|
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73070 50
|
| Hospital Charge Code |
Px09727307001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73070 50
|
| Hospital Charge Code |
Px09727307001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73080 26
|
| Hospital Charge Code |
Px09727308001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73080 26
|
| Hospital Charge Code |
Px09727308001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Exam Hip Uni 1 View - Xr Hip 1 Vw
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73501 26
|
| Hospital Charge Code |
Px09727350101
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Exam Hip Uni 1 View - Xr Hip 1 Vw
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73501 26
|
| Hospital Charge Code |
Px09727350101
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Exam of Finger(S) - Xr Fingers 2+ Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73140 26
|
| Hospital Charge Code |
Px09727314001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Exam of Finger(S) - Xr Fingers 2+ Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73140 26
|
| Hospital Charge Code |
Px09727314001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Foot 2 Vw - Xr Foot 1-2 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73620 26
|
| Hospital Charge Code |
Px09727362001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Foot 2 Vw - Xr Foot 1-2 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73620 26
|
| Hospital Charge Code |
Px09727362001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Foot 3+ Vw - Xr Foot 3+ Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73630 26
|
| Hospital Charge Code |
Px09727363001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Foot 3+ Vw - Xr Foot 3+ Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73630 26
|
| Hospital Charge Code |
Px09727363001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Forearm 2 Vw - Xr Forearm 2 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73090 26
|
| Hospital Charge Code |
Px09727309001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Forearm 2 Vw - Xr Forearm 2 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73090 26
|
| Hospital Charge Code |
Px09727309001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Hand 2 Vw - Xr Hand 1-2 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73120 26
|
| Hospital Charge Code |
Px09727312001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Hand 2 Vw - Xr Hand 1-2 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73120 26
|
| Hospital Charge Code |
Px09727312001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$142.49 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$131.94
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$142.49
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$131.94
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$131.94
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$99.33
|
|
|
X-Ray Hand 3+ Vw - Xr Hand 3+ Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73130 26
|
| Hospital Charge Code |
Px09727313001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Hand 3+ Vw - Xr Hand 3+ Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73130 26
|
| Hospital Charge Code |
Px09727313001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Heel - Xr Calcaneus 2 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73650 26
|
| Hospital Charge Code |
Px09727365001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Heel - Xr Calcaneus 2 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73650 26
|
| Hospital Charge Code |
Px09727365001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Knee 1 or 2 View - Xr Knee 1-2 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73560 26
|
| Hospital Charge Code |
Px09727356001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Knee 1 or 2 View - Xr Knee 1-2 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73560 26
|
| Hospital Charge Code |
Px09727356001
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Knee 3 View - Xr Knee 3 Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73562 26
|
| Hospital Charge Code |
Px09727356201
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
|
X-Ray Knee 3 View - Xr Knee 3 Views
|
Facility
|
OP
|
$30.03
|
|
|
Service Code
|
CPT 73562 26
|
| Hospital Charge Code |
Px09727356201
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$17.12 |
| Max. Negotiated Rate |
$118.62 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$21.17
|
| Rate for Payer: Aetna Workers' Compensation |
$21.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$20.81
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$23.66
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$23.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$23.66
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| Rate for Payer: Cigna Commercial |
$18.38
|
| Rate for Payer: Cigna Medicare Advantage |
$17.12
|
| Rate for Payer: Family Health Partners Medicaid |
$109.83
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$18.92
|
| Rate for Payer: Healthy Blue Medicaid |
$118.62
|
| Rate for Payer: Home State Health Plan Exchange |
$17.12
|
| Rate for Payer: Home State Health Plan Medicaid |
$109.83
|
| Rate for Payer: Humana Medicare |
$22.52
|
| Rate for Payer: Mercy CarePlus Medicaid |
$109.83
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
| Rate for Payer: UnitedHealthcare Commercial |
$19.82
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$30.03
|
| Rate for Payer: UnitedHealthcare Medicaid |
$82.69
|
|
|
X-Ray Knee 4+ View - Xr Knee 4+ Views
|
Facility
|
IP
|
$30.03
|
|
|
Service Code
|
CPT 73564 26
|
| Hospital Charge Code |
Px09727356401
|
|
Hospital Revenue Code
|
972
|
| Min. Negotiated Rate |
$22.52 |
| 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 |
$30.03
|
| Rate for Payer: Cash Price |
$30.03
|
| 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 |
$22.52
|
| Rate for Payer: Provider Network of America Commercial |
$24.02
|
|
