Ray County Hospital

All Charges

Charge

Type

Setting

Price

EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT

Facility

$19,700.58

Service Code	APR-DRG 8433
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$19,700.58
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	$19,700.58
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$19,700.58
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$19,700.58
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$19,700.58

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$57,494.91

Service Code	APR-DRG 8412
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$57,494.91
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	$57,494.91
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$57,494.91
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$57,494.91
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$57,494.91

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$54,619.66

Service Code	APR-DRG 8411
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$54,619.66
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	$54,619.66
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$54,619.66
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$54,619.66
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$54,619.66

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$91,675.30

Service Code	APR-DRG 8413
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$91,675.30
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	$91,675.30
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$91,675.30
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$91,675.30
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$91,675.30

EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT

Facility

$244,340.20

Service Code	APR-DRG 8414
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$244,340.20
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	$244,340.20
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$244,340.20
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$244,340.20
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$244,340.20

External Ecg Rec>48hr<7d Review & Interpretation

Facility

$278.25

Service Code	CPT 93244
Hospital Charge Code	Px07319324401
Hospital Revenue Code	731
Min. Negotiated Rate	$158.60
Max. Negotiated Rate	$278.25
Rate for Payer: Aetna Commercial/Medicare Advantage	$196.17
Rate for Payer: Aetna Workers' Compensation	$196.17
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO)	$192.83
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO)	$192.83
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network	$219.26
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$219.26
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$219.26
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO)	$214.25
Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional	$219.26
Rate for Payer: Cash Price	$278.25
Rate for Payer: Cigna Commercial	$170.29
Rate for Payer: Cigna Medicare Advantage	$158.60
Rate for Payer: Harmony Health CHIP/Medicaid	$175.30
Rate for Payer: Home State Health Plan Exchange	$158.60
Rate for Payer: Humana Medicare	$208.69
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$208.69
Rate for Payer: Provider Network of America Commercial	$222.60
Rate for Payer: UnitedHealthcare Commercial	$183.65
Rate for Payer: UnitedHealthcare Individual Exchange	$278.25

External Ecg Rec>48hr<7d Review & Interpretation

Facility

$278.25

Service Code	CPT 93244
Hospital Charge Code	Px07319324401
Hospital Revenue Code	731
Min. Negotiated Rate	$208.69
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	$278.25
Rate for Payer: Cash Price	$278.25
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	$208.69
Rate for Payer: Provider Network of America Commercial	$222.60

External Ecg Rec>7d<15d Review & Interpretation

Facility

$412.65

Service Code	CPT 93248
Hospital Charge Code	Px07319324801
Hospital Revenue Code	731
Min. Negotiated Rate	$235.21
Max. Negotiated Rate	$412.65
Rate for Payer: Aetna Commercial/Medicare Advantage	$290.92
Rate for Payer: Aetna Workers' Compensation	$290.92
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO)	$285.97
Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO)	$285.97
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network	$325.17
Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select	$325.17
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care	$325.17
Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO)	$317.74
Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional	$325.17
Rate for Payer: Cash Price	$412.65
Rate for Payer: Cigna Commercial	$252.54
Rate for Payer: Cigna Medicare Advantage	$235.21
Rate for Payer: Harmony Health CHIP/Medicaid	$259.97
Rate for Payer: Home State Health Plan Exchange	$235.21
Rate for Payer: Humana Medicare	$309.49
Rate for Payer: Oscar Health EPO/HMO/POS/PPO	$309.49
Rate for Payer: Provider Network of America Commercial	$330.12
Rate for Payer: UnitedHealthcare Commercial	$272.35
Rate for Payer: UnitedHealthcare Individual Exchange	$412.65

External Ecg Rec>7d<15d Review & Interpretation

Facility

$412.65

Service Code	CPT 93248
Hospital Charge Code	Px07319324801
Hospital Revenue Code	731
Min. Negotiated Rate	$309.49
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	$412.65
Rate for Payer: Cash Price	$412.65
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	$309.49
Rate for Payer: Provider Network of America Commercial	$330.12

EXTERNAL HEART ASSIST DEVICES

Facility

$64,173.64

Service Code	APR-DRG 1783
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$64,173.64
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	$64,173.64
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$64,173.64
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$64,173.64
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$64,173.64

EXTERNAL HEART ASSIST DEVICES

Facility

$47,380.67

Service Code	APR-DRG 1781
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$47,380.67
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	$47,380.67
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$47,380.67
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$47,380.67
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$47,380.67

EXTERNAL HEART ASSIST DEVICES

Facility

$83,351.86

Service Code	APR-DRG 1784
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$83,351.86
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	$83,351.86
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$83,351.86
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$83,351.86
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$83,351.86

EXTERNAL HEART ASSIST DEVICES

Facility

$52,558.91

Service Code	APR-DRG 1782
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$52,558.91
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	$52,558.91
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$52,558.91
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$52,558.91
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$52,558.91

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$59,168.29

Service Code	APR-DRG 0092
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$59,168.29
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	$59,168.29
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$59,168.29
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$59,168.29
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$59,168.29

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$254,427.63

Service Code	APR-DRG 0094
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$254,427.63
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: Family Health Partners Medicaid	$254,427.63
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$254,427.63
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$254,427.63
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$254,427.63

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$142,950.05

Service Code	APR-DRG 0093
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$142,950.05
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	$142,950.05
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$142,950.05
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$142,950.05
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$142,950.05

EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO)

Facility

$56,209.83

Service Code	APR-DRG 0091
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$56,209.83
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	$56,209.83
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$56,209.83
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$56,209.83
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$56,209.83

EXTRACRANIAL PROCEDURES WITH CC

Facility

$7,626.22

Service Code	MSDRG 038
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$7,626.22
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	$7,626.22

EXTRACRANIAL PROCEDURES WITH MCC

Facility

$15,472.87

Service Code	MSDRG 037
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$15,472.87
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: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Humana Medicare	$15,472.87

EXTRACRANIAL PROCEDURES WITHOUT CC/MCC

Facility

$6,053.00

Service Code	MSDRG 039
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	$5,524.85

EXTRAOCULAR PROCEDURES EXCEPT ORBIT

Facility

$7,214.03

Service Code	MSDRG 115
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$7,214.03
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	$7,214.03

EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE

Facility

$27,934.45

Service Code	MSDRG 790
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$27,934.45
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	$27,934.45

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$22,625.75

Service Code	APR-DRG 0824
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$22,625.75
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	$22,625.75
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$22,625.75
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$22,625.75
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$22,625.75

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$8,526.84

Service Code	APR-DRG 0822
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$8,526.84
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	$8,526.84
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$8,526.84
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$8,526.84
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$8,526.84

EYE INFECTIONS AND OTHER EYE DISORDERS

Facility

$6,415.24

Service Code	APR-DRG 0821
Min. Negotiated Rate	$875.00
Max. Negotiated Rate	$6,415.24
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	$6,415.24
Rate for Payer: Harmony Health CHIP/Medicaid	$1,826.00
Rate for Payer: Healthy Blue Medicaid	$6,415.24
Rate for Payer: Home State Health Plan Exchange	$6,053.00
Rate for Payer: Home State Health Plan Medicaid	$6,415.24
Rate for Payer: Humana Medicare	$1,185.00
Rate for Payer: Mercy CarePlus Medicaid	$6,415.24

Know your out-of-pocket cost for care.

All Charges