|
HC Blood Methemoglobin, Quant - Methemoglobin
|
Facility
|
IP
|
$81.90
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
Px03018305001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.42 |
| 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 |
$81.90
|
| Rate for Payer: Cash Price |
$81.90
|
| 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 |
$61.42
|
| Rate for Payer: Provider Network of America Commercial |
$65.52
|
|
|
HC Blood Occult,by Peroxid,Feces - Occult Bld
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
Px03018227201
|
|
Hospital Revenue Code
|
301
|
| 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 Blood Occult,by Peroxid,Feces - Occult Bld
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 82272
|
| Hospital Charge Code |
Px03018227201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.02 |
| 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 |
$5.33
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$44.98
|
| Rate for Payer: Healthy Blue Medicaid |
$5.76
|
| Rate for Payer: Home State Health Plan Exchange |
$40.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.33
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.33
|
| 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 |
$4.23
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.02
|
|
|
HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Fecal Imm
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
Px03018227002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$33.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$29.61
|
| Rate for Payer: Aetna Workers' Compensation |
$29.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$29.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$29.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$32.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$33.10
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Commercial |
$22.01
|
| Rate for Payer: Cigna Medicare Advantage |
$23.94
|
| Rate for Payer: Family Health Partners Medicaid |
$5.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$26.46
|
| Rate for Payer: Healthy Blue Medicaid |
$5.96
|
| Rate for Payer: Home State Health Plan Exchange |
$23.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.52
|
| Rate for Payer: Humana Medicare |
$31.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$31.50
|
| Rate for Payer: Provider Network of America Commercial |
$33.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.72
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.15
|
|
|
HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Fecal Imm
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
Px03018227002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.50 |
| 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 |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| 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 |
$31.50
|
| Rate for Payer: Provider Network of America Commercial |
$33.60
|
|
|
HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Occult Bld
|
Facility
|
IP
|
$42.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
Px03018227001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.50 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| 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 |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Medicare Advantage |
$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: Oscar Health EPO/HMO/POS/PPO |
$31.50
|
| Rate for Payer: Provider Network of America Commercial |
$33.60
|
|
|
HC Blood Occult,by Peroxid,Feces,Single, Colorectal Screen - Occult Bld
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 82270
|
| Hospital Charge Code |
Px03018227001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$33.60 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$29.61
|
| Rate for Payer: Aetna Workers' Compensation |
$29.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$29.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$29.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$33.10
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$32.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$33.10
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cash Price |
$42.00
|
| Rate for Payer: Cigna Commercial |
$22.01
|
| Rate for Payer: Cigna Medicare Advantage |
$23.94
|
| Rate for Payer: Family Health Partners Medicaid |
$5.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$26.46
|
| Rate for Payer: Healthy Blue Medicaid |
$5.96
|
| Rate for Payer: Home State Health Plan Exchange |
$23.94
|
| Rate for Payer: Home State Health Plan Medicaid |
$5.52
|
| Rate for Payer: Humana Medicare |
$31.50
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5.52
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$31.50
|
| Rate for Payer: Provider Network of America Commercial |
$33.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$27.72
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$4.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$4.15
|
|
|
HC Blood Occult,by Peroxid,Nonfecal - Colorectal Screen
|
Facility
|
OP
|
$69.30
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
Px03018227101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.05 |
| Max. Negotiated Rate |
$55.44 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$48.86
|
| Rate for Payer: Aetna Workers' Compensation |
$48.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$48.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$48.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$54.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$54.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$54.61
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$53.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$54.61
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cigna Commercial |
$36.31
|
| Rate for Payer: Cigna Medicare Advantage |
$39.50
|
| Rate for Payer: Family Health Partners Medicaid |
$6.71
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$43.66
|
| Rate for Payer: Healthy Blue Medicaid |
$7.24
|
| Rate for Payer: Home State Health Plan Exchange |
$39.50
|
| Rate for Payer: Home State Health Plan Medicaid |
$6.71
|
| Rate for Payer: Humana Medicare |
$51.98
|
| Rate for Payer: Mercy CarePlus Medicaid |
$6.71
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$51.98
|
| Rate for Payer: Provider Network of America Commercial |
$55.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$45.74
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.32
|
| Rate for Payer: UnitedHealthcare Medicaid |
$5.05
|
|
|
HC Blood Occult,by Peroxid,Nonfecal - Colorectal Screen
|
Facility
|
IP
|
$69.30
|
|
|
Service Code
|
CPT 82271
|
| Hospital Charge Code |
Px03018227101
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.98 |
| 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 |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| 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 |
$51.98
|
| Rate for Payer: Provider Network of America Commercial |
$55.44
|
|
|
HC Blood Ph - Ph Arterial
|
Facility
|
IP
|
$121.80
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
Px03018280002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.35 |
| 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 |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| 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 |
$91.35
|
| Rate for Payer: Provider Network of America Commercial |
$97.44
|
|
|
HC Blood Ph - Ph Arterial
|
Facility
|
OP
|
$121.80
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
Px03018280002
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$97.44 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$85.87
|
| Rate for Payer: Aetna Workers' Compensation |
$85.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$84.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$84.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$95.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$95.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$95.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$93.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$95.98
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$63.82
|
| Rate for Payer: Cigna Medicare Advantage |
$69.43
|
| Rate for Payer: Family Health Partners Medicaid |
$13.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$76.73
|
| Rate for Payer: Healthy Blue Medicaid |
$14.97
|
| Rate for Payer: Home State Health Plan Exchange |
$69.43
|
| Rate for Payer: Home State Health Plan Medicaid |
$13.86
|
| Rate for Payer: Humana Medicare |
$91.35
|
| Rate for Payer: Mercy CarePlus Medicaid |
$13.86
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$91.35
|
| Rate for Payer: Provider Network of America Commercial |
$97.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.39
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.43
|
|
|
HC Blood Ph - Ph Venous
|
Facility
|
OP
|
$121.80
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
Px03018280001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.43 |
| Max. Negotiated Rate |
$97.44 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$85.87
|
| Rate for Payer: Aetna Workers' Compensation |
$85.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$84.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$84.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$95.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$95.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$95.98
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$93.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$95.98
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| Rate for Payer: Cigna Commercial |
$63.82
|
| Rate for Payer: Cigna Medicare Advantage |
$69.43
|
| Rate for Payer: Family Health Partners Medicaid |
$13.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$76.73
|
| Rate for Payer: Healthy Blue Medicaid |
$14.97
|
| Rate for Payer: Home State Health Plan Exchange |
$69.43
|
| Rate for Payer: Home State Health Plan Medicaid |
$13.86
|
| Rate for Payer: Humana Medicare |
$91.35
|
| Rate for Payer: Mercy CarePlus Medicaid |
$13.86
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$91.35
|
| Rate for Payer: Provider Network of America Commercial |
$97.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$80.39
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.43
|
|
|
HC Blood Ph - Ph Venous
|
Facility
|
IP
|
$121.80
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
Px03018280001
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$91.35 |
| 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 |
$121.80
|
| Rate for Payer: Cash Price |
$121.80
|
| 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 |
$91.35
|
| Rate for Payer: Provider Network of America Commercial |
$97.44
|
|
|
HC Blood Smear,Micro Exam,Manual Diff Wbc - Manual Differential
|
Facility
|
OP
|
$76.65
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
Px03058500701
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$61.32 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$54.04
|
| Rate for Payer: Aetna Workers' Compensation |
$54.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$53.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$53.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$60.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$60.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$60.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$59.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$60.40
|
| Rate for Payer: Cash Price |
$76.65
|
| Rate for Payer: Cash Price |
$76.65
|
| Rate for Payer: Cigna Commercial |
$40.16
|
| Rate for Payer: Cigna Medicare Advantage |
$43.69
|
| Rate for Payer: Family Health Partners Medicaid |
$4.79
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$48.29
|
| Rate for Payer: Healthy Blue Medicaid |
$5.17
|
| Rate for Payer: Home State Health Plan Exchange |
$43.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$4.79
|
| Rate for Payer: Humana Medicare |
$57.49
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4.79
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$57.49
|
| Rate for Payer: Provider Network of America Commercial |
$61.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$50.59
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.80
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3.60
|
|
|
HC Blood Smear,Micro Exam,Manual Diff Wbc - Manual Differential
|
Facility
|
IP
|
$76.65
|
|
|
Service Code
|
CPT 85007
|
| Hospital Charge Code |
Px03058500701
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$57.49 |
| 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 |
$76.65
|
| Rate for Payer: Cash Price |
$76.65
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$57.49
|
| Rate for Payer: Provider Network of America Commercial |
$61.32
|
|
|
HC Blood Transfusion Service
|
Facility
|
IP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px07613643001
|
|
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 |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| 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 |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
|
|
HC Blood Transfusion Service
|
Facility
|
IP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643001
|
|
Hospital Revenue Code
|
391
|
| 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 |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| 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 |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
|
|
HC Blood Transfusion Service
|
Facility
|
OP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643001
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,205.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$849.81
|
| Rate for Payer: Aetna Workers' Compensation |
$849.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$928.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$949.86
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cigna Commercial |
$737.70
|
| Rate for Payer: Cigna Medicare Advantage |
$687.08
|
| Rate for Payer: Family Health Partners Medicaid |
$556.78
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$759.40
|
| Rate for Payer: Healthy Blue Medicaid |
$601.32
|
| Rate for Payer: Home State Health Plan Exchange |
$687.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$556.78
|
| Rate for Payer: Humana Medicare |
$904.05
|
| Rate for Payer: Mercy CarePlus Medicaid |
$556.78
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$795.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,205.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.18
|
|
|
HC Blood Transfusion Service
|
Facility
|
OP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px07613643001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,205.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$849.81
|
| Rate for Payer: Aetna Workers' Compensation |
$849.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$928.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$949.86
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cigna Commercial |
$737.70
|
| Rate for Payer: Cigna Medicare Advantage |
$687.08
|
| Rate for Payer: Family Health Partners Medicaid |
$556.78
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$759.40
|
| Rate for Payer: Healthy Blue Medicaid |
$601.32
|
| Rate for Payer: Home State Health Plan Exchange |
$687.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$556.78
|
| Rate for Payer: Humana Medicare |
$904.05
|
| Rate for Payer: Mercy CarePlus Medicaid |
$556.78
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$795.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,205.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.18
|
|
|
HC Blood Transfusion Service 0-4 Hrs
|
Facility
|
OP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643003
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,205.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$849.81
|
| Rate for Payer: Aetna Workers' Compensation |
$849.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$928.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$949.86
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cigna Commercial |
$737.70
|
| Rate for Payer: Cigna Medicare Advantage |
$687.08
|
| Rate for Payer: Family Health Partners Medicaid |
$556.78
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$759.40
|
| Rate for Payer: Healthy Blue Medicaid |
$601.32
|
| Rate for Payer: Home State Health Plan Exchange |
$687.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$556.78
|
| Rate for Payer: Humana Medicare |
$904.05
|
| Rate for Payer: Mercy CarePlus Medicaid |
$556.78
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$795.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,205.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.18
|
|
|
HC Blood Transfusion Service 0-4 Hrs
|
Facility
|
IP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643003
|
|
Hospital Revenue Code
|
391
|
| 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 |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| 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 |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
|
|
HC Blood Transfusion Service 0-6 Hrs
|
Facility
|
OP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643004
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,205.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$849.81
|
| Rate for Payer: Aetna Workers' Compensation |
$849.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$928.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$949.86
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cigna Commercial |
$737.70
|
| Rate for Payer: Cigna Medicare Advantage |
$687.08
|
| Rate for Payer: Family Health Partners Medicaid |
$556.78
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$759.40
|
| Rate for Payer: Healthy Blue Medicaid |
$601.32
|
| Rate for Payer: Home State Health Plan Exchange |
$687.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$556.78
|
| Rate for Payer: Humana Medicare |
$904.05
|
| Rate for Payer: Mercy CarePlus Medicaid |
$556.78
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$795.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,205.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.18
|
|
|
HC Blood Transfusion Service 0-6 Hrs
|
Facility
|
IP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643004
|
|
Hospital Revenue Code
|
391
|
| 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 |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| 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 |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
|
|
HC Blood Transfusion Service > 8 Hrs
|
Facility
|
IP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643006
|
|
Hospital Revenue Code
|
391
|
| 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 |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| 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 |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
|
|
HC Blood Transfusion Service > 8 Hrs
|
Facility
|
OP
|
$1,205.40
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
Px03913643006
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$419.18 |
| Max. Negotiated Rate |
$1,205.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$849.81
|
| Rate for Payer: Aetna Workers' Compensation |
$849.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$835.34
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$949.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$928.16
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$949.86
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cash Price |
$1,205.40
|
| Rate for Payer: Cigna Commercial |
$737.70
|
| Rate for Payer: Cigna Medicare Advantage |
$687.08
|
| Rate for Payer: Family Health Partners Medicaid |
$556.78
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$759.40
|
| Rate for Payer: Healthy Blue Medicaid |
$601.32
|
| Rate for Payer: Home State Health Plan Exchange |
$687.08
|
| Rate for Payer: Home State Health Plan Medicaid |
$556.78
|
| Rate for Payer: Humana Medicare |
$904.05
|
| Rate for Payer: Mercy CarePlus Medicaid |
$556.78
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$904.05
|
| Rate for Payer: Provider Network of America Commercial |
$964.32
|
| Rate for Payer: UnitedHealthcare Commercial |
$795.56
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,205.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$419.18
|
|
