|
HC Cardiac Stress Tst,Tracing - Echocardiogram Dobutamine Stress Test
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301733
|
|
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 - Echocardiogram Dobutamine Stress Test
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301733
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing - Echocardiogram Exercise Stress Test
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301734
|
|
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 - Echocardiogram Exercise Stress Test
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301734
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301701
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301701
|
|
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 Only - Adenosine W NM Bld Pl 1st Pass
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301737
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Adenosine W NM Bld Pl 1st Pass
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301737
|
|
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 Only - Adenosine W NM Bld Pl Muga
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301738
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Adenosine W NM Bld Pl Muga
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301738
|
|
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 Only - Adenosine W NM Bld Pl Muga W Rvef
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301739
|
|
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 Only - Adenosine W NM Bld Pl Muga W Rvef
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301739
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Complete Echocardiogram Dobutamine
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301736
|
|
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 Only - Complete Echocardiogram Dobutamine
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301736
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Complete Echocardiogram Exercise
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301735
|
|
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 Only - Complete Echocardiogram Exercise
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301735
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Dipyridamole W NM Bld Pl 1st Pass
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301740
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Dipyridamole W NM Bld Pl 1st Pass
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301740
|
|
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 Only - Dipyridamole W NM Bld Pl Muga
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301741
|
|
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 Only - Dipyridamole W NM Bld Pl Muga
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301741
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Dipyridamole W NM Bld Pl Muga Rvef
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301742
|
|
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 Only - Dipyridamole W NM Bld Pl Muga Rvef
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301742
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Dobutamine W NM Bld Pl 1st Pass
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301743
|
|
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 Only - Dobutamine W NM Bld Pl 1st Pass
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301743
|
|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Dobutamine W NM Bld Pl Muga
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301744
|
|
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
|
|
