|
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
|
|
|
HC Cannula Etcos Adult 7'
|
Facility
|
IP
|
$5.80
|
|
| Hospital Charge Code |
Px02700001033
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.35 |
| 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 |
$5.80
|
| Rate for Payer: Cash Price |
$5.80
|
| 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 |
$4.35
|
| Rate for Payer: Provider Network of America Commercial |
$4.64
|
|
|
HC Cannula Etcos Adult 7'
|
Facility
|
OP
|
$5.80
|
|
| Hospital Charge Code |
Px02700001033
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$5.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$4.09
|
| Rate for Payer: Aetna Workers' Compensation |
$4.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$4.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$4.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$4.57
|
| Rate for Payer: Cash Price |
$5.80
|
| Rate for Payer: Cigna Commercial |
$3.55
|
| Rate for Payer: Cigna Medicare Advantage |
$3.31
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$3.65
|
| Rate for Payer: Home State Health Plan Exchange |
$3.31
|
| Rate for Payer: Humana Medicare |
$4.35
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4.35
|
| Rate for Payer: Provider Network of America Commercial |
$4.64
|
| Rate for Payer: UnitedHealthcare Commercial |
$3.83
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$5.80
|
|
|
HC Cannula Microfilter Co2 Adult 7
|
Facility
|
OP
|
$25.32
|
|
| Hospital Charge Code |
Px02720000559
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.43 |
| Max. Negotiated Rate |
$25.32 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$17.85
|
| Rate for Payer: Aetna Workers' Compensation |
$17.85
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$17.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$17.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$19.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$19.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$19.95
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$19.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$19.95
|
| Rate for Payer: Cash Price |
$25.32
|
| Rate for Payer: Cigna Commercial |
$15.50
|
| Rate for Payer: Cigna Medicare Advantage |
$14.43
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$15.95
|
| Rate for Payer: Home State Health Plan Exchange |
$14.43
|
| Rate for Payer: Humana Medicare |
$18.99
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$18.99
|
| Rate for Payer: Provider Network of America Commercial |
$20.26
|
| Rate for Payer: UnitedHealthcare Commercial |
$16.71
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.32
|
|
|
HC Cannula Microfilter Co2 Adult 7
|
Facility
|
IP
|
$25.32
|
|
| Hospital Charge Code |
Px02720000559
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.99 |
| 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 |
$25.32
|
| Rate for Payer: Cash Price |
$25.32
|
| 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 |
$18.99
|
| Rate for Payer: Provider Network of America Commercial |
$20.26
|
|
|
HC Cannula O2 Infant
|
Facility
|
IP
|
$8.53
|
|
| Hospital Charge Code |
Px02720000562
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.40 |
| 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 |
$8.53
|
| Rate for Payer: Cash Price |
$8.53
|
| 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 |
$6.40
|
| Rate for Payer: Provider Network of America Commercial |
$6.82
|
|
|
HC Cannula O2 Infant
|
Facility
|
OP
|
$8.53
|
|
| Hospital Charge Code |
Px02720000562
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$8.53 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$6.01
|
| Rate for Payer: Aetna Workers' Compensation |
$6.01
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$5.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$5.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$6.72
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$6.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$6.72
|
| Rate for Payer: Cash Price |
$8.53
|
| Rate for Payer: Cigna Commercial |
$5.22
|
| Rate for Payer: Cigna Medicare Advantage |
$4.86
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$5.37
|
| Rate for Payer: Home State Health Plan Exchange |
$4.86
|
| Rate for Payer: Humana Medicare |
$6.40
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$6.40
|
| Rate for Payer: Provider Network of America Commercial |
$6.82
|
| Rate for Payer: UnitedHealthcare Commercial |
$5.63
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$8.53
|
|
|
HC Cannula Oxygen 14ft
|
Facility
|
OP
|
$3.41
|
|
| Hospital Charge Code |
Px02720000660
|
|
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 Oxygen 14ft
|
Facility
|
IP
|
$3.41
|
|
| Hospital Charge Code |
Px02720000660
|
|
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 Can Suction 2000cc
|
Facility
|
IP
|
$9.68
|
|
| Hospital Charge Code |
Px02720000523
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.26 |
| 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 |
$9.68
|
| Rate for Payer: Cash Price |
$10.16
|
| Rate for Payer: Cash Price |
$10.16
|
| Rate for Payer: Cash Price |
$9.68
|
| 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 |
$7.62
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.26
|
| Rate for Payer: Provider Network of America Commercial |
$8.13
|
| Rate for Payer: Provider Network of America Commercial |
$7.74
|
|
|
HC Can Suction 2000cc
|
Facility
|
OP
|
$10.16
|
|
| Hospital Charge Code |
Px02720000523
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$10.16 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$7.16
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$6.82
|
| Rate for Payer: Aetna Workers' Compensation |
$7.16
|
| Rate for Payer: Aetna Workers' Compensation |
$6.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$7.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$6.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$7.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$6.71
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$7.63
|
| 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 |
$7.63
|
| 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 |
$7.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$7.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$7.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$7.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$8.01
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cash Price |
$10.16
|
| Rate for Payer: Cigna Commercial |
$6.22
|
| Rate for Payer: Cigna Commercial |
$5.92
|
| Rate for Payer: Cigna Medicare Advantage |
$5.79
|
| Rate for Payer: Cigna Medicare Advantage |
$5.52
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$6.40
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$6.10
|
| Rate for Payer: Home State Health Plan Exchange |
$5.79
|
| Rate for Payer: Home State Health Plan Exchange |
$5.52
|
| Rate for Payer: Humana Medicare |
$7.62
|
| Rate for Payer: Humana Medicare |
$7.26
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.62
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$7.26
|
| Rate for Payer: Provider Network of America Commercial |
$8.13
|
| Rate for Payer: Provider Network of America Commercial |
$7.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$6.39
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$10.16
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$9.68
|
|
|
HC Can Suction Kit 850cc
|
Facility
|
IP
|
$16.42
|
|
| Hospital Charge Code |
Px02720000658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.31 |
| 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 |
$16.42
|
| Rate for Payer: Cash Price |
$16.42
|
| 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 |
$12.31
|
| Rate for Payer: Provider Network of America Commercial |
$13.14
|
|
|
HC Can Suction Kit 850cc
|
Facility
|
OP
|
$16.42
|
|
| Hospital Charge Code |
Px02720000658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$11.58
|
| Rate for Payer: Aetna Workers' Compensation |
$11.58
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$11.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$11.38
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$12.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$12.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$12.94
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$12.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$12.94
|
| Rate for Payer: Cash Price |
$16.42
|
| Rate for Payer: Cigna Commercial |
$10.05
|
| Rate for Payer: Cigna Medicare Advantage |
$9.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$10.34
|
| Rate for Payer: Home State Health Plan Exchange |
$9.36
|
| Rate for Payer: Humana Medicare |
$12.31
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$12.31
|
| Rate for Payer: Provider Network of America Commercial |
$13.14
|
| Rate for Payer: UnitedHealthcare Commercial |
$10.84
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$16.42
|
|
|
HC Capnocheck Attachment Kit
|
Facility
|
OP
|
$22.18
|
|
| Hospital Charge Code |
Px02700000961
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$22.18 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$15.64
|
| Rate for Payer: Aetna Workers' Compensation |
$15.64
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$15.37
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$17.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$17.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$17.48
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$17.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$17.48
|
| Rate for Payer: Cash Price |
$22.18
|
| Rate for Payer: Cigna Commercial |
$13.57
|
| Rate for Payer: Cigna Medicare Advantage |
$12.64
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$13.97
|
| Rate for Payer: Home State Health Plan Exchange |
$12.64
|
| Rate for Payer: Humana Medicare |
$16.64
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$16.64
|
| Rate for Payer: Provider Network of America Commercial |
$17.74
|
| Rate for Payer: UnitedHealthcare Commercial |
$14.64
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$22.18
|
|
|
HC Capnocheck Attachment Kit
|
Facility
|
IP
|
$22.18
|
|
| Hospital Charge Code |
Px02700000961
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$16.64 |
| 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 |
$22.18
|
| Rate for Payer: Cash Price |
$22.18
|
| 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 |
$16.64
|
| Rate for Payer: Provider Network of America Commercial |
$17.74
|
|
|
HC Capsul Mttarphlngl Jt W/WO Tenorrhaphy Ea Jt Spx
|
Facility
|
OP
|
$6,604.50
|
|
|
Service Code
|
CPT 28270
|
| Hospital Charge Code |
Px03612827001
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,108.82 |
| Max. Negotiated Rate |
$6,604.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$4,576.92
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$5,204.35
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$5,085.47
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$5,204.35
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| Rate for Payer: Cigna Commercial |
$4,378.78
|
| Rate for Payer: Cigna Medicare Advantage |
$3,764.57
|
| Rate for Payer: Family Health Partners Medicaid |
$4,129.36
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$4,160.84
|
| Rate for Payer: Healthy Blue Medicaid |
$4,459.70
|
| Rate for Payer: Home State Health Plan Exchange |
$3,764.57
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,129.36
|
| Rate for Payer: Humana Medicare |
$4,953.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,129.36
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$4,358.97
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$6,604.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,108.82
|
|
|
HC Capsul Mttarphlngl Jt W/WO Tenorrhaphy Ea Jt Spx
|
Facility
|
IP
|
$6,604.50
|
|
|
Service Code
|
CPT 28270
|
| Hospital Charge Code |
Px03612827001
|
|
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 |
$6,604.50
|
| Rate for Payer: Cash Price |
$6,604.50
|
| 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 |
$4,953.38
|
| Rate for Payer: Provider Network of America Commercial |
$5,283.60
|
|
|
HC Capsulotomy Iphal Joint Each Joint Spx
|
Facility
|
OP
|
$3,433.50
|
|
|
Service Code
|
CPT 28272
|
| Hospital Charge Code |
Px03612827201
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,527.79 |
| Max. Negotiated Rate |
$3,433.50 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,379.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,379.42
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,705.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,705.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,705.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,643.80
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,705.60
|
| Rate for Payer: Cash Price |
$3,433.50
|
| Rate for Payer: Cash Price |
$3,433.50
|
| Rate for Payer: Cigna Commercial |
$2,276.41
|
| Rate for Payer: Cigna Medicare Advantage |
$1,957.10
|
| Rate for Payer: Family Health Partners Medicaid |
$2,029.33
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,163.11
|
| Rate for Payer: Healthy Blue Medicaid |
$2,191.67
|
| Rate for Payer: Home State Health Plan Exchange |
$1,957.10
|
| Rate for Payer: Home State Health Plan Medicaid |
$2,029.33
|
| Rate for Payer: Humana Medicare |
$2,575.12
|
| Rate for Payer: Mercy CarePlus Medicaid |
$2,029.33
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,575.12
|
| Rate for Payer: Provider Network of America Commercial |
$2,746.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,266.11
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,433.50
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,527.79
|
|
|
HC Capsulotomy Iphal Joint Each Joint Spx
|
Facility
|
IP
|
$3,433.50
|
|
|
Service Code
|
CPT 28272
|
| Hospital Charge Code |
Px03612827201
|
|
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 |
$3,433.50
|
| Rate for Payer: Cash Price |
$3,433.50
|
| 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 |
$2,575.12
|
| Rate for Payer: Provider Network of America Commercial |
$2,746.80
|
|
|
HC Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen)
|
Facility
|
IP
|
$220.50
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
Px03018237801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$165.38 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| 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 |
$165.38
|
| Rate for Payer: Provider Network of America Commercial |
$176.40
|
|
|
HC Carcinoembryonic Antigen - Cea (Carcinoembryonic Antigen)
|
Facility
|
OP
|
$220.50
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
Px03018237801
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.98 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$155.45
|
| Rate for Payer: Aetna Workers' Compensation |
$155.45
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$152.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$173.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$169.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$173.75
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cash Price |
$220.50
|
| Rate for Payer: Cigna Commercial |
$115.54
|
| Rate for Payer: Cigna Medicare Advantage |
$125.69
|
| Rate for Payer: Family Health Partners Medicaid |
$23.88
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$138.91
|
| Rate for Payer: Healthy Blue Medicaid |
$25.79
|
| Rate for Payer: Home State Health Plan Exchange |
$125.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$23.88
|
| Rate for Payer: Humana Medicare |
$165.38
|
| Rate for Payer: Mercy CarePlus Medicaid |
$23.88
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$165.38
|
| Rate for Payer: Provider Network of America Commercial |
$176.40
|
| Rate for Payer: UnitedHealthcare Commercial |
$145.53
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$18.96
|
| Rate for Payer: UnitedHealthcare Medicaid |
$17.98
|
|
|
HC Cardiac Rehab W/O Cont Ecg Monitor
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
Px09439379701
|
|
Hospital Revenue Code
|
943
|
| 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 Cardiac Rehab W/O Cont Ecg Monitor
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
Px09439379701
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$40.70 |
| Max. Negotiated Rate |
$175.71 |
| 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 |
$43.70
|
| Rate for Payer: Cigna Medicare Advantage |
$40.70
|
| Rate for Payer: Family Health Partners Medicaid |
$162.69
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$44.98
|
| Rate for Payer: Healthy Blue Medicaid |
$175.71
|
| Rate for Payer: Home State Health Plan Exchange |
$40.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$162.69
|
| Rate for Payer: Humana Medicare |
$53.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$162.69
|
| 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 |
$71.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$122.49
|
|
|
HC Cardiac Stress Tst,Tracing - Dobutamine W Nuc Med Blood Pool Muga
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301707
|
|
Hospital Revenue Code
|
482
|
| 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 |
$1,260.00
|
| Rate for Payer: Cash Price |
$1,260.00
|
| 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 |
$945.00
|
| Rate for Payer: Provider Network of America Commercial |
$1,008.00
|
|
|
HC Cardiac Stress Tst,Tracing - Dobutamine W Nuc Med Blood Pool Muga
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301707
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$205.16 |
| Max. Negotiated Rate |
$1,260.00 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$888.30
|
| Rate for Payer: Aetna Workers' Compensation |
$888.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$873.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$873.18
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$992.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$992.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$992.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$970.20
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$992.88
|
| Rate for Payer: Cash Price |
$1,260.00
|
| Rate for Payer: Cash Price |
$1,260.00
|
| Rate for Payer: Cigna Commercial |
$771.12
|
| Rate for Payer: Cigna Medicare Advantage |
$718.20
|
| Rate for Payer: Family Health Partners Medicaid |
$272.51
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$793.80
|
| Rate for Payer: Healthy Blue Medicaid |
$294.31
|
| Rate for Payer: Home State Health Plan Exchange |
$718.20
|
| Rate for Payer: Home State Health Plan Medicaid |
$272.51
|
| Rate for Payer: Humana Medicare |
$945.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$272.51
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$945.00
|
| Rate for Payer: Provider Network of America Commercial |
$1,008.00
|
| Rate for Payer: UnitedHealthcare Commercial |
$831.60
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$1,260.00
|
| Rate for Payer: UnitedHealthcare Medicaid |
$205.16
|
|
