|
HC Bx Anorectal Wall Anal Approach
|
Facility
|
OP
|
$6,300.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
Px07504510001
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$2,637.22 |
| Max. Negotiated Rate |
$6,300.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,365.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,365.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$4,964.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$4,964.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$4,964.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$4,851.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$4,964.40
|
| Rate for Payer: Cash Price |
$6,300.00
|
| Rate for Payer: Cash Price |
$6,300.00
|
| Rate for Payer: Cigna Commercial |
$4,176.90
|
| Rate for Payer: Cigna Medicare Advantage |
$3,591.00
|
| Rate for Payer: Family Health Partners Medicaid |
$3,502.95
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$3,969.00
|
| Rate for Payer: Healthy Blue Medicaid |
$3,783.19
|
| Rate for Payer: Home State Health Plan Exchange |
$3,591.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$3,502.95
|
| Rate for Payer: Humana Medicare |
$4,725.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$3,502.95
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,725.00
|
| Rate for Payer: Provider Network of America Commercial |
$5,040.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,158.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,300.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$2,637.22
|
|
|
HC Bx Anorectal Wall Anal Approach
|
Facility
|
IP
|
$6,300.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
Px07504510001
|
|
Hospital Revenue Code
|
750
|
| 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 |
$6,300.00
|
| Rate for Payer: Cash Price |
$6,300.00
|
| 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 |
$4,725.00
|
| Rate for Payer: Provider Network of America Commercial |
$5,040.00
|
|
|
HC Bx Breast W Device 1st Lesion Ultrasound Guide
|
Facility
|
IP
|
$3,431.40
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
Px04021908301
|
|
Hospital Revenue Code
|
402
|
| 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 |
$3,431.40
|
| Rate for Payer: Cash Price |
$3,431.40
|
| 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 |
$2,573.55
|
| Rate for Payer: Provider Network of America Commercial |
$2,745.12
|
|
|
HC Bx Breast W Device 1st Lesion Ultrasound Guide
|
Facility
|
OP
|
$3,431.40
|
|
|
Service Code
|
CPT 19083
|
| Hospital Charge Code |
Px04021908301
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$1,569.23 |
| Max. Negotiated Rate |
$3,431.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2,419.14
|
| Rate for Payer: Aetna Workers' Compensation |
$2,419.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,377.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,377.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,703.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,703.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,703.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,642.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,703.94
|
| Rate for Payer: Cash Price |
$3,431.40
|
| Rate for Payer: Cash Price |
$3,431.40
|
| Rate for Payer: Cigna Commercial |
$2,100.02
|
| Rate for Payer: Cigna Medicare Advantage |
$1,955.90
|
| Rate for Payer: Family Health Partners Medicaid |
$2,084.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,161.78
|
| Rate for Payer: Healthy Blue Medicaid |
$2,251.11
|
| Rate for Payer: Home State Health Plan Exchange |
$1,955.90
|
| Rate for Payer: Home State Health Plan Medicaid |
$2,084.36
|
| Rate for Payer: Humana Medicare |
$2,573.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$2,084.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,573.55
|
| Rate for Payer: Provider Network of America Commercial |
$2,745.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,264.72
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,431.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,569.23
|
|
|
HC Bx Breast W Device Addl Lesion Ultrasound Guide
|
Facility
|
OP
|
$1,066.80
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
Px04021908401
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$608.08 |
| Max. Negotiated Rate |
$1,066.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$752.09
|
| Rate for Payer: Aetna Workers' Compensation |
$752.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$739.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$739.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$840.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$840.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$840.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$821.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$840.64
|
| Rate for Payer: Cash Price |
$1,066.80
|
| Rate for Payer: Cigna Commercial |
$652.88
|
| Rate for Payer: Cigna Medicare Advantage |
$608.08
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$672.08
|
| Rate for Payer: Home State Health Plan Exchange |
$608.08
|
| Rate for Payer: Humana Medicare |
$800.10
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$800.10
|
| Rate for Payer: Provider Network of America Commercial |
$853.44
|
| Rate for Payer: UnitedHealthcare Commercial |
$704.09
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,066.80
|
|
|
HC Bx Breast W Device Addl Lesion Ultrasound Guide
|
Facility
|
IP
|
$1,066.80
|
|
|
Service Code
|
CPT 19084
|
| Hospital Charge Code |
Px04021908401
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$800.10 |
| 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 |
$1,066.80
|
| Rate for Payer: Cash Price |
$1,066.80
|
| 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 |
$800.10
|
| Rate for Payer: Provider Network of America Commercial |
$853.44
|
|
|
HC Bx Excision Lymph Node Open Deep Cervica
|
Facility
|
IP
|
$7,364.67
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
Px03603851001
|
|
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 Bx Excision Lymph Node Open Deep Cervica
|
Facility
|
OP
|
$7,364.67
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
Px03603851001
|
|
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 Cadmium / Heavy Metal Panel Arup
|
Facility
|
IP
|
$135.45
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
Px03018230004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$101.59 |
| 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 |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| 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 |
$101.59
|
| Rate for Payer: Provider Network of America Commercial |
$108.36
|
|
|
HC Cadmium / Heavy Metal Panel Arup
|
Facility
|
OP
|
$135.45
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
Px03018230004
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.43 |
| Max. Negotiated Rate |
$108.36 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$95.49
|
| Rate for Payer: Aetna Workers' Compensation |
$95.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$93.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$93.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$106.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$106.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$106.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$104.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$106.73
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cash Price |
$135.45
|
| Rate for Payer: Cigna Commercial |
$70.98
|
| Rate for Payer: Cigna Medicare Advantage |
$77.21
|
| Rate for Payer: Family Health Partners Medicaid |
$29.79
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$85.33
|
| Rate for Payer: Healthy Blue Medicaid |
$32.18
|
| Rate for Payer: Home State Health Plan Exchange |
$77.21
|
| Rate for Payer: Home State Health Plan Medicaid |
$29.79
|
| Rate for Payer: Humana Medicare |
$101.59
|
| Rate for Payer: Mercy CarePlus Medicaid |
$29.79
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$101.59
|
| Rate for Payer: Provider Network of America Commercial |
$108.36
|
| Rate for Payer: UnitedHealthcare Commercial |
$89.40
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$23.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$22.43
|
|
|
HC Calazime
|
Facility
|
OP
|
$9.40
|
|
| Hospital Charge Code |
Px02700002644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$9.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$6.63
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$6.96
|
| Rate for Payer: Aetna Workers' Compensation |
$6.63
|
| Rate for Payer: Aetna Workers' Compensation |
$6.96
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$6.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$6.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$6.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$7.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$7.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$7.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$7.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$7.41
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$7.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$7.24
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$7.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$7.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$7.41
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cigna Commercial |
$5.75
|
| Rate for Payer: Cigna Commercial |
$6.04
|
| Rate for Payer: Cigna Medicare Advantage |
$5.36
|
| Rate for Payer: Cigna Medicare Advantage |
$5.63
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$5.92
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$6.22
|
| Rate for Payer: Home State Health Plan Exchange |
$5.36
|
| Rate for Payer: Home State Health Plan Exchange |
$5.63
|
| Rate for Payer: Humana Medicare |
$7.05
|
| Rate for Payer: Humana Medicare |
$7.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.05
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.40
|
| Rate for Payer: Provider Network of America Commercial |
$7.52
|
| Rate for Payer: Provider Network of America Commercial |
$7.90
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.51
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.40
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.87
|
|
|
HC Calazime
|
Facility
|
IP
|
$9.40
|
|
| Hospital Charge Code |
Px02700002644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.05 |
| 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 |
$9.87
|
| Rate for Payer: Cash Price |
$9.87
|
| Rate for Payer: Cash Price |
$9.40
|
| Rate for Payer: Cash Price |
$9.40
|
| 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 |
$7.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.05
|
| Rate for Payer: Provider Network of America Commercial |
$7.52
|
| Rate for Payer: Provider Network of America Commercial |
$7.90
|
|
|
HC Calcitriol (1,25 Di-Oh Vit D)
|
Facility
|
OP
|
$155.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
Px03018265202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.52 |
| Max. Negotiated Rate |
$124.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$109.28
|
| Rate for Payer: Aetna Workers' Compensation |
$109.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$107.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$107.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$122.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$122.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$122.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$119.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$122.14
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cash Price |
$155.00
|
| Rate for Payer: Cigna Commercial |
$81.22
|
| Rate for Payer: Cigna Medicare Advantage |
$88.35
|
| Rate for Payer: Family Health Partners Medicaid |
$48.51
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$97.65
|
| Rate for Payer: Healthy Blue Medicaid |
$52.39
|
| Rate for Payer: Home State Health Plan Exchange |
$88.35
|
| Rate for Payer: Home State Health Plan Medicaid |
$48.51
|
| Rate for Payer: Humana Medicare |
$116.25
|
| Rate for Payer: Mercy CarePlus Medicaid |
$48.51
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$116.25
|
| Rate for Payer: Provider Network of America Commercial |
$124.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$102.30
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$38.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.52
|
|
|
HC Calcitriol (1,25 Di-Oh Vit D)
|
Facility
|
IP
|
$155.00
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
Px03018265202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$116.25 |
| 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 |
$155.00
|
| Rate for Payer: Cash Price |
$155.00
|
| 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 |
$116.25
|
| Rate for Payer: Provider Network of America Commercial |
$124.00
|
|
|
HC Calr, Gene Analysis
|
Facility
|
OP
|
$655.20
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
Px03108121901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$115.38 |
| Max. Negotiated Rate |
$524.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$461.92
|
| Rate for Payer: Aetna Workers' Compensation |
$461.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$454.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$454.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$516.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$516.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$516.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$504.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$516.30
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cash Price |
$655.20
|
| Rate for Payer: Cigna Commercial |
$343.32
|
| Rate for Payer: Cigna Medicare Advantage |
$373.46
|
| Rate for Payer: Family Health Partners Medicaid |
$153.26
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$412.78
|
| Rate for Payer: Healthy Blue Medicaid |
$165.52
|
| Rate for Payer: Home State Health Plan Exchange |
$373.46
|
| Rate for Payer: Home State Health Plan Medicaid |
$153.26
|
| Rate for Payer: Humana Medicare |
$491.40
|
| Rate for Payer: Mercy CarePlus Medicaid |
$153.26
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$491.40
|
| Rate for Payer: Provider Network of America Commercial |
$524.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$432.43
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$121.63
|
| Rate for Payer: UnitedHealthcare Medicaid |
$115.38
|
|
|
HC Calr, Gene Analysis
|
Facility
|
IP
|
$655.20
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
Px03108121901
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$491.40 |
| 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 |
$655.20
|
| Rate for Payer: Cash Price |
$655.20
|
| 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 |
$491.40
|
| Rate for Payer: Provider Network of America Commercial |
$524.16
|
|
|
HC Canalith Repositioning Procedure, per Day
|
Facility
|
IP
|
$94.50
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
Px07619599201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.88 |
| 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 |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| 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 |
$70.88
|
| Rate for Payer: Provider Network of America Commercial |
$75.60
|
|
|
HC Canalith Repositioning Procedure, per Day
|
Facility
|
OP
|
$94.50
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
Px07619599201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.87 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$66.62
|
| Rate for Payer: Aetna Workers' Compensation |
$66.62
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$65.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$65.49
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$74.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$74.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$74.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$72.77
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$74.47
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cigna Commercial |
$57.83
|
| Rate for Payer: Cigna Medicare Advantage |
$53.87
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$59.53
|
| Rate for Payer: Home State Health Plan Exchange |
$53.87
|
| Rate for Payer: Humana Medicare |
$70.88
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$70.88
|
| Rate for Payer: Provider Network of America Commercial |
$75.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$62.37
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$94.50
|
|
|
HC Canister 12l Suction
|
Facility
|
OP
|
$10.17
|
|
| Hospital Charge Code |
Px02710000086
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.80 |
| Max. Negotiated Rate |
$10.17 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$7.17
|
| Rate for Payer: Aetna Workers' Compensation |
$7.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$7.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$7.05
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$8.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$7.83
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$8.01
|
| Rate for Payer: Cash Price |
$10.17
|
| Rate for Payer: Cigna Commercial |
$6.22
|
| Rate for Payer: Cigna Medicare Advantage |
$5.80
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$6.41
|
| Rate for Payer: Home State Health Plan Exchange |
$5.80
|
| Rate for Payer: Humana Medicare |
$7.63
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.63
|
| Rate for Payer: Provider Network of America Commercial |
$8.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.71
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$10.17
|
|
|
HC Canister 12l Suction
|
Facility
|
IP
|
$10.17
|
|
| Hospital Charge Code |
Px02710000086
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$7.63 |
| 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 |
$10.17
|
| Rate for Payer: Cash Price |
$10.17
|
| 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 |
$7.63
|
| Rate for Payer: Provider Network of America Commercial |
$8.14
|
|
|
HC Cannula 02 Pediatric
|
Facility
|
OP
|
$3.41
|
|
| Hospital Charge Code |
Px02720000576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$3.41 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2.40
|
| Rate for Payer: Aetna Workers' Compensation |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2.69
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cigna Commercial |
$2.09
|
| Rate for Payer: Cigna Medicare Advantage |
$1.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2.15
|
| Rate for Payer: Home State Health Plan Exchange |
$1.94
|
| Rate for Payer: Humana Medicare |
$2.56
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.25
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.41
|
|
|
HC Cannula 02 Pediatric
|
Facility
|
IP
|
$3.41
|
|
| Hospital Charge Code |
Px02720000576
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
|
|
HC Cannula Comfort Flo Plus Medium
|
Facility
|
IP
|
$71.66
|
|
| Hospital Charge Code |
Px02720000550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.74 |
| 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 |
$71.66
|
| Rate for Payer: Cash Price |
$71.66
|
| 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 |
$53.74
|
| Rate for Payer: Provider Network of America Commercial |
$57.33
|
|
|
HC Cannula Comfort Flo Plus Medium
|
Facility
|
OP
|
$71.66
|
|
| Hospital Charge Code |
Px02720000550
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.85 |
| Max. Negotiated Rate |
$71.66 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$50.52
|
| Rate for Payer: Aetna Workers' Compensation |
$50.52
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$49.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$49.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$56.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$56.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$56.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$55.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$56.47
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cigna Commercial |
$43.86
|
| Rate for Payer: Cigna Medicare Advantage |
$40.85
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$45.15
|
| Rate for Payer: Home State Health Plan Exchange |
$40.85
|
| Rate for Payer: Humana Medicare |
$53.74
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$53.74
|
| Rate for Payer: Provider Network of America Commercial |
$57.33
|
| Rate for Payer: UnitedHealthcare Commercial |
$47.30
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$71.66
|
|
|
HC Cannula Comfort Flo Plus Small
|
Facility
|
IP
|
$71.66
|
|
| Hospital Charge Code |
Px02720000583
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$53.74 |
| 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 |
$71.66
|
| Rate for Payer: Cash Price |
$71.66
|
| 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 |
$53.74
|
| Rate for Payer: Provider Network of America Commercial |
$57.33
|
|
