|
HC Acetylcholine Recept Arup
|
Facility
|
OP
|
$202.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
Px03018351624
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.94 |
| Max. Negotiated Rate |
$162.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$142.87
|
| Rate for Payer: Aetna Workers' Compensation |
$142.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$156.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$159.69
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cigna Commercial |
$106.19
|
| Rate for Payer: Cigna Medicare Advantage |
$115.51
|
| Rate for Payer: Family Health Partners Medicaid |
$14.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$127.67
|
| Rate for Payer: Healthy Blue Medicaid |
$15.69
|
| Rate for Payer: Home State Health Plan Exchange |
$115.51
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.53
|
| Rate for Payer: Humana Medicare |
$151.99
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$133.75
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.94
|
|
|
HC Acne Surgery
|
Facility
|
IP
|
$418.95
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
Px07611004001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$314.21 |
| 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 |
$418.95
|
| Rate for Payer: Cash Price |
$418.95
|
| 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 |
$314.21
|
| Rate for Payer: Provider Network of America Commercial |
$335.16
|
|
|
HC Acne Surgery
|
Facility
|
OP
|
$418.95
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
Px07611004001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$190.63 |
| Max. Negotiated Rate |
$418.95 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$295.36
|
| Rate for Payer: Aetna Workers' Compensation |
$295.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$290.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$290.33
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$330.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$330.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$330.13
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$322.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$330.13
|
| Rate for Payer: Cash Price |
$418.95
|
| Rate for Payer: Cash Price |
$418.95
|
| Rate for Payer: Cigna Commercial |
$256.40
|
| Rate for Payer: Cigna Medicare Advantage |
$238.80
|
| Rate for Payer: Family Health Partners Medicaid |
$253.20
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$263.94
|
| Rate for Payer: Healthy Blue Medicaid |
$273.46
|
| Rate for Payer: Home State Health Plan Exchange |
$238.80
|
| Rate for Payer: Home State Health Plan Medicaid |
$253.20
|
| Rate for Payer: Humana Medicare |
$314.21
|
| Rate for Payer: Mercy CarePlus Medicaid |
$253.20
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$314.21
|
| Rate for Payer: Provider Network of America Commercial |
$335.16
|
| Rate for Payer: UnitedHealthcare Commercial |
$276.51
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$418.95
|
| Rate for Payer: UnitedHealthcare Medicaid |
$190.63
|
|
|
HC Actin Antibody Icg - Ref Lab
|
Facility
|
IP
|
$202.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
Px03018351625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$151.99 |
| 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 |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| 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 |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
|
|
HC Actin Antibody Icg - Ref Lab
|
Facility
|
OP
|
$202.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
Px03018351625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.94 |
| Max. Negotiated Rate |
$162.12 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$142.87
|
| Rate for Payer: Aetna Workers' Compensation |
$142.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$140.44
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$159.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$156.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$159.69
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cash Price |
$202.65
|
| Rate for Payer: Cigna Commercial |
$106.19
|
| Rate for Payer: Cigna Medicare Advantage |
$115.51
|
| Rate for Payer: Family Health Partners Medicaid |
$14.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$127.67
|
| Rate for Payer: Healthy Blue Medicaid |
$15.69
|
| Rate for Payer: Home State Health Plan Exchange |
$115.51
|
| Rate for Payer: Home State Health Plan Medicaid |
$14.53
|
| Rate for Payer: Humana Medicare |
$151.99
|
| Rate for Payer: Mercy CarePlus Medicaid |
$14.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$151.99
|
| Rate for Payer: Provider Network of America Commercial |
$162.12
|
| Rate for Payer: UnitedHealthcare Commercial |
$133.75
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$11.53
|
| Rate for Payer: UnitedHealthcare Medicaid |
$10.94
|
|
|
HC Actin Smooth Muscle Antibody Each
|
Facility
|
IP
|
$110.25
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
Px03028601501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$82.69 |
| 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 |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| 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 |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
|
|
HC Actin Smooth Muscle Antibody Each
|
Facility
|
OP
|
$110.25
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
Px03028601501
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$77.73
|
| Rate for Payer: Aetna Workers' Compensation |
$77.73
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$76.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$86.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$84.89
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$86.88
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cash Price |
$110.25
|
| Rate for Payer: Cigna Commercial |
$57.77
|
| Rate for Payer: Cigna Medicare Advantage |
$62.84
|
| Rate for Payer: Family Health Partners Medicaid |
$15.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$69.46
|
| Rate for Payer: Healthy Blue Medicaid |
$16.41
|
| Rate for Payer: Home State Health Plan Exchange |
$62.84
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.19
|
| Rate for Payer: Humana Medicare |
$82.69
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.19
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$82.69
|
| Rate for Payer: Provider Network of America Commercial |
$88.20
|
| Rate for Payer: UnitedHealthcare Commercial |
$72.77
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.44
|
|
|
HC Actin Smooth Muscle Antibody Each - Liver Panel
|
Facility
|
IP
|
$124.95
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
Px03028601502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$93.71 |
| 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 |
$124.95
|
| Rate for Payer: Cash Price |
$124.95
|
| 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 |
$93.71
|
| Rate for Payer: Provider Network of America Commercial |
$99.96
|
|
|
HC Actin Smooth Muscle Antibody Each - Liver Panel
|
Facility
|
OP
|
$124.95
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
Px03028601502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$99.96 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$88.09
|
| Rate for Payer: Aetna Workers' Compensation |
$88.09
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$86.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$86.59
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$98.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$98.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$98.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$96.21
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$98.46
|
| Rate for Payer: Cash Price |
$124.95
|
| Rate for Payer: Cash Price |
$124.95
|
| Rate for Payer: Cigna Commercial |
$65.47
|
| Rate for Payer: Cigna Medicare Advantage |
$71.22
|
| Rate for Payer: Family Health Partners Medicaid |
$15.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$78.72
|
| Rate for Payer: Healthy Blue Medicaid |
$16.41
|
| Rate for Payer: Home State Health Plan Exchange |
$71.22
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.19
|
| Rate for Payer: Humana Medicare |
$93.71
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.19
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$93.71
|
| Rate for Payer: Provider Network of America Commercial |
$99.96
|
| Rate for Payer: UnitedHealthcare Commercial |
$82.47
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.44
|
|
|
HC Acute GI Blood Loss Imaging - NM Gastrointestinal Bleeding
|
Facility
|
OP
|
$931.35
|
|
|
Service Code
|
CPT 78278
|
| Hospital Charge Code |
Px03417827801
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$379.84 |
| Max. Negotiated Rate |
$931.35 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$656.60
|
| Rate for Payer: Aetna Workers' Compensation |
$656.60
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$645.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$645.43
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$733.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$733.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$733.90
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$717.14
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$733.90
|
| Rate for Payer: Cash Price |
$931.35
|
| Rate for Payer: Cash Price |
$931.35
|
| Rate for Payer: Cigna Commercial |
$569.99
|
| Rate for Payer: Cigna Medicare Advantage |
$530.87
|
| Rate for Payer: Family Health Partners Medicaid |
$504.53
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$586.75
|
| Rate for Payer: Healthy Blue Medicaid |
$544.89
|
| Rate for Payer: Home State Health Plan Exchange |
$530.87
|
| Rate for Payer: Home State Health Plan Medicaid |
$504.53
|
| Rate for Payer: Humana Medicare |
$698.51
|
| Rate for Payer: Mercy CarePlus Medicaid |
$504.53
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$698.51
|
| Rate for Payer: Provider Network of America Commercial |
$745.08
|
| Rate for Payer: UnitedHealthcare Commercial |
$614.69
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$931.35
|
| Rate for Payer: UnitedHealthcare Medicaid |
$379.84
|
|
|
HC Acute GI Blood Loss Imaging - NM Gastrointestinal Bleeding
|
Facility
|
IP
|
$931.35
|
|
|
Service Code
|
CPT 78278
|
| Hospital Charge Code |
Px03417827801
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$698.51 |
| 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 |
$931.35
|
| Rate for Payer: Cash Price |
$931.35
|
| 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 |
$698.51
|
| Rate for Payer: Provider Network of America Commercial |
$745.08
|
|
|
HC Adapter Clave Male W/Ll
|
Facility
|
IP
|
$3.41
|
|
| Hospital Charge Code |
Px02700002679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.56 |
| 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 |
$3.41
|
| Rate for Payer: Cash Price |
$3.25
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cash Price |
$3.25
|
| 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 |
$2.56
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.44
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
| Rate for Payer: Provider Network of America Commercial |
$2.60
|
|
|
HC Adapter Clave Male W/Ll
|
Facility
|
OP
|
$3.41
|
|
| Hospital Charge Code |
Px02700002679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$3.41 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2.40
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2.29
|
| Rate for Payer: Aetna Workers' Compensation |
$2.29
|
| Rate for Payer: Aetna Workers' Compensation |
$2.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2.25
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2.36
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2.69
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2.63
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2.50
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2.56
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2.69
|
| Rate for Payer: Cash Price |
$3.41
|
| Rate for Payer: Cash Price |
$3.25
|
| Rate for Payer: Cigna Commercial |
$1.99
|
| Rate for Payer: Cigna Commercial |
$2.09
|
| Rate for Payer: Cigna Medicare Advantage |
$1.94
|
| Rate for Payer: Cigna Medicare Advantage |
$1.85
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2.15
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2.05
|
| Rate for Payer: Home State Health Plan Exchange |
$1.85
|
| Rate for Payer: Home State Health Plan Exchange |
$1.94
|
| Rate for Payer: Humana Medicare |
$2.56
|
| Rate for Payer: Humana Medicare |
$2.44
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.44
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2.56
|
| Rate for Payer: Provider Network of America Commercial |
$2.73
|
| Rate for Payer: Provider Network of America Commercial |
$2.60
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.15
|
| Rate for Payer: UnitedHealthcare Commercial |
$2.25
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.25
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3.41
|
|
|
HC Adenovirus Dna Qn
|
Facility
|
OP
|
$373.80
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
Px03008779901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$40.64 |
| Max. Negotiated Rate |
$299.04 |
| Rate for Payer: Cigna Medicare Advantage |
$213.07
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$263.53
|
| Rate for Payer: Aetna Workers' Compensation |
$263.53
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$259.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$259.04
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$294.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$294.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$294.55
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$287.83
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$294.55
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Cash Price |
$373.80
|
| Rate for Payer: Cigna Commercial |
$195.87
|
| Rate for Payer: Family Health Partners Medicaid |
$53.98
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$235.49
|
| Rate for Payer: Healthy Blue Medicaid |
$58.30
|
| Rate for Payer: Home State Health Plan Exchange |
$213.07
|
| Rate for Payer: Home State Health Plan Medicaid |
$53.98
|
| Rate for Payer: Humana Medicare |
$280.35
|
| Rate for Payer: Mercy CarePlus Medicaid |
$53.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$280.35
|
| Rate for Payer: Provider Network of America Commercial |
$299.04
|
| Rate for Payer: UnitedHealthcare Commercial |
$246.71
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$42.84
|
| Rate for Payer: UnitedHealthcare Medicaid |
$40.64
|
|
|
HC Adenovirus Dna Qn
|
Facility
|
IP
|
$373.80
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
Px03008779901
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$280.35 |
| 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 |
$373.80
|
| Rate for Payer: Cash Price |
$373.80
|
| 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 |
$280.35
|
| Rate for Payer: Provider Network of America Commercial |
$299.04
|
|
|
HC Adh Copeptin Ref Lab
|
Facility
|
IP
|
$359.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
Px03028625511
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$269.32 |
| 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 |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| 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 |
$269.32
|
| Rate for Payer: Provider Network of America Commercial |
$287.28
|
|
|
HC Adh Copeptin Ref Lab
|
Facility
|
OP
|
$359.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
Px03028625511
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$287.28 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$253.17
|
| Rate for Payer: Aetna Workers' Compensation |
$253.17
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$248.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$248.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$282.97
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$282.97
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$282.97
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$276.51
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$282.97
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cash Price |
$359.10
|
| Rate for Payer: Cigna Commercial |
$188.17
|
| Rate for Payer: Cigna Medicare Advantage |
$204.69
|
| Rate for Payer: Family Health Partners Medicaid |
$15.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$226.23
|
| Rate for Payer: Healthy Blue Medicaid |
$16.41
|
| Rate for Payer: Home State Health Plan Exchange |
$204.69
|
| Rate for Payer: Home State Health Plan Medicaid |
$15.19
|
| Rate for Payer: Humana Medicare |
$269.32
|
| Rate for Payer: Mercy CarePlus Medicaid |
$15.19
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$269.32
|
| Rate for Payer: Provider Network of America Commercial |
$287.28
|
| Rate for Payer: UnitedHealthcare Commercial |
$237.01
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$12.05
|
| Rate for Payer: UnitedHealthcare Medicaid |
$11.44
|
|
|
HC Adjt Tis Trnsfr/Reargmt Scalp/Arm/Leg 10 Sq Cm/<
|
Facility
|
OP
|
$3,994.64
|
|
|
Service Code
|
CPT 14040
|
| Hospital Charge Code |
Px07611404001
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,960.38 |
| Max. Negotiated Rate |
$3,994.64 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2,816.22
|
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$2,682.12
|
| Rate for Payer: Aetna Workers' Compensation |
$2,816.22
|
| Rate for Payer: Aetna Workers' Compensation |
$2,682.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,768.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$2,636.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,768.29
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$2,636.46
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$2,997.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$2,997.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$2,997.88
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$2,929.40
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$3,075.87
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$3,147.78
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$2,997.88
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cash Price |
$3,804.42
|
| Rate for Payer: Cash Price |
$3,804.42
|
| Rate for Payer: Cigna Commercial |
$2,444.72
|
| Rate for Payer: Cigna Commercial |
$2,328.31
|
| Rate for Payer: Cigna Medicare Advantage |
$2,168.52
|
| Rate for Payer: Cigna Medicare Advantage |
$2,276.94
|
| Rate for Payer: Family Health Partners Medicaid |
$2,603.92
|
| Rate for Payer: Family Health Partners Medicaid |
$2,603.92
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,516.62
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$2,396.78
|
| Rate for Payer: Healthy Blue Medicaid |
$2,812.23
|
| Rate for Payer: Healthy Blue Medicaid |
$2,812.23
|
| Rate for Payer: Home State Health Plan Exchange |
$2,276.94
|
| Rate for Payer: Home State Health Plan Exchange |
$2,168.52
|
| Rate for Payer: Home State Health Plan Medicaid |
$2,603.92
|
| Rate for Payer: Home State Health Plan Medicaid |
$2,603.92
|
| Rate for Payer: Humana Medicare |
$2,853.32
|
| Rate for Payer: Humana Medicare |
$2,995.98
|
| Rate for Payer: Mercy CarePlus Medicaid |
$2,603.92
|
| Rate for Payer: Mercy CarePlus Medicaid |
$2,603.92
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,853.32
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,995.98
|
| Rate for Payer: Provider Network of America Commercial |
$3,043.54
|
| Rate for Payer: Provider Network of America Commercial |
$3,195.71
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,510.92
|
| Rate for Payer: UnitedHealthcare Commercial |
$2,636.46
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,804.42
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$3,994.64
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,960.38
|
| Rate for Payer: UnitedHealthcare Medicaid |
$1,960.38
|
|
|
HC Adjt Tis Trnsfr/Reargmt Scalp/Arm/Leg 10 Sq Cm/<
|
Facility
|
IP
|
$3,994.64
|
|
|
Service Code
|
CPT 14040
|
| Hospital Charge Code |
Px07611404001
|
|
Hospital Revenue Code
|
761
|
| 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 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 |
$3,804.42
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cash Price |
$3,994.64
|
| Rate for Payer: Cash Price |
$3,804.42
|
| 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 |
$2,995.98
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$2,853.32
|
| Rate for Payer: Provider Network of America Commercial |
$3,195.71
|
| Rate for Payer: Provider Network of America Commercial |
$3,043.54
|
|
|
HC Admin Influenza Virus Vac
|
Facility
|
IP
|
$93.32
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
Px0771G000801
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$69.99 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$93.32
|
| Rate for Payer: Cash Price |
$93.32
|
| 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 |
$69.99
|
| Rate for Payer: Provider Network of America Commercial |
$74.66
|
|
|
HC Admin Influenza Virus Vac
|
Facility
|
OP
|
$93.32
|
|
|
Service Code
|
CPT G0008
|
| Hospital Charge Code |
Px0771G000801
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$74.66 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.79
|
| Rate for Payer: Aetna Workers' Compensation |
$65.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.54
|
| Rate for Payer: Cash Price |
$93.32
|
| Rate for Payer: Cash Price |
$93.32
|
| Rate for Payer: Cigna Commercial |
$57.11
|
| Rate for Payer: Cigna Medicare Advantage |
$53.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.79
|
| Rate for Payer: Home State Health Plan Exchange |
$53.19
|
| Rate for Payer: Humana Medicare |
$69.99
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$69.99
|
| Rate for Payer: Provider Network of America Commercial |
$74.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.59
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$46.90
|
|
|
HC Admin Pneumococcal Vaccine
|
Facility
|
IP
|
$93.32
|
|
|
Service Code
|
CPT G0009
|
| Hospital Charge Code |
Px0771G000901
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$69.99 |
| Max. Negotiated Rate |
$6,053.00 |
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$875.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$900.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$950.00
|
| Rate for Payer: Cash Price |
$93.32
|
| Rate for Payer: Cash Price |
$93.32
|
| 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 |
$69.99
|
| Rate for Payer: Provider Network of America Commercial |
$74.66
|
|
|
HC Admin Pneumococcal Vaccine
|
Facility
|
OP
|
$93.32
|
|
|
Service Code
|
CPT G0009
|
| Hospital Charge Code |
Px0771G000901
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$46.90 |
| Max. Negotiated Rate |
$74.66 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$65.79
|
| Rate for Payer: Aetna Workers' Compensation |
$65.79
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$64.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$64.67
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$73.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$73.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$73.54
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$71.86
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$73.54
|
| Rate for Payer: Cash Price |
$93.32
|
| Rate for Payer: Cash Price |
$93.32
|
| Rate for Payer: Cigna Commercial |
$57.11
|
| Rate for Payer: Cigna Medicare Advantage |
$53.19
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$58.79
|
| Rate for Payer: Home State Health Plan Exchange |
$53.19
|
| Rate for Payer: Humana Medicare |
$69.99
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$69.99
|
| Rate for Payer: Provider Network of America Commercial |
$74.66
|
| Rate for Payer: UnitedHealthcare Commercial |
$61.59
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$46.90
|
|
|
HC Adrenocorticotropic Hormone Acth
|
Facility
|
IP
|
$323.40
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
Px03018202402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$242.55 |
| 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 |
$323.40
|
| Rate for Payer: Cash Price |
$323.40
|
| 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 |
$242.55
|
| Rate for Payer: Provider Network of America Commercial |
$258.72
|
|
|
HC Adrenocorticotropic Hormone Acth
|
Facility
|
OP
|
$323.40
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
Px03018202402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.64 |
| Max. Negotiated Rate |
$258.72 |
| Rate for Payer: Aetna Commercial/Medicare Advantage |
$228.00
|
| Rate for Payer: Aetna Workers' Compensation |
$228.00
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Advantage (HMO) |
$224.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Blue Care (HMO) |
$224.12
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network |
$254.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Freedom Network Select |
$254.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care |
$254.84
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Preferred Care Blue Risk (PPO) |
$249.02
|
| Rate for Payer: Blue Cross Blue Shield of Kansas City Traditional |
$254.84
|
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cash Price |
$323.40
|
| Rate for Payer: Cigna Commercial |
$169.46
|
| Rate for Payer: Cigna Medicare Advantage |
$184.34
|
| Rate for Payer: Family Health Partners Medicaid |
$48.66
|
| Rate for Payer: Harmony Health CHIP/Medicaid |
$203.74
|
| Rate for Payer: Healthy Blue Medicaid |
$52.56
|
| Rate for Payer: Home State Health Plan Exchange |
$184.34
|
| Rate for Payer: Home State Health Plan Medicaid |
$48.66
|
| Rate for Payer: Humana Medicare |
$242.55
|
| Rate for Payer: Mercy CarePlus Medicaid |
$48.66
|
| Rate for Payer: Oscar Health EPO/HMO/POS/PPO |
$242.55
|
| Rate for Payer: Provider Network of America Commercial |
$258.72
|
| Rate for Payer: UnitedHealthcare Commercial |
$213.44
|
| Rate for Payer: UnitedHealthcare Individual Exchange |
$38.62
|
| Rate for Payer: UnitedHealthcare Medicaid |
$36.64
|
|
