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Service Code CPT 10060
Hospital Charge Code 8799068
Hospital Revenue Code 975
Min. Negotiated Rate $97.80
Max. Negotiated Rate $291.20
Rate for Payer: Aetna of IA Medicare $97.80
Rate for Payer: Amerigroup Medicaid $101.13
Rate for Payer: Cash Price $332.80
Rate for Payer: Cash Price $332.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $117.36
Rate for Payer: Iowa Total Care Managed Medicaid $99.76
Rate for Payer: Medical Associates Commercial $185.82
Rate for Payer: Medical Associates Managed Medicare $97.80
Rate for Payer: Midlands Choice Commercial $291.20
Rate for Payer: Partners Health Alliance Commercial $146.70
Rate for Payer: Wellmark IA HMO $200.00
Rate for Payer: Wellmark IA PPO $235.00
Service Code CPT 10061
Hospital Charge Code 8799069
Hospital Revenue Code 975
Min. Negotiated Rate $168.42
Max. Negotiated Rate $485.10
Rate for Payer: Aetna of IA Medicare $168.42
Rate for Payer: Amerigroup Medicaid $174.15
Rate for Payer: Cash Price $554.40
Rate for Payer: Cash Price $554.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $202.10
Rate for Payer: Iowa Total Care Managed Medicaid $171.79
Rate for Payer: Medical Associates Commercial $320.00
Rate for Payer: Medical Associates Managed Medicare $168.42
Rate for Payer: Midlands Choice Commercial $485.10
Rate for Payer: Partners Health Alliance Commercial $252.63
Rate for Payer: Wellmark IA HMO $348.00
Rate for Payer: Wellmark IA PPO $409.00
Service Code CPT 10061
Hospital Charge Code 8069020
Hospital Revenue Code 975
Min. Negotiated Rate $168.42
Max. Negotiated Rate $478.80
Rate for Payer: Aetna of IA Medicare $168.42
Rate for Payer: Amerigroup Medicaid $174.15
Rate for Payer: Cash Price $547.20
Rate for Payer: Cash Price $547.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $202.10
Rate for Payer: Iowa Total Care Managed Medicaid $171.79
Rate for Payer: Medical Associates Commercial $320.00
Rate for Payer: Medical Associates Managed Medicare $168.42
Rate for Payer: Midlands Choice Commercial $478.80
Rate for Payer: Partners Health Alliance Commercial $252.63
Rate for Payer: Wellmark IA HMO $348.00
Rate for Payer: Wellmark IA PPO $409.00
Service Code CPT 10080
Hospital Charge Code 8799070
Hospital Revenue Code 975
Min. Negotiated Rate $95.56
Max. Negotiated Rate $233.00
Rate for Payer: Aetna of IA Medicare $95.56
Rate for Payer: Amerigroup Medicaid $98.81
Rate for Payer: Cash Price $236.00
Rate for Payer: Cash Price $236.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $114.67
Rate for Payer: Iowa Total Care Managed Medicaid $97.47
Rate for Payer: Medical Associates Commercial $181.56
Rate for Payer: Medical Associates Managed Medicare $95.56
Rate for Payer: Midlands Choice Commercial $206.50
Rate for Payer: Partners Health Alliance Commercial $143.34
Rate for Payer: Wellmark IA HMO $199.00
Rate for Payer: Wellmark IA PPO $233.00
Service Code CPT 10120
Hospital Charge Code 8799071
Hospital Revenue Code 975
Min. Negotiated Rate $96.60
Max. Negotiated Rate $352.80
Rate for Payer: Aetna of IA Medicare $96.60
Rate for Payer: Amerigroup Medicaid $99.88
Rate for Payer: Cash Price $403.20
Rate for Payer: Cash Price $403.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $115.92
Rate for Payer: Iowa Total Care Managed Medicaid $98.53
Rate for Payer: Medical Associates Commercial $183.54
Rate for Payer: Medical Associates Managed Medicare $96.60
Rate for Payer: Midlands Choice Commercial $352.80
Rate for Payer: Partners Health Alliance Commercial $144.90
Rate for Payer: Wellmark IA HMO $200.00
Rate for Payer: Wellmark IA PPO $235.00
Service Code CPT 10121
Hospital Charge Code 8069115
Hospital Revenue Code 975
Min. Negotiated Rate $166.86
Max. Negotiated Rate $634.20
Rate for Payer: Aetna of IA Medicare $166.86
Rate for Payer: Amerigroup Medicaid $172.53
Rate for Payer: Cash Price $724.80
Rate for Payer: Cash Price $724.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $200.23
Rate for Payer: Iowa Total Care Managed Medicaid $170.20
Rate for Payer: Medical Associates Commercial $317.03
Rate for Payer: Medical Associates Managed Medicare $166.86
Rate for Payer: Midlands Choice Commercial $634.20
Rate for Payer: Partners Health Alliance Commercial $250.29
Rate for Payer: Wellmark IA HMO $327.00
Rate for Payer: Wellmark IA PPO $384.00
Service Code CPT 10140
Hospital Charge Code 8069092
Hospital Revenue Code 975
Min. Negotiated Rate $108.09
Max. Negotiated Rate $378.00
Rate for Payer: Aetna of IA Medicare $108.09
Rate for Payer: Amerigroup Medicaid $111.77
Rate for Payer: Cash Price $432.00
Rate for Payer: Cash Price $432.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $129.71
Rate for Payer: Iowa Total Care Managed Medicaid $110.25
Rate for Payer: Medical Associates Commercial $205.37
Rate for Payer: Medical Associates Managed Medicare $108.09
Rate for Payer: Midlands Choice Commercial $378.00
Rate for Payer: Partners Health Alliance Commercial $162.14
Rate for Payer: Wellmark IA HMO $224.00
Rate for Payer: Wellmark IA PPO $262.00
Service Code CPT 10180
Hospital Charge Code 8068952
Hospital Revenue Code 975
Min. Negotiated Rate $160.07
Max. Negotiated Rate $571.20
Rate for Payer: Aetna of IA Medicare $160.07
Rate for Payer: Amerigroup Medicaid $165.51
Rate for Payer: Cash Price $652.80
Rate for Payer: Cash Price $652.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $192.08
Rate for Payer: Iowa Total Care Managed Medicaid $163.27
Rate for Payer: Medical Associates Commercial $304.13
Rate for Payer: Medical Associates Managed Medicare $160.07
Rate for Payer: Midlands Choice Commercial $571.20
Rate for Payer: Partners Health Alliance Commercial $240.10
Rate for Payer: Wellmark IA HMO $340.00
Rate for Payer: Wellmark IA PPO $399.00
Service Code CPT C1713
Hospital Charge Code 8781515
Hospital Revenue Code 278
Min. Negotiated Rate $1,386.00
Max. Negotiated Rate $1,782.00
Rate for Payer: Aetna of IA Commercial $1,782.00
Rate for Payer: Aetna of IA Medical Rental Products $1,782.00
Rate for Payer: Cash Price $1,584.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1,485.00
Rate for Payer: Medical Associates Commercial $1,485.00
Rate for Payer: Midlands Choice Commercial $1,386.00
Rate for Payer: United Healthcare Commercial $1,782.00
Service Code CPT C1713
Hospital Charge Code 8781515
Hospital Revenue Code 278
Min. Negotiated Rate $989.60
Max. Negotiated Rate $1,782.00
Rate for Payer: Aetna of IA Commercial $1,782.00
Rate for Payer: Aetna of IA Medical Rental Products $1,782.00
Rate for Payer: Aetna of IA Medicare $1,128.60
Rate for Payer: Amerigroup Medicaid $999.31
Rate for Payer: Amerigroup Medicare $999.90
Rate for Payer: Cash Price $1,584.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1,485.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $990.00
Rate for Payer: Iowa Total Care Managed Medicaid $989.60
Rate for Payer: Medical Associates Commercial $1,485.00
Rate for Payer: Medical Associates Managed Medicare $990.00
Rate for Payer: Midlands Choice Commercial $1,386.00
Rate for Payer: Molina Healthcare Managed Medicaid $1,004.85
Rate for Payer: Partners Health Alliance Commercial $1,485.00
Rate for Payer: United Healthcare Commercial $1,782.00
Rate for Payer: United Healthcare Managed Medicare $1,168.20
Service Code CPT C1713
Hospital Charge Code 8895427
Hospital Revenue Code 278
Min. Negotiated Rate $1,732.50
Max. Negotiated Rate $2,227.50
Rate for Payer: Aetna of IA Commercial $2,227.50
Rate for Payer: Aetna of IA Medical Rental Products $2,227.50
Rate for Payer: Cash Price $1,980.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1,856.25
Rate for Payer: Medical Associates Commercial $1,856.25
Rate for Payer: Midlands Choice Commercial $1,732.50
Rate for Payer: United Healthcare Commercial $2,227.50
Service Code CPT C1713
Hospital Charge Code 8895427
Hospital Revenue Code 278
Min. Negotiated Rate $1,237.00
Max. Negotiated Rate $2,227.50
Rate for Payer: Aetna of IA Commercial $2,227.50
Rate for Payer: Aetna of IA Medical Rental Products $2,227.50
Rate for Payer: Aetna of IA Medicare $1,410.75
Rate for Payer: Amerigroup Medicaid $1,249.13
Rate for Payer: Amerigroup Medicare $1,249.88
Rate for Payer: Cash Price $1,980.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1,856.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $1,237.50
Rate for Payer: Iowa Total Care Managed Medicaid $1,237.00
Rate for Payer: Medical Associates Commercial $1,856.25
Rate for Payer: Medical Associates Managed Medicare $1,237.50
Rate for Payer: Midlands Choice Commercial $1,732.50
Rate for Payer: Molina Healthcare Managed Medicaid $1,256.06
Rate for Payer: Partners Health Alliance Commercial $1,856.25
Rate for Payer: United Healthcare Commercial $2,227.50
Rate for Payer: United Healthcare Managed Medicare $1,460.25
Service Code CPT 11008
Hospital Charge Code 8069116
Min. Negotiated Rate $237.43
Max. Negotiated Rate $651.00
Rate for Payer: Amerigroup Medicaid $245.50
Rate for Payer: Cash Price $744.00
Rate for Payer: Cash Price $744.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $284.92
Rate for Payer: Iowa Total Care Managed Medicaid $242.18
Rate for Payer: Medical Associates Commercial $451.12
Rate for Payer: Medical Associates Managed Medicare $237.43
Rate for Payer: Midlands Choice Commercial $651.00
Rate for Payer: Partners Health Alliance Commercial $356.14
Rate for Payer: Wellmark IA HMO $483.00
Rate for Payer: Wellmark IA PPO $567.00
Service Code CPT 11042
Hospital Charge Code 8799072
Hospital Revenue Code 975
Min. Negotiated Rate $55.05
Max. Negotiated Rate $291.20
Rate for Payer: Aetna of IA Medicare $55.05
Rate for Payer: Amerigroup Medicaid $56.92
Rate for Payer: Cash Price $332.80
Rate for Payer: Cash Price $332.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $66.06
Rate for Payer: Iowa Total Care Managed Medicaid $56.15
Rate for Payer: Medical Associates Commercial $104.60
Rate for Payer: Medical Associates Managed Medicare $55.05
Rate for Payer: Midlands Choice Commercial $291.20
Rate for Payer: Partners Health Alliance Commercial $82.58
Rate for Payer: Wellmark IA HMO $113.00
Rate for Payer: Wellmark IA PPO $132.00
Service Code CPT 11043
Hospital Charge Code 8799073
Hospital Revenue Code 975
Min. Negotiated Rate $138.64
Max. Negotiated Rate $539.70
Rate for Payer: Aetna of IA Medicare $138.64
Rate for Payer: Amerigroup Medicaid $143.35
Rate for Payer: Cash Price $616.80
Rate for Payer: Cash Price $616.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $166.37
Rate for Payer: Iowa Total Care Managed Medicaid $141.41
Rate for Payer: Medical Associates Commercial $263.42
Rate for Payer: Medical Associates Managed Medicare $138.64
Rate for Payer: Midlands Choice Commercial $539.70
Rate for Payer: Partners Health Alliance Commercial $207.96
Rate for Payer: Wellmark IA HMO $290.00
Rate for Payer: Wellmark IA PPO $340.00
Service Code CPT 11044
Hospital Charge Code 8799226
Hospital Revenue Code 975
Min. Negotiated Rate $202.72
Max. Negotiated Rate $728.70
Rate for Payer: Aetna of IA Medicare $202.72
Rate for Payer: Amerigroup Medicaid $209.61
Rate for Payer: Cash Price $832.80
Rate for Payer: Cash Price $832.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $243.26
Rate for Payer: Iowa Total Care Managed Medicaid $206.77
Rate for Payer: Medical Associates Commercial $385.17
Rate for Payer: Medical Associates Managed Medicare $202.72
Rate for Payer: Midlands Choice Commercial $728.70
Rate for Payer: Partners Health Alliance Commercial $304.08
Rate for Payer: Wellmark IA HMO $425.00
Rate for Payer: Wellmark IA PPO $499.00
Service Code CPT 11045
Hospital Charge Code 8799074
Hospital Revenue Code 975
Min. Negotiated Rate $22.65
Max. Negotiated Rate $96.60
Rate for Payer: Aetna of IA Medicare $22.65
Rate for Payer: Amerigroup Medicaid $23.42
Rate for Payer: Cash Price $110.40
Rate for Payer: Cash Price $110.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $27.18
Rate for Payer: Iowa Total Care Managed Medicaid $23.10
Rate for Payer: Medical Associates Commercial $43.04
Rate for Payer: Medical Associates Managed Medicare $22.65
Rate for Payer: Midlands Choice Commercial $96.60
Rate for Payer: Partners Health Alliance Commercial $33.98
Rate for Payer: Wellmark IA HMO $48.00
Rate for Payer: Wellmark IA PPO $56.00
Service Code CPT 11046
Hospital Charge Code 8799075
Hospital Revenue Code 975
Min. Negotiated Rate $48.83
Max. Negotiated Rate $172.20
Rate for Payer: Aetna of IA Medicare $48.83
Rate for Payer: Amerigroup Medicaid $50.49
Rate for Payer: Cash Price $196.80
Rate for Payer: Cash Price $196.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $58.60
Rate for Payer: Iowa Total Care Managed Medicaid $49.81
Rate for Payer: Medical Associates Commercial $92.78
Rate for Payer: Medical Associates Managed Medicare $48.83
Rate for Payer: Midlands Choice Commercial $172.20
Rate for Payer: Partners Health Alliance Commercial $73.24
Rate for Payer: Wellmark IA HMO $103.00
Rate for Payer: Wellmark IA PPO $121.00
Service Code CPT 11055
Hospital Charge Code 8799076
Hospital Revenue Code 975
Min. Negotiated Rate $14.30
Max. Negotiated Rate $144.90
Rate for Payer: Aetna of IA Medicare $14.30
Rate for Payer: Amerigroup Medicaid $14.79
Rate for Payer: Cash Price $165.60
Rate for Payer: Cash Price $165.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $17.16
Rate for Payer: Iowa Total Care Managed Medicaid $14.59
Rate for Payer: Medical Associates Commercial $27.17
Rate for Payer: Medical Associates Managed Medicare $14.30
Rate for Payer: Midlands Choice Commercial $144.90
Rate for Payer: Partners Health Alliance Commercial $21.45
Rate for Payer: Wellmark IA HMO $30.00
Rate for Payer: Wellmark IA PPO $35.00
Service Code CPT 11200
Hospital Charge Code 8799077
Hospital Revenue Code 975
Min. Negotiated Rate $70.05
Max. Negotiated Rate $170.00
Rate for Payer: Aetna of IA Medicare $70.05
Rate for Payer: Amerigroup Medicaid $72.43
Rate for Payer: Cash Price $187.20
Rate for Payer: Cash Price $187.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $84.06
Rate for Payer: Iowa Total Care Managed Medicaid $71.45
Rate for Payer: Medical Associates Commercial $133.10
Rate for Payer: Medical Associates Managed Medicare $70.05
Rate for Payer: Midlands Choice Commercial $163.80
Rate for Payer: Partners Health Alliance Commercial $105.08
Rate for Payer: Wellmark IA HMO $145.00
Rate for Payer: Wellmark IA PPO $170.00
Service Code CPT 11300
Hospital Charge Code 8799078
Hospital Revenue Code 975
Min. Negotiated Rate $30.86
Max. Negotiated Rate $226.10
Rate for Payer: Aetna of IA Medicare $30.86
Rate for Payer: Amerigroup Medicaid $31.91
Rate for Payer: Cash Price $258.40
Rate for Payer: Cash Price $258.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $37.03
Rate for Payer: Iowa Total Care Managed Medicaid $31.48
Rate for Payer: Medical Associates Commercial $58.63
Rate for Payer: Medical Associates Managed Medicare $30.86
Rate for Payer: Midlands Choice Commercial $226.10
Rate for Payer: Partners Health Alliance Commercial $46.29
Rate for Payer: Wellmark IA HMO $64.00
Rate for Payer: Wellmark IA PPO $76.00
Service Code CPT 11301
Hospital Charge Code 8799079
Hospital Revenue Code 975
Min. Negotiated Rate $46.51
Max. Negotiated Rate $281.40
Rate for Payer: Aetna of IA Medicare $46.51
Rate for Payer: Amerigroup Medicaid $48.09
Rate for Payer: Cash Price $321.60
Rate for Payer: Cash Price $321.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $55.81
Rate for Payer: Iowa Total Care Managed Medicaid $47.44
Rate for Payer: Medical Associates Commercial $88.37
Rate for Payer: Medical Associates Managed Medicare $46.51
Rate for Payer: Midlands Choice Commercial $281.40
Rate for Payer: Partners Health Alliance Commercial $69.76
Rate for Payer: Wellmark IA HMO $97.00
Rate for Payer: Wellmark IA PPO $114.00
Service Code CPT 11400
Hospital Charge Code 8799081
Hospital Revenue Code 975
Min. Negotiated Rate $77.01
Max. Negotiated Rate $292.60
Rate for Payer: Aetna of IA Medicare $77.01
Rate for Payer: Amerigroup Medicaid $79.63
Rate for Payer: Cash Price $334.40
Rate for Payer: Cash Price $334.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $92.41
Rate for Payer: Iowa Total Care Managed Medicaid $78.55
Rate for Payer: Medical Associates Commercial $146.32
Rate for Payer: Medical Associates Managed Medicare $77.01
Rate for Payer: Midlands Choice Commercial $292.60
Rate for Payer: Partners Health Alliance Commercial $115.52
Rate for Payer: Wellmark IA HMO $150.00
Rate for Payer: Wellmark IA PPO $176.00
Service Code CPT 11401
Hospital Charge Code 8799082
Hospital Revenue Code 975
Min. Negotiated Rate $96.62
Max. Negotiated Rate $351.40
Rate for Payer: Aetna of IA Medicare $96.62
Rate for Payer: Amerigroup Medicaid $99.91
Rate for Payer: Cash Price $401.60
Rate for Payer: Cash Price $401.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $115.94
Rate for Payer: Iowa Total Care Managed Medicaid $98.55
Rate for Payer: Medical Associates Commercial $183.58
Rate for Payer: Medical Associates Managed Medicare $96.62
Rate for Payer: Midlands Choice Commercial $351.40
Rate for Payer: Partners Health Alliance Commercial $144.93
Rate for Payer: Wellmark IA HMO $190.00
Rate for Payer: Wellmark IA PPO $223.00
Service Code CPT 11402
Hospital Charge Code 8799083
Hospital Revenue Code 975
Min. Negotiated Rate $105.63
Max. Negotiated Rate $388.50
Rate for Payer: Aetna of IA Medicare $105.63
Rate for Payer: Amerigroup Medicaid $109.22
Rate for Payer: Cash Price $444.00
Rate for Payer: Cash Price $444.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $126.76
Rate for Payer: Iowa Total Care Managed Medicaid $107.74
Rate for Payer: Medical Associates Commercial $200.70
Rate for Payer: Medical Associates Managed Medicare $105.63
Rate for Payer: Midlands Choice Commercial $388.50
Rate for Payer: Partners Health Alliance Commercial $158.44
Rate for Payer: Wellmark IA HMO $206.00
Rate for Payer: Wellmark IA PPO $242.00