|
Removal Foreign Body Foot Subcutaneous
|
Facility
|
IP
|
$197.93
|
|
|
Service Code
|
CPT 28190
|
| Hospital Charge Code |
Px09832819001
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$148.45 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cash Price |
$197.93
|
| Rate for Payer: Cash Price |
$197.93
|
| Rate for Payer: Cash Price |
$188.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$148.45
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$141.38
|
| Rate for Payer: Provider Network of America Commercial |
$158.34
|
| Rate for Payer: Provider Network of America Commercial |
$150.80
|
|
|
Removal Foreign Body Pharynx
|
Professional
|
Both
|
$435.00
|
|
|
Service Code
|
CPT 42809
|
| Hospital Charge Code |
Px00000042809
|
|
Hospital Revenue Code
|
520
|
| Min. Negotiated Rate |
$137.70 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Cash Price |
$435.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$137.70
|
|
|
Removal Intrauterine Device Iud
|
Facility
|
IP
|
$696.15
|
|
|
Service Code
|
CPT 58301
|
| Hospital Charge Code |
Px05105830101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$556.92 |
| 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 |
$696.15
|
| Rate for Payer: Cash Price |
$696.15
|
| 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: Provider Network of America Commercial |
$556.92
|
|
|
Removal Intrauterine Device Iud
|
Facility
|
OP
|
$696.15
|
|
|
Service Code
|
CPT 58301
|
| Hospital Charge Code |
Px05105830101
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$289.53 |
| Max. Negotiated Rate |
$696.15 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$490.79
|
| Rate for Payer: Aetna Workers' Compensation |
$490.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$482.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$482.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$548.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$548.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$548.57
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$536.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$548.57
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cash Price |
$696.15
|
| Rate for Payer: Cigna Medicare Advantage |
$396.81
|
| Rate for Payer: Family Health Partners Medicaid |
$384.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$438.57
|
| Rate for Payer: Healthy Blue Medicaid |
$415.35
|
| Rate for Payer: Home State Health Plan Exchange |
$396.81
|
| Rate for Payer: Home State Health Plan Medicaid |
$384.58
|
| Rate for Payer: Humana Medicare |
$522.11
|
| Rate for Payer: Mercy CarePlus Medicaid |
$384.58
|
| Rate for Payer: Provider Network of America Commercial |
$556.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$459.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$696.15
|
| Rate for Payer: UnitedHealthcare Medicaid |
$289.53
|
|
|
Removal Intrauterine Device Iud
|
Facility
|
OP
|
$49.18
|
|
|
Service Code
|
CPT 58301
|
| Hospital Charge Code |
Px09835830101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$28.03 |
| Max. Negotiated Rate |
$415.35 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$34.67
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$33.02
|
| Rate for Payer: Aetna Workers' Compensation |
$34.67
|
| Rate for Payer: Aetna Workers' Compensation |
$33.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$32.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$34.08
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$32.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$38.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$36.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$38.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$36.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$36.91
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$38.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$36.07
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$37.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$38.75
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$36.91
|
| Rate for Payer: Cash Price |
$49.18
|
| Rate for Payer: Cash Price |
$49.18
|
| Rate for Payer: Cash Price |
$46.84
|
| Rate for Payer: Cash Price |
$46.84
|
| Rate for Payer: Cigna Commercial |
$30.10
|
| Rate for Payer: Cigna Commercial |
$28.67
|
| Rate for Payer: Cigna Medicare Advantage |
$26.70
|
| Rate for Payer: Cigna Medicare Advantage |
$28.03
|
| Rate for Payer: Family Health Partners Medicaid |
$384.58
|
| Rate for Payer: Family Health Partners Medicaid |
$384.58
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$30.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$29.51
|
| Rate for Payer: Healthy Blue Medicaid |
$415.35
|
| Rate for Payer: Healthy Blue Medicaid |
$415.35
|
| Rate for Payer: Home State Health Plan Exchange |
$28.03
|
| Rate for Payer: Home State Health Plan Exchange |
$26.70
|
| Rate for Payer: Home State Health Plan Medicaid |
$384.58
|
| Rate for Payer: Home State Health Plan Medicaid |
$384.58
|
| Rate for Payer: Humana Medicare |
$35.13
|
| Rate for Payer: Humana Medicare |
$36.88
|
| Rate for Payer: Mercy CarePlus Medicaid |
$384.58
|
| Rate for Payer: Mercy CarePlus Medicaid |
$384.58
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$35.13
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$36.88
|
| Rate for Payer: Provider Network of America Commercial |
$37.47
|
| Rate for Payer: Provider Network of America Commercial |
$39.34
|
| Rate for Payer: UnitedHealthcare Commercial |
$30.91
|
| Rate for Payer: UnitedHealthcare Commercial |
$32.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$46.84
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$49.18
|
| Rate for Payer: UnitedHealthcare Medicaid |
$289.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$289.53
|
|
|
Removal Intrauterine Device Iud
|
Facility
|
IP
|
$49.18
|
|
|
Service Code
|
CPT 58301
|
| Hospital Charge Code |
Px09835830101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$36.88 |
| 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 Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$46.84
|
| Rate for Payer: Cash Price |
$49.18
|
| Rate for Payer: Cash Price |
$49.18
|
| Rate for Payer: Cash Price |
$46.84
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$36.88
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$35.13
|
| Rate for Payer: Provider Network of America Commercial |
$39.34
|
| Rate for Payer: Provider Network of America Commercial |
$37.47
|
|
|
RENAL DIALYSIS ACCESS PROCEDURES
|
Facility
|
IP
|
$40,653.87
|
|
|
Service Code
|
APR-DRG 4444
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$40,653.87 |
| 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 |
$40,653.87
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$40,653.87
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$40,653.87
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$40,653.87
|
|
|
RENAL DIALYSIS ACCESS PROCEDURES
|
Facility
|
IP
|
$25,731.21
|
|
|
Service Code
|
APR-DRG 4443
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$25,731.21 |
| 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 |
$25,731.21
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$25,731.21
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$25,731.21
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$25,731.21
|
|
|
RENAL DIALYSIS ACCESS PROCEDURES
|
Facility
|
IP
|
$12,617.84
|
|
|
Service Code
|
APR-DRG 4441
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$12,617.84 |
| 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 |
$12,617.84
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$12,617.84
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$12,617.84
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$12,617.84
|
|
|
RENAL DIALYSIS ACCESS PROCEDURES
|
Facility
|
IP
|
$18,705.79
|
|
|
Service Code
|
APR-DRG 4442
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$18,705.79 |
| 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 |
$18,705.79
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$18,705.79
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$18,705.79
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$18,705.79
|
|
|
RENAL FAILURE WITH CC
|
Facility
|
IP
|
$6,053.00
|
|
|
Service Code
|
MSDRG 683
|
| 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 |
$4,116.26
|
|
|
RENAL FAILURE WITH MCC
|
Facility
|
IP
|
$6,960.70
|
|
|
Service Code
|
MSDRG 682
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$6,960.70 |
| 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 |
$6,960.70
|
|
|
RENAL FAILURE WITHOUT CC/MCC
|
Facility
|
IP
|
$6,053.00
|
|
|
Service Code
|
MSDRG 684
|
| 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 |
$2,821.41
|
|
|
Repair Complex Wnd Head,Fac,Hand 1.1-2.5 Cm
|
Facility
|
OP
|
$284.03
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
Px09831313101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$161.90 |
| Max. Negotiated Rate |
$554.07 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$200.24
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$190.70
|
| Rate for Payer: Aetna Workers' Compensation |
$200.24
|
| Rate for Payer: Aetna Workers' Compensation |
$190.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$196.83
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$187.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$196.83
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$187.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$223.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$223.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$213.15
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$223.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$208.28
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$218.70
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$223.82
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$213.15
|
| Rate for Payer: Cash Price |
$284.03
|
| Rate for Payer: Cash Price |
$284.03
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cigna Commercial |
$173.83
|
| Rate for Payer: Cigna Commercial |
$165.55
|
| Rate for Payer: Cigna Medicare Advantage |
$154.19
|
| Rate for Payer: Cigna Medicare Advantage |
$161.90
|
| Rate for Payer: Family Health Partners Medicaid |
$513.03
|
| Rate for Payer: Family Health Partners Medicaid |
$513.03
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$178.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$170.41
|
| Rate for Payer: Healthy Blue Medicaid |
$554.07
|
| Rate for Payer: Healthy Blue Medicaid |
$554.07
|
| Rate for Payer: Home State Health Plan Exchange |
$161.90
|
| Rate for Payer: Home State Health Plan Exchange |
$154.19
|
| Rate for Payer: Home State Health Plan Medicaid |
$513.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$513.03
|
| Rate for Payer: Humana Medicare |
$202.88
|
| Rate for Payer: Humana Medicare |
$213.02
|
| Rate for Payer: Mercy CarePlus Medicaid |
$513.03
|
| Rate for Payer: Mercy CarePlus Medicaid |
$513.03
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$202.88
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$213.02
|
| Rate for Payer: Provider Network of America Commercial |
$216.40
|
| Rate for Payer: Provider Network of America Commercial |
$227.22
|
| Rate for Payer: UnitedHealthcare Commercial |
$178.53
|
| Rate for Payer: UnitedHealthcare Commercial |
$187.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$270.50
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$284.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$386.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$386.24
|
|
|
Repair Complex Wnd Head,Fac,Hand 1.1-2.5 Cm
|
Facility
|
IP
|
$284.03
|
|
|
Service Code
|
CPT 13131
|
| Hospital Charge Code |
Px09831313101
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$213.02 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cash Price |
$284.03
|
| Rate for Payer: Cash Price |
$284.03
|
| Rate for Payer: Cash Price |
$270.50
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$213.02
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$202.88
|
| Rate for Payer: Provider Network of America Commercial |
$227.22
|
| Rate for Payer: Provider Network of America Commercial |
$216.40
|
|
|
Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated
|
Facility
|
OP
|
$4,880.06
|
|
|
Service Code
|
CPT 49507
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$3,401.84 |
| Max. Negotiated Rate |
$4,880.06 |
| Rate for Payer: Family Health Partners Medicaid |
$4,518.57
|
| Rate for Payer: Healthy Blue Medicaid |
$4,880.06
|
| Rate for Payer: Home State Health Plan Medicaid |
$4,518.57
|
| Rate for Payer: Mercy CarePlus Medicaid |
$4,518.57
|
| Rate for Payer: UnitedHealthcare Medicaid |
$3,401.84
|
|
|
Repair Intermediate N/H/F/Xtrnl Gent 2.6-7.5 Cm
|
Facility
|
IP
|
$806.40
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
Px03601204201
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$604.80 |
| 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 |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$604.80
|
| Rate for Payer: Provider Network of America Commercial |
$645.12
|
|
|
Repair Intermediate N/H/F/Xtrnl Gent 2.6-7.5 Cm
|
Facility
|
OP
|
$806.40
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
Px07611204201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$386.24 |
| Max. Negotiated Rate |
$806.40 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$568.51
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$382.81
|
| Rate for Payer: Aetna Workers' Compensation |
$568.51
|
| Rate for Payer: Aetna Workers' Compensation |
$382.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$558.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$376.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$558.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$376.30
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$427.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$427.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$427.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$418.11
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$620.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$427.88
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$543.00
|
| Rate for Payer: Cash Price |
$543.00
|
| Rate for Payer: Cigna Commercial |
$493.52
|
| Rate for Payer: Cigna Commercial |
$332.32
|
| Rate for Payer: Cigna Medicare Advantage |
$309.51
|
| Rate for Payer: Cigna Medicare Advantage |
$459.65
|
| Rate for Payer: Family Health Partners Medicaid |
$513.03
|
| Rate for Payer: Family Health Partners Medicaid |
$513.03
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$508.03
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$342.09
|
| Rate for Payer: Healthy Blue Medicaid |
$554.07
|
| Rate for Payer: Healthy Blue Medicaid |
$554.07
|
| Rate for Payer: Home State Health Plan Exchange |
$459.65
|
| Rate for Payer: Home State Health Plan Exchange |
$309.51
|
| Rate for Payer: Home State Health Plan Medicaid |
$513.03
|
| Rate for Payer: Home State Health Plan Medicaid |
$513.03
|
| Rate for Payer: Humana Medicare |
$407.25
|
| Rate for Payer: Humana Medicare |
$604.80
|
| Rate for Payer: Mercy CarePlus Medicaid |
$513.03
|
| Rate for Payer: Mercy CarePlus Medicaid |
$513.03
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$407.25
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$604.80
|
| Rate for Payer: Provider Network of America Commercial |
$434.40
|
| Rate for Payer: Provider Network of America Commercial |
$645.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$358.38
|
| Rate for Payer: UnitedHealthcare Commercial |
$532.22
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$543.00
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$806.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$386.24
|
| Rate for Payer: UnitedHealthcare Medicaid |
$386.24
|
|
|
Repair Intermediate N/H/F/Xtrnl Gent 2.6-7.5 Cm
|
Facility
|
IP
|
$806.40
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
Px07611204201
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$604.80 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$543.00
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$543.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Cigna Medicare Advantage |
$6,053.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$604.80
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$407.25
|
| Rate for Payer: Provider Network of America Commercial |
$645.12
|
| Rate for Payer: Provider Network of America Commercial |
$434.40
|
|
|
Repair Intermediate N/H/F/Xtrnl Gent 2.6-7.5 Cm
|
Facility
|
OP
|
$806.40
|
|
|
Service Code
|
CPT 12042
|
| Hospital Charge Code |
Px03601204201
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$386.24 |
| Max. Negotiated Rate |
$806.40 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$558.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$558.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$635.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$620.93
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$635.44
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cash Price |
$806.40
|
| Rate for Payer: Cigna Commercial |
$534.64
|
| Rate for Payer: Cigna Medicare Advantage |
$459.65
|
| Rate for Payer: Family Health Partners Medicaid |
$513.03
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$508.03
|
| Rate for Payer: Healthy Blue Medicaid |
$554.07
|
| Rate for Payer: Home State Health Plan Exchange |
$459.65
|
| Rate for Payer: Home State Health Plan Medicaid |
$513.03
|
| Rate for Payer: Humana Medicare |
$604.80
|
| Rate for Payer: Mercy CarePlus Medicaid |
$513.03
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$604.80
|
| Rate for Payer: Provider Network of America Commercial |
$645.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$532.22
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$806.40
|
| Rate for Payer: UnitedHealthcare Medicaid |
$386.24
|
|
|
RESPIRATORY FAILURE
|
Facility
|
IP
|
$12,545.72
|
|
|
Service Code
|
APR-DRG 1333
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$12,545.72 |
| 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 |
$12,545.72
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$12,545.72
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$12,545.72
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$12,545.72
|
|
|
RESPIRATORY FAILURE
|
Facility
|
IP
|
$21,593.99
|
|
|
Service Code
|
APR-DRG 1334
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$21,593.99 |
| 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 |
$21,593.99
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$21,593.99
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$21,593.99
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$21,593.99
|
|
|
RESPIRATORY FAILURE
|
Facility
|
IP
|
$8,034.07
|
|
|
Service Code
|
APR-DRG 1332
|
| Min. Negotiated Rate |
$875.00 |
| Max. Negotiated Rate |
$8,034.07 |
| 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 |
$8,034.07
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$8,034.07
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$8,034.07
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$8,034.07
|
|
|
RESPIRATORY FAILURE
|
Facility
|
IP
|
$6,053.00
|
|
|
Service Code
|
APR-DRG 1331
|
| 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 |
$5,965.00
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$1,826.00
|
| Rate for Payer: Healthy Blue Medicaid |
$5,965.00
|
| Rate for Payer: Home State Health Plan Exchange |
$6,053.00
|
| Rate for Payer: Home State Health Plan Medicaid |
$5,965.00
|
| Rate for Payer: Humana Medicare |
$1,185.00
|
| Rate for Payer: Mercy CarePlus Medicaid |
$5,965.00
|
|
|
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC
|
Facility
|
IP
|
$6,053.00
|
|
|
Service Code
|
MSDRG 178
|
| 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 |
$4,587.20
|
|
