Ray County Hospital

All Charges

Charge

Type

Setting

Price

NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC

Facility

$6,053.00

Service Code	MSDRG 989
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: 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	$5,636.24

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$14,299.54

Service Code	APR-DRG 9522
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$14,299.54
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$14,299.54
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$14,299.54
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$14,299.54
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$14,299.54

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$22,304.02

Service Code	APR-DRG 9523
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$22,304.02
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$22,304.02
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$22,304.02
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$22,304.02
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$22,304.02

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$10,579.27

Service Code	APR-DRG 9521
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$10,579.27
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$10,579.27
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$10,579.27
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$10,579.27
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$10,579.27

NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS

Facility

$38,619.93

Service Code	APR-DRG 9524
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$38,619.93
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$38,619.93
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$38,619.93
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$38,619.93
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$38,619.93

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$10,876.04

Service Code	APR-DRG 4263
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$10,876.04
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$10,876.04
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$10,876.04
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$10,876.04
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$10,876.04

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$6,954.23

Service Code	APR-DRG 4262
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$6,954.23
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$6,954.23
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$6,954.23
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$6,954.23
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$6,954.23

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$19,119.05

Service Code	APR-DRG 4264
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$19,119.05
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$19,119.05
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$19,119.05
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$19,119.05
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$19,119.05

NON-HYPOVOLEMIC SODIUM DISORDERS

Facility

$6,053.00

Service Code	APR-DRG 4261
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$5,168.99
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$5,168.99
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$5,168.99
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$5,168.99

Noninvasive Ear/Pulse Oximetry Multiple Deter

Professional

Both

$218.00

Service Code	CPT 94761
Hospital Charge Code	Px00000094761
Hospital Revenue Code	410
Min. Negotiated Rate	$4.72
Max. Negotiated Rate	$4.72
Rate for Payer: Cash Price	$218.00
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$4.72

Noninvasive Ear/Pulse Oximetry Overnight Monitor

Professional

Both

$430.00

Service Code	CPT 94762
Hospital Charge Code	Px00000094762
Hospital Revenue Code	410
Min. Negotiated Rate	$25.96
Max. Negotiated Rate	$25.96
Rate for Payer: Cash Price	$430.00
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$25.96

Noninvasive Ear/Pulse Oximetry Single Deter

Professional

Both

$147.00

Service Code	CPT 94760
Hospital Charge Code	Px00000094760
Hospital Revenue Code	410
Min. Negotiated Rate	$4.36
Max. Negotiated Rate	$4.36
Rate for Payer: Cash Price	$147.00
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$4.36

NON-MALIGNANT BREAST DISORDERS WITH CC/MCC

Facility

$6,053.00

Service Code	MSDRG 600
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: 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	$4,895.52

NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC

Facility

$6,053.00

Service Code	MSDRG 601
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: 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	$2,843.50

Non-Regulated Chain of Custody Drug Screening

Facility

$93.45

Service Code	CPT 99001
Hospital Charge Code	Px03009900002
Hospital Revenue Code	300
Min. Negotiated Rate	$48.97
Max. Negotiated Rate	$93.45
Rate for Payer: Aetna Commercial/Medicare Advantage	$65.88
Rate for Payer: Aetna Workers' Compensation	$65.88
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO)	$64.76
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO)	$64.76
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network	$73.64
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$73.64
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$73.64
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO)	$71.96
Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional	$73.64
Rate for Payer: Cash Price	$93.45
Rate for Payer: Cigna Commercial	$48.97
Rate for Payer: Cigna Medicare Advantage	$53.27
Rate for Payer: Harmony Health CHIP/Medicaid	$58.87
Rate for Payer: Home State Health Plan Exchange	$53.27
Rate for Payer: Humana Medicare	$70.09
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$70.09
Rate for Payer: Provider Network of America Commercial	$74.76
Rate for Payer: UnitedHealthcare Commercial	$61.68
Rate for Payer: UnitedHealthcare Individual Exchange	$93.45

Non-Regulated Chain of Custody Drug Screening

Facility

$93.45

Service Code	CPT 99001
Hospital Charge Code	Px03009900002
Hospital Revenue Code	300
Min. Negotiated Rate	$70.09
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	$93.45
Rate for Payer: Cash Price	$93.45
Rate for Payer: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$70.09
Rate for Payer: Provider Network of America Commercial	$74.76

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$8,376.14

Service Code	APR-DRG 0461
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$8,376.14
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$8,376.14
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$8,376.14
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$8,376.14
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$8,376.14

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$24,159.53

Service Code	APR-DRG 0464
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$24,159.53
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$24,159.53
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$24,159.53
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$24,159.53
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$24,159.53

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$10,457.23

Service Code	APR-DRG 0462
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$10,457.23
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$10,457.23
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$10,457.23
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$10,457.23
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$10,457.23

NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION

Facility

$13,639.43

Service Code	APR-DRG 0463
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$13,639.43
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: Cigna Medicare Advantage	$6,053.00
Rate for Payer: Family Health Partners Medicaid	$13,639.43
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$13,639.43
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$13,639.43
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$13,639.43

NONTRAUMATIC STUPOR AND COMA WITH MCC

Facility

$8,507.00

Service Code	MSDRG 080
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$8,507.00
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: 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	$8,507.00

NONTRAUMATIC STUPOR AND COMA WITHOUT MCC

Facility

$6,053.00

Service Code	MSDRG 081
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: 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	$4,209.32

norepinephrine 1 mg/mL solution 4 mL Vial

Facility

$69.84

Service Code	NDC 72078000200
Hospital Revenue Code	258
Min. Negotiated Rate	$39.81
Max. Negotiated Rate	$69.84
Rate for Payer: Aetna Commercial/Medicare Advantage	$49.24
Rate for Payer: Aetna Workers' Compensation	$49.24
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO)	$48.40
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO)	$48.40
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network	$55.03
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$55.03
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$55.03
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO)	$53.78
Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional	$55.03
Rate for Payer: Cash Price	$69.84
Rate for Payer: Cigna Commercial	$42.74
Rate for Payer: Cigna Medicare Advantage	$39.81
Rate for Payer: Harmony Health CHIP/Medicaid	$44.00
Rate for Payer: Home State Health Plan Exchange	$39.81
Rate for Payer: Humana Medicare	$52.38
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$52.38
Rate for Payer: Provider Network of America Commercial	$55.87
Rate for Payer: UnitedHealthcare Commercial	$46.09
Rate for Payer: UnitedHealthcare Individual Exchange	$69.84

norepinephrine 1 mg/mL solution 4 mL Vial

Facility

$69.84

Service Code	NDC 72078000200
Hospital Revenue Code	258
Min. Negotiated Rate	$52.38
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	$69.84
Rate for Payer: Cash Price	$69.84
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	$52.38
Rate for Payer: Provider Network of America Commercial	$55.87

norepinephrine 1 mg/mL solution 4 mL Vial

Facility

$69.84

Service Code	NDC 67457085200
Hospital Revenue Code	258
Min. Negotiated Rate	$52.38
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	$69.84
Rate for Payer: Cash Price	$69.84
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	$52.38
Rate for Payer: Provider Network of America Commercial	$55.87

Know your out-of-pocket cost for care.

All Charges