Ray County Hospital

All Charges

Charge

Type

Setting

Price

VENTRICULAR SHUNT PROCEDURES

Facility

$51,680.61

Service Code	APR-DRG 0224
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$51,680.61
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	$51,680.61
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$51,680.61
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$51,680.61
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$51,680.61

VENTRICULAR SHUNT PROCEDURES

Facility

$18,209.33

Service Code	APR-DRG 0222
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$18,209.33
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	$18,209.33
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$18,209.33
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$18,209.33
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$18,209.33

VENTRICULAR SHUNT PROCEDURES WITH CC

Facility

$10,015.70

Service Code	MSDRG 032
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$10,015.70
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	$10,015.70

VENTRICULAR SHUNT PROCEDURES WITH MCC

Facility

$21,058.35

Service Code	MSDRG 031
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$21,058.35
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	$21,058.35

VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC

Facility

$7,815.63

Service Code	MSDRG 033
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$7,815.63
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	$7,815.63

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$13,534.96

Service Code	APR-DRG 3101
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$13,534.96
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	$13,534.96
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$13,534.96
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$13,534.96
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$13,534.96

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$37,521.60

Service Code	APR-DRG 3104
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$37,521.60
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	$37,521.60
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$37,521.60
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$37,521.60
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$37,521.60

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$26,538.32

Service Code	APR-DRG 3103
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$26,538.32
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	$26,538.32
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$26,538.32
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$26,538.32
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$26,538.32

VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES

Facility

$18,595.78

Service Code	APR-DRG 3102
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$18,595.78
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	$18,595.78
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$18,595.78
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$18,595.78
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$18,595.78

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$7,001.38

Service Code	APR-DRG 1111
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$7,001.38
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	$7,001.38
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$7,001.38
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$7,001.38
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$7,001.38

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$7,897.24

Service Code	APR-DRG 1112
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$7,897.24
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	$7,897.24
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$7,897.24
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$7,897.24
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$7,897.24

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$15,827.77

Service Code	APR-DRG 1114
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$15,827.77
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	$15,827.77
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$15,827.77
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$15,827.77
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$15,827.77

VERTIGO AND OTHER LABYRINTH DISORDERS

Facility

$10,365.71

Service Code	APR-DRG 1113
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$10,365.71
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	$10,365.71
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$10,365.71
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$10,365.71
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$10,365.71

Vincristine sulfate 1 mg inj

Facility

$85.58

Service Code	HCPCS J9370
Hospital Charge Code	Px0636J937001
Hospital Revenue Code	636
Min. Negotiated Rate	$64.19
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	$85.58
Rate for Payer: Cash Price	$85.58
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	$64.19
Rate for Payer: Provider Network of America Commercial	$68.46

Vincristine sulfate 1 mg inj

Facility

$85.58

Service Code	HCPCS J9370
Hospital Charge Code	Px0636J937001
Hospital Revenue Code	636
Min. Negotiated Rate	$48.78
Max. Negotiated Rate	$85.58
Rate for Payer: Aetna Commercial/Medicare Advantage	$60.33
Rate for Payer: Aetna Workers' Compensation	$60.33
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO)	$59.31
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO)	$59.31
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network	$67.44
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$67.44
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$67.44
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO)	$65.90
Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional	$67.44
Rate for Payer: Cash Price	$85.58
Rate for Payer: Cigna Commercial	$52.37
Rate for Payer: Cigna Medicare Advantage	$48.78
Rate for Payer: Harmony Health CHIP/Medicaid	$53.92
Rate for Payer: Home State Health Plan Exchange	$48.78
Rate for Payer: Humana Medicare	$64.19
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$64.19
Rate for Payer: Provider Network of America Commercial	$68.46
Rate for Payer: UnitedHealthcare Commercial	$56.48
Rate for Payer: UnitedHealthcare Individual Exchange	$85.58

Vinorelbine tartrate inj

Facility

$224.54

Service Code	HCPCS J9390
Hospital Charge Code	Px0636J939001
Hospital Revenue Code	636
Min. Negotiated Rate	$168.41
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	$224.54
Rate for Payer: Cash Price	$224.54
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	$168.41
Rate for Payer: Provider Network of America Commercial	$179.63

Vinorelbine tartrate inj

Facility

$224.54

Service Code	HCPCS J9390
Hospital Charge Code	Px0636J939001
Hospital Revenue Code	636
Min. Negotiated Rate	$127.99
Max. Negotiated Rate	$224.54
Rate for Payer: Aetna Commercial/Medicare Advantage	$158.30
Rate for Payer: Aetna Workers' Compensation	$158.30
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO)	$155.61
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO)	$155.61
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network	$176.94
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$176.94
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$176.94
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO)	$172.90
Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional	$176.94
Rate for Payer: Cash Price	$224.54
Rate for Payer: Cigna Commercial	$137.42
Rate for Payer: Cigna Medicare Advantage	$127.99
Rate for Payer: Harmony Health CHIP/Medicaid	$141.46
Rate for Payer: Home State Health Plan Exchange	$127.99
Rate for Payer: Humana Medicare	$168.41
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$168.41
Rate for Payer: Provider Network of America Commercial	$179.63
Rate for Payer: UnitedHealthcare Commercial	$148.20
Rate for Payer: UnitedHealthcare Individual Exchange	$224.54

VIRAL ILLNESS

Facility

$6,053.00

Service Code	APR-DRG 7231
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	$4,357.26
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$4,357.26
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$4,357.26
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$4,357.26

VIRAL ILLNESS

Facility

$10,586.67

Service Code	APR-DRG 7233
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$10,586.67
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	$10,586.67
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$10,586.67
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$10,586.67
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$10,586.67

VIRAL ILLNESS

Facility

$21,422.95

Service Code	APR-DRG 7234
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$21,422.95
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	$21,422.95
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$21,422.95
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$21,422.95
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$21,422.95

VIRAL ILLNESS

Facility

$6,377.33

Service Code	APR-DRG 7232
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$6,377.33
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	$6,377.33
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$6,377.33
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$6,377.33
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$6,377.33

VIRAL ILLNESS WITH MCC

Facility

$7,042.01

Service Code	MSDRG 865
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$7,042.01
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 Freedom Network	$5,448.00
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$5,448.00
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$5,448.00
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 Traditional	$5,448.00
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	$7,042.01

VIRAL ILLNESS WITHOUT MCC

Facility

$6,053.00

Service Code	MSDRG 866
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	$4,087.12

VIRAL MENINGITIS

Facility

$14,750.70

Service Code	APR-DRG 0513
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$14,750.70
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: Family Health Partners Medicaid	$14,750.70
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$14,750.70
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$14,750.70
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$14,750.70

VIRAL MENINGITIS

Facility

$6,053.00

Service Code	APR-DRG 0511
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	$5,880.87
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$5,880.87
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$5,880.87
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$5,880.87

Know your out-of-pocket cost for care.

All Charges