
|
Facility
|
OP
|
$1,575.00
|
|
|
Service Code
|
CPT 57500
|
| Hospital Charge Code |
Px03615750001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$875.12 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: Healthy Blue Medicaid |
$1,255.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$1,091.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$1,091.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$1,241.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$1,241.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$1,241.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$1,212.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Cigna Commercial |
$1,044.22
|
| Rate for Payer: Cigna Medicare Advantage |
$897.75
|
| Rate for Payer: Family Health Partners Medicaid |
$1,162.39
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$992.25
|
| Rate for Payer: Home State Health Plan Exchange |
$897.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$1,162.39
|
| Rate for Payer: Humana Medicare |
$1,181.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$1,162.39
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,181.25
|
| Rate for Payer: Provider Network of America Commercial |
$1,260.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,039.50
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,575.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$875.12
|
|
|
HC Biopsy Excision Lymph Node Open Deep
|
Facility
|
OP
|
$7,364.67
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
Px03603852501
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,720.16 |
| Max. Negotiated Rate |
$7,364.67 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5,103.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5,103.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,670.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,803.36
|
| Rate for Payer: Cash Price |
$7,364.67
|
| Rate for Payer: Cash Price |
$7,364.67
|
| Rate for Payer: Cigna Commercial |
$4,882.78
|
| Rate for Payer: Cigna Medicare Advantage |
$4,197.86
|
| Rate for Payer: Family Health Partners Medicaid |
$4,941.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,639.74
|
| Rate for Payer: Healthy Blue Medicaid |
$5,336.69
|
| Rate for Payer: Home State Health Plan Exchange |
$4,197.86
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,941.38
|
| Rate for Payer: Humana Medicare |
$5,523.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,941.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$5,523.50
|
| Rate for Payer: Provider Network of America Commercial |
$5,891.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,860.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7,364.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,720.16
|
|
|
HC Biopsy Excision Lymph Node Open Deep
|
Facility
|
IP
|
$7,364.67
|
|
|
Service Code
|
CPT 38525
|
| Hospital Charge Code |
Px03603852501
|
|
Hospital Revenue Code
|
360
|
| 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 |
$7,364.67
|
| Rate for Payer: Cash Price |
$7,364.67
|
| 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 |
$5,523.50
|
| Rate for Payer: Provider Network of America Commercial |
$5,891.74
|
|
|
HC Biopsy/Excision, Lymph Node(S)
|
Facility
|
OP
|
$7,364.67
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
Px07613850001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,720.16 |
| Max. Negotiated Rate |
$7,364.67 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$5,192.09
|
| Rate for Payer: Aetna Workers' Compensation |
$5,192.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5,103.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5,103.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,670.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,803.36
|
| Rate for Payer: Cash Price |
$7,364.67
|
| Rate for Payer: Cash Price |
$7,364.67
|
| Rate for Payer: Cigna Commercial |
$4,507.18
|
| Rate for Payer: Cigna Medicare Advantage |
$4,197.86
|
| Rate for Payer: Family Health Partners Medicaid |
$4,941.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,639.74
|
| Rate for Payer: Healthy Blue Medicaid |
$5,336.69
|
| Rate for Payer: Home State Health Plan Exchange |
$4,197.86
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,941.38
|
| Rate for Payer: Humana Medicare |
$5,523.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,941.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$5,523.50
|
| Rate for Payer: Provider Network of America Commercial |
$5,891.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,860.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7,364.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,720.16
|
|
|
HC Biopsy/Excision, Lymph Node(S)
|
Facility
|
IP
|
$7,364.67
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
Px07613850001
|
|
Hospital Revenue Code
|
761
|
| 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 |
$7,364.67
|
| Rate for Payer: Cash Price |
$7,364.67
|
| 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 |
$5,523.50
|
| Rate for Payer: Provider Network of America Commercial |
$5,891.74
|
|
|
HC Biopsy/Excision, Lymph Node(S) Superficial
|
Facility
|
IP
|
$7,364.67
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
Px03603850001
|
|
Hospital Revenue Code
|
360
|
| 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 |
$7,364.67
|
| Rate for Payer: Cash Price |
$7,364.67
|
| 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 |
$5,523.50
|
| Rate for Payer: Provider Network of America Commercial |
$5,891.74
|
|
|
HC Biopsy/Excision, Lymph Node(S) Superficial
|
Facility
|
OP
|
$7,364.67
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
Px03603850001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,720.16 |
| Max. Negotiated Rate |
$7,364.67 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5,103.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5,103.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,803.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,670.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,803.36
|
| Rate for Payer: Cash Price |
$7,364.67
|
| Rate for Payer: Cash Price |
$7,364.67
|
| Rate for Payer: Cigna Commercial |
$4,882.78
|
| Rate for Payer: Cigna Medicare Advantage |
$4,197.86
|
| Rate for Payer: Family Health Partners Medicaid |
$4,941.38
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,639.74
|
| Rate for Payer: Healthy Blue Medicaid |
$5,336.69
|
| Rate for Payer: Home State Health Plan Exchange |
$4,197.86
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,941.38
|
| Rate for Payer: Humana Medicare |
$5,523.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,941.38
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$5,523.50
|
| Rate for Payer: Provider Network of America Commercial |
$5,891.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,860.68
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$7,364.67
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,720.16
|
|
|
HC Biopsy of Breast, Needle Core
|
Facility
|
IP
|
$3,281.25
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
Px07611910001
|
|
Hospital Revenue Code
|
761
|
| 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 |
$3,281.25
|
| Rate for Payer: Cash Price |
$3,281.25
|
| 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 |
$2,460.94
|
| Rate for Payer: Provider Network of America Commercial |
$2,625.00
|
|
|
HC Biopsy of Breast, Needle Core
|
Facility
|
OP
|
$3,281.25
|
|
|
Service Code
|
CPT 19100
|
| Hospital Charge Code |
Px07611910001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,569.23 |
| Max. Negotiated Rate |
$3,281.25 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2,313.28
|
| Rate for Payer: Aetna Workers' Compensation |
$2,313.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,273.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,273.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,585.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,585.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,585.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,526.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,585.62
|
| Rate for Payer: Cash Price |
$3,281.25
|
| Rate for Payer: Cash Price |
$3,281.25
|
| Rate for Payer: Cigna Commercial |
$2,008.12
|
| Rate for Payer: Cigna Medicare Advantage |
$1,870.31
|
| Rate for Payer: Family Health Partners Medicaid |
$2,084.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,067.19
|
| Rate for Payer: Healthy Blue Medicaid |
$2,251.11
|
| Rate for Payer: Home State Health Plan Exchange |
$1,870.31
|
| Rate for Payer: Home State Health Plan Medicaid |
$2,084.36
|
| Rate for Payer: Humana Medicare |
$2,460.94
|
| Rate for Payer: Mercy CarePlus Medicaid |
$2,084.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,460.94
|
| Rate for Payer: Provider Network of America Commercial |
$2,625.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,165.62
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,281.25
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,569.23
|
|
|
HC Biopsy of Skin Lesion
|
Facility
|
IP
|
$288.75
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
Px07611110001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$216.56 |
| 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 |
$288.75
|
| Rate for Payer: Cash Price |
$288.75
|
| 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 |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
|
|
HC Biopsy of Skin Lesion
|
Facility
|
OP
|
$288.75
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
Px07611110001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.59 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$203.57
|
| Rate for Payer: Aetna Workers' Compensation |
$203.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$222.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$227.53
|
| Rate for Payer: Cash Price |
$288.75
|
| Rate for Payer: Cigna Commercial |
$176.72
|
| Rate for Payer: Cigna Medicare Advantage |
$164.59
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$181.91
|
| Rate for Payer: Home State Health Plan Exchange |
$164.59
|
| Rate for Payer: Humana Medicare |
$216.56
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.57
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$288.75
|
|
|
HC Biopsy of Throat
|
Facility
|
IP
|
$3,154.90
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
Px07614280001
|
|
Hospital Revenue Code
|
761
|
| 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 |
$3,154.90
|
| Rate for Payer: Cash Price |
$3,154.90
|
| 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 |
$2,366.18
|
| Rate for Payer: Provider Network of America Commercial |
$2,523.92
|
|
|
HC Biopsy of Throat
|
Facility
|
OP
|
$3,154.90
|
|
|
Service Code
|
CPT 42800
|
| Hospital Charge Code |
Px07614280001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,474.20 |
| Max. Negotiated Rate |
$3,154.90 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2,224.20
|
| Rate for Payer: Aetna Workers' Compensation |
$2,224.20
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,186.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,186.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,486.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,486.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,486.06
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,429.27
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,486.06
|
| Rate for Payer: Cash Price |
$3,154.90
|
| Rate for Payer: Cash Price |
$3,154.90
|
| Rate for Payer: Cigna Commercial |
$1,930.80
|
| Rate for Payer: Cigna Medicare Advantage |
$1,798.29
|
| Rate for Payer: Family Health Partners Medicaid |
$1,958.14
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,987.59
|
| Rate for Payer: Healthy Blue Medicaid |
$2,114.79
|
| Rate for Payer: Home State Health Plan Exchange |
$1,798.29
|
| Rate for Payer: Home State Health Plan Medicaid |
$1,958.14
|
| Rate for Payer: Humana Medicare |
$2,366.18
|
| Rate for Payer: Mercy CarePlus Medicaid |
$1,958.14
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,366.18
|
| Rate for Payer: Provider Network of America Commercial |
$2,523.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,082.23
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,154.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,474.20
|
|
|
HC Biopsy of Tongue, Anterior Two Thirds
|
Facility
|
IP
|
$1,575.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
Px07614110001
|
|
Hospital Revenue Code
|
761
|
| 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 |
$1,575.00
|
| Rate for Payer: Cash Price |
$1,575.00
|
| 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 |
$1,181.25
|
| Rate for Payer: Provider Network of America Commercial |
$1,260.00
|
|
|
HC Biopsy of Tongue, Anterior Two Thirds
|
Facility
|
OP
|
$1,575.00
|
|
|
Service Code
|
CPT 41100
|
| Hospital Charge Code |
Px07614110001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$512.43 |
| Max. Negotiated Rate |
$1,575.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$1,110.38
|
| Rate for Payer: Aetna Workers' Compensation |
$1,110.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$1,091.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$1,091.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$1,241.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$1,241.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$1,241.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$1,212.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$1,241.10
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Cash Price |
$1,575.00
|
| Rate for Payer: Cigna Commercial |
$963.90
|
| Rate for Payer: Cigna Medicare Advantage |
$897.75
|
| Rate for Payer: Family Health Partners Medicaid |
$680.65
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$992.25
|
| Rate for Payer: Healthy Blue Medicaid |
$735.10
|
| Rate for Payer: Home State Health Plan Exchange |
$897.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$680.65
|
| Rate for Payer: Humana Medicare |
$1,181.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$680.65
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,181.25
|
| Rate for Payer: Provider Network of America Commercial |
$1,260.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$1,039.50
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,575.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$512.43
|
|
|
HC Biopsy Palate Uvula
|
Facility
|
OP
|
$3,336.90
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
Px07614210001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,474.20 |
| Max. Negotiated Rate |
$3,336.90 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2,352.51
|
| Rate for Payer: Aetna Workers' Compensation |
$2,352.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,312.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,312.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,629.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,629.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,629.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,569.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,629.48
|
| Rate for Payer: Cash Price |
$3,336.90
|
| Rate for Payer: Cash Price |
$3,336.90
|
| Rate for Payer: Cigna Commercial |
$2,042.18
|
| Rate for Payer: Cigna Medicare Advantage |
$1,902.03
|
| Rate for Payer: Family Health Partners Medicaid |
$1,958.14
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,102.25
|
| Rate for Payer: Healthy Blue Medicaid |
$2,114.79
|
| Rate for Payer: Home State Health Plan Exchange |
$1,902.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$1,958.14
|
| Rate for Payer: Humana Medicare |
$2,502.68
|
| Rate for Payer: Mercy CarePlus Medicaid |
$1,958.14
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,502.68
|
| Rate for Payer: Provider Network of America Commercial |
$2,669.52
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,202.35
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,336.90
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,474.20
|
|
|
HC Biopsy Palate Uvula
|
Facility
|
IP
|
$3,336.90
|
|
|
Service Code
|
CPT 42100
|
| Hospital Charge Code |
Px07614210001
|
|
Hospital Revenue Code
|
761
|
| 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 |
$3,336.90
|
| Rate for Payer: Cash Price |
$3,336.90
|
| 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 |
$2,502.68
|
| Rate for Payer: Provider Network of America Commercial |
$2,669.52
|
|
|
HC Biopsy Salivary Gland,Needle
|
Facility
|
OP
|
$1,451.10
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
Px03614240001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$672.81 |
| Max. Negotiated Rate |
$1,451.10 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$1,005.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$1,005.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$1,143.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$1,143.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$1,143.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$1,117.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$1,143.47
|
| Rate for Payer: Cash Price |
$1,451.10
|
| Rate for Payer: Cash Price |
$1,451.10
|
| Rate for Payer: Cigna Commercial |
$962.08
|
| Rate for Payer: Cigna Medicare Advantage |
$827.13
|
| Rate for Payer: Family Health Partners Medicaid |
$893.68
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$914.19
|
| Rate for Payer: Healthy Blue Medicaid |
$965.17
|
| Rate for Payer: Home State Health Plan Exchange |
$827.13
|
| Rate for Payer: Home State Health Plan Medicaid |
$893.68
|
| Rate for Payer: Humana Medicare |
$1,088.33
|
| Rate for Payer: Mercy CarePlus Medicaid |
$893.68
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$1,088.33
|
| Rate for Payer: Provider Network of America Commercial |
$1,160.88
|
| Rate for Payer: UnitedHealthcare Commercial |
$957.73
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,451.10
|
| Rate for Payer: UnitedHealthcare Medicaid |
$672.81
|
|
|
HC Biopsy Salivary Gland,Needle
|
Facility
|
IP
|
$1,451.10
|
|
|
Service Code
|
CPT 42400
|
| Hospital Charge Code |
Px03614240001
|
|
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 |
$1,451.10
|
| Rate for Payer: Cash Price |
$1,451.10
|
| 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 |
$1,088.33
|
| Rate for Payer: Provider Network of America Commercial |
$1,160.88
|
|
|
HC Biopsy Skin, Subq Tissue, Addtl Lesion
|
Facility
|
OP
|
$157.50
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
Px03601110101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$89.78 |
| Max. Negotiated Rate |
$157.50 |
| 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 |
$104.42
|
| 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
|
|
|
HC Biopsy Skin, Subq Tissue, Addtl Lesion
|
Facility
|
IP
|
$157.50
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
Px03601110101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$118.12 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cash Price |
$157.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$118.12
|
| Rate for Payer: Provider Network of America Commercial |
$126.00
|
|
|
HC Biopsy Skin, Subq Tissue, Musous Membran
|
Facility
|
IP
|
$288.75
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
Px03601110001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$216.56 |
| 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 |
$288.75
|
| Rate for Payer: Cash Price |
$288.75
|
| 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 |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
|
|
HC Biopsy Skin, Subq Tissue, Musous Membran
|
Facility
|
OP
|
$288.75
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
Px03601110001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$164.59 |
| Max. Negotiated Rate |
$288.75 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$200.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$227.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$222.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$227.53
|
| Rate for Payer: Cash Price |
$288.75
|
| Rate for Payer: Cigna Commercial |
$191.44
|
| Rate for Payer: Cigna Medicare Advantage |
$164.59
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$181.91
|
| Rate for Payer: Home State Health Plan Exchange |
$164.59
|
| Rate for Payer: Humana Medicare |
$216.56
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$216.56
|
| Rate for Payer: Provider Network of America Commercial |
$231.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$190.57
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$288.75
|
|
