|
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
|
|
|
HC Cardiac Stress Tst,Tracing Only - Dobutamine W NM Bld Pl Muga W Rvef
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301745
|
|
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 W Rvef
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301745
|
|
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 - Exercise W NM Bld Pl 1st Pass
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301746
|
|
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 - Exercise W NM Bld Pl 1st Pass
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301746
|
|
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 - Exercise W NM Bld Pl Muga
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301747
|
|
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 - Exercise W NM Bld Pl Muga
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301747
|
|
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 - Exercise W NM Bld Pl Muga W Rvef
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301748
|
|
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 - Exercise W NM Bld Pl Muga W Rvef
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301748
|
|
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 - Regadenoson W NM Bld Pl 1st Pass
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301749
|
|
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 - Regadenoson W NM Bld Pl 1st Pass
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301749
|
|
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 - Regadenoson W NM Bld Pl Muga
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301750
|
|
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 - Regadenoson W NM Bld Pl Muga
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301750
|
|
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 - Regadenoson W NM Bld Pl Muga Rvef
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301751
|
|
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 - Regadenoson W NM Bld Pl Muga Rvef
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301751
|
|
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 - Stress Test Only, Exercise
|
Facility
|
IP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301702
|
|
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 - Stress Test Only, Exercise
|
Facility
|
OP
|
$1,260.00
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
Px04829301702
|
|
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 Cardiolipin Antibody - Cardiolipin Antibody
|
Facility
|
IP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614701
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$133.88 |
| 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 |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| 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 |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody
|
Facility
|
OP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614701
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$125.84
|
| Rate for Payer: Aetna Workers' Compensation |
$125.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$137.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$140.66
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cigna Commercial |
$93.53
|
| Rate for Payer: Cigna Medicare Advantage |
$101.75
|
| Rate for Payer: Family Health Partners Medicaid |
$32.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$112.45
|
| Rate for Payer: Healthy Blue Medicaid |
$34.64
|
| Rate for Payer: Home State Health Plan Exchange |
$101.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.07
|
| Rate for Payer: Humana Medicare |
$133.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.07
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.81
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.15
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody, Iga
|
Facility
|
OP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614702
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$125.84
|
| Rate for Payer: Aetna Workers' Compensation |
$125.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$137.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$140.66
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cigna Commercial |
$93.53
|
| Rate for Payer: Cigna Medicare Advantage |
$101.75
|
| Rate for Payer: Family Health Partners Medicaid |
$32.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$112.45
|
| Rate for Payer: Healthy Blue Medicaid |
$34.64
|
| Rate for Payer: Home State Health Plan Exchange |
$101.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.07
|
| Rate for Payer: Humana Medicare |
$133.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.07
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.81
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.15
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody, Iga
|
Facility
|
IP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614702
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$133.88 |
| 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 |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| 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 |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody, Igg
|
Facility
|
OP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614703
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: Cigna Medicare Advantage |
$101.75
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$125.84
|
| Rate for Payer: Aetna Workers' Compensation |
$125.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$137.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$140.66
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cigna Commercial |
$93.53
|
| Rate for Payer: Family Health Partners Medicaid |
$32.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$112.45
|
| Rate for Payer: Healthy Blue Medicaid |
$34.64
|
| Rate for Payer: Home State Health Plan Exchange |
$101.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.07
|
| Rate for Payer: Humana Medicare |
$133.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.07
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.81
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.15
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody, Igg
|
Facility
|
IP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614703
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$133.88 |
| 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 |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| 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 |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody, Igm
|
Facility
|
OP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614704
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.15 |
| Max. Negotiated Rate |
$142.80 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$125.84
|
| Rate for Payer: Aetna Workers' Compensation |
$125.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$123.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$140.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$137.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$140.66
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| Rate for Payer: Cigna Commercial |
$93.53
|
| Rate for Payer: Cigna Medicare Advantage |
$101.75
|
| Rate for Payer: Family Health Partners Medicaid |
$32.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$112.45
|
| Rate for Payer: Healthy Blue Medicaid |
$34.64
|
| Rate for Payer: Home State Health Plan Exchange |
$101.75
|
| Rate for Payer: Home State Health Plan Medicaid |
$32.07
|
| Rate for Payer: Humana Medicare |
$133.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$32.07
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
| Rate for Payer: UnitedHealthcare Commercial |
$117.81
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$25.45
|
| Rate for Payer: UnitedHealthcare Medicaid |
$24.15
|
|
|
HC Cardiolipin Antibody - Cardiolipin Antibody, Igm
|
Facility
|
IP
|
$178.50
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
Px03028614704
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$133.88 |
| 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 |
$178.50
|
| Rate for Payer: Cash Price |
$178.50
|
| 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 |
$133.88
|
| Rate for Payer: Provider Network of America Commercial |
$142.80
|
|
