|
44139 TAKE DOWN SPLENIC FLEXURE
|
Professional
|
$412.00
|
|
|
Service Code
|
CPT 44139
|
| Hospital Charge Code |
8069063
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$105.31 |
| Max. Negotiated Rate |
$288.40 |
| Rate for Payer: Aetna of IA Medicare |
$105.31
|
| Rate for Payer: Amerigroup Medicaid |
$108.89
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$126.37
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$107.42
|
| Rate for Payer: Medical Associates Commercial |
$200.09
|
| Rate for Payer: Medical Associates Managed Medicare |
$105.31
|
| Rate for Payer: Midlands Choice Commercial |
$288.40
|
| Rate for Payer: Partners Health Alliance Commercial |
$157.96
|
| Rate for Payer: Wellmark IA HMO |
$227.00
|
| Rate for Payer: Wellmark IA PPO |
$266.00
|
|
|
44140 COLECTOMY PARTIAL W/ANATOMOSIS
|
Professional
|
$4,535.00
|
|
|
Service Code
|
CPT 44140
|
| Hospital Charge Code |
8068961
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,185.67 |
| Max. Negotiated Rate |
$3,174.50 |
| Rate for Payer: Aetna of IA Medicare |
$1,185.67
|
| Rate for Payer: Amerigroup Medicaid |
$1,225.98
|
| Rate for Payer: Cash Price |
$3,628.00
|
| Rate for Payer: Cash Price |
$3,628.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,422.80
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,209.38
|
| Rate for Payer: Medical Associates Commercial |
$2,252.77
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,185.67
|
| Rate for Payer: Midlands Choice Commercial |
$3,174.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,778.50
|
| Rate for Payer: Wellmark IA HMO |
$2,546.00
|
| Rate for Payer: Wellmark IA PPO |
$2,988.00
|
|
|
44143 COLECTOMY PARTAL HARTMANNS PRC
|
Professional
|
$5,630.00
|
|
|
Service Code
|
CPT 44143
|
| Hospital Charge Code |
8069109
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,456.41 |
| Max. Negotiated Rate |
$3,941.00 |
| Rate for Payer: Aetna of IA Medicare |
$1,456.41
|
| Rate for Payer: Amerigroup Medicaid |
$1,505.93
|
| Rate for Payer: Cash Price |
$4,504.00
|
| Rate for Payer: Cash Price |
$4,504.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,747.69
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,485.54
|
| Rate for Payer: Medical Associates Commercial |
$2,767.18
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,456.41
|
| Rate for Payer: Midlands Choice Commercial |
$3,941.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$2,184.62
|
| Rate for Payer: Wellmark IA HMO |
$3,135.00
|
| Rate for Payer: Wellmark IA PPO |
$3,680.00
|
|
|
44146 LOW ANTERIOR RESECTION
|
Professional
|
$7,177.00
|
|
|
Service Code
|
CPT 44146
|
| Hospital Charge Code |
8069142
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,855.40 |
| Max. Negotiated Rate |
$5,023.90 |
| Rate for Payer: Aetna of IA Medicare |
$1,855.40
|
| Rate for Payer: Amerigroup Medicaid |
$1,918.48
|
| Rate for Payer: Cash Price |
$5,741.60
|
| Rate for Payer: Cash Price |
$5,741.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,226.48
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,892.51
|
| Rate for Payer: Medical Associates Commercial |
$3,525.26
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,855.40
|
| Rate for Payer: Midlands Choice Commercial |
$5,023.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$2,783.10
|
| Rate for Payer: Wellmark IA HMO |
$3,968.00
|
| Rate for Payer: Wellmark IA PPO |
$4,657.00
|
|
|
44210 COLECTOMY
|
Professional
|
$6,026.00
|
|
|
Service Code
|
CPT 44210
|
| Hospital Charge Code |
8069042
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,577.74 |
| Max. Negotiated Rate |
$4,218.20 |
| Rate for Payer: Aetna of IA Medicare |
$1,577.74
|
| Rate for Payer: Amerigroup Medicaid |
$1,631.38
|
| Rate for Payer: Cash Price |
$4,820.80
|
| Rate for Payer: Cash Price |
$4,820.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,893.29
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,609.29
|
| Rate for Payer: Medical Associates Commercial |
$2,997.71
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,577.74
|
| Rate for Payer: Midlands Choice Commercial |
$4,218.20
|
| Rate for Payer: Partners Health Alliance Commercial |
$2,366.61
|
| Rate for Payer: Wellmark IA HMO |
$3,343.00
|
| Rate for Payer: Wellmark IA PPO |
$3,924.00
|
|
|
44310 Ileostomy or jejunostomy non-tube
|
Professional
|
$3,530.00
|
|
|
Service Code
|
CPT 44310
|
| Hospital Charge Code |
8799176
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$922.97 |
| Max. Negotiated Rate |
$2,471.00 |
| Rate for Payer: Aetna of IA Medicare |
$922.97
|
| Rate for Payer: Amerigroup Medicaid |
$954.35
|
| Rate for Payer: Cash Price |
$2,824.00
|
| Rate for Payer: Cash Price |
$2,824.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,107.56
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$941.43
|
| Rate for Payer: Medical Associates Commercial |
$1,753.64
|
| Rate for Payer: Medical Associates Managed Medicare |
$922.97
|
| Rate for Payer: Midlands Choice Commercial |
$2,471.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,384.46
|
| Rate for Payer: Wellmark IA HMO |
$1,972.00
|
| Rate for Payer: Wellmark IA PPO |
$2,314.00
|
|
|
44320 COLOSTOMY
|
Professional
|
$4,061.00
|
|
|
Service Code
|
CPT 44320
|
| Hospital Charge Code |
8068990
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,064.57 |
| Max. Negotiated Rate |
$2,842.70 |
| Rate for Payer: Aetna of IA Medicare |
$1,064.57
|
| Rate for Payer: Amerigroup Medicaid |
$1,100.77
|
| Rate for Payer: Cash Price |
$3,248.80
|
| Rate for Payer: Cash Price |
$3,248.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,277.48
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,085.86
|
| Rate for Payer: Medical Associates Commercial |
$2,022.68
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,064.57
|
| Rate for Payer: Midlands Choice Commercial |
$2,842.70
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,596.86
|
| Rate for Payer: Wellmark IA HMO |
$2,276.00
|
| Rate for Payer: Wellmark IA PPO |
$2,671.00
|
|
|
44346 HERNIA REPR PARACOLOSTOMY
|
Professional
|
$4,000.00
|
|
|
Service Code
|
CPT 44346
|
| Hospital Charge Code |
8069177
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,050.16 |
| Max. Negotiated Rate |
$2,800.00 |
| Rate for Payer: Aetna of IA Medicare |
$1,050.16
|
| Rate for Payer: Amerigroup Medicaid |
$1,085.87
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Cash Price |
$3,200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,260.19
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,071.16
|
| Rate for Payer: Medical Associates Commercial |
$1,995.30
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,050.16
|
| Rate for Payer: Midlands Choice Commercial |
$2,800.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,575.24
|
| Rate for Payer: Wellmark IA HMO |
$2,243.00
|
| Rate for Payer: Wellmark IA PPO |
$2,633.00
|
|
|
44602 REPAIR BOWEL OR
|
Professional
|
$4,775.00
|
|
|
Service Code
|
CPT 44602
|
| Hospital Charge Code |
8069030
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,237.34 |
| Max. Negotiated Rate |
$3,342.50 |
| Rate for Payer: Aetna of IA Medicare |
$1,237.34
|
| Rate for Payer: Amerigroup Medicaid |
$1,279.41
|
| Rate for Payer: Cash Price |
$3,820.00
|
| Rate for Payer: Cash Price |
$3,820.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,484.81
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,262.09
|
| Rate for Payer: Medical Associates Commercial |
$2,350.95
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,237.34
|
| Rate for Payer: Midlands Choice Commercial |
$3,342.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,856.01
|
| Rate for Payer: Wellmark IA HMO |
$2,668.00
|
| Rate for Payer: Wellmark IA PPO |
$3,131.00
|
|
|
44604 Suture of large intestine w/o colostomy
|
Professional
|
$3,577.00
|
|
|
Service Code
|
CPT 44604
|
| Hospital Charge Code |
8799177
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$931.63 |
| Max. Negotiated Rate |
$2,503.90 |
| Rate for Payer: Aetna of IA Medicare |
$931.63
|
| Rate for Payer: Amerigroup Medicaid |
$963.31
|
| Rate for Payer: Cash Price |
$2,861.60
|
| Rate for Payer: Cash Price |
$2,861.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,117.96
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$950.26
|
| Rate for Payer: Medical Associates Commercial |
$1,770.10
|
| Rate for Payer: Medical Associates Managed Medicare |
$931.63
|
| Rate for Payer: Midlands Choice Commercial |
$2,503.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,397.44
|
| Rate for Payer: Wellmark IA HMO |
$2,001.00
|
| Rate for Payer: Wellmark IA PPO |
$2,349.00
|
|
|
44620 CLOSURE ENTEROSTOMY
|
Professional
|
$2,935.00
|
|
|
Service Code
|
CPT 44620
|
| Hospital Charge Code |
8069130
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$768.36 |
| Max. Negotiated Rate |
$2,054.50 |
| Rate for Payer: Aetna of IA Medicare |
$768.36
|
| Rate for Payer: Amerigroup Medicaid |
$794.48
|
| Rate for Payer: Cash Price |
$2,348.00
|
| Rate for Payer: Cash Price |
$2,348.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$922.03
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$783.73
|
| Rate for Payer: Medical Associates Commercial |
$1,459.88
|
| Rate for Payer: Medical Associates Managed Medicare |
$768.36
|
| Rate for Payer: Midlands Choice Commercial |
$2,054.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,152.54
|
| Rate for Payer: Wellmark IA HMO |
$1,641.00
|
| Rate for Payer: Wellmark IA PPO |
$1,926.00
|
|
|
44800 EXC MECKEL DIVERTICULUM
|
Professional
|
$2,584.00
|
|
|
Service Code
|
CPT 44800
|
| Hospital Charge Code |
8069123
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$691.18 |
| Max. Negotiated Rate |
$1,808.80 |
| Rate for Payer: Aetna of IA Medicare |
$691.18
|
| Rate for Payer: Amerigroup Medicaid |
$714.68
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Cash Price |
$2,067.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$829.42
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$705.00
|
| Rate for Payer: Medical Associates Commercial |
$1,313.24
|
| Rate for Payer: Medical Associates Managed Medicare |
$691.18
|
| Rate for Payer: Midlands Choice Commercial |
$1,808.80
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,036.77
|
| Rate for Payer: Wellmark IA HMO |
$1,477.00
|
| Rate for Payer: Wellmark IA PPO |
$1,734.00
|
|
|
44950 APPENDECTOMY OPEN
|
Professional
|
$2,168.00
|
|
|
Service Code
|
CPT 44950
|
| Hospital Charge Code |
8069169
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$568.81 |
| Max. Negotiated Rate |
$1,517.60 |
| Rate for Payer: Aetna of IA Medicare |
$568.81
|
| Rate for Payer: Amerigroup Medicaid |
$588.15
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Cash Price |
$1,734.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$682.57
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$580.19
|
| Rate for Payer: Medical Associates Commercial |
$1,080.74
|
| Rate for Payer: Medical Associates Managed Medicare |
$568.81
|
| Rate for Payer: Midlands Choice Commercial |
$1,517.60
|
| Rate for Payer: Partners Health Alliance Commercial |
$853.22
|
| Rate for Payer: Wellmark IA HMO |
$1,224.00
|
| Rate for Payer: Wellmark IA PPO |
$1,437.00
|
|
|
44955 APPENDECTOMY W/OTHER PROC
|
Professional
|
$285.00
|
|
|
Service Code
|
CPT 44955
|
| Hospital Charge Code |
8069018
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$73.42 |
| Max. Negotiated Rate |
$199.50 |
| Rate for Payer: Aetna of IA Medicare |
$73.42
|
| Rate for Payer: Amerigroup Medicaid |
$75.92
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Cash Price |
$228.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$88.10
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$74.89
|
| Rate for Payer: Medical Associates Commercial |
$139.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$73.42
|
| Rate for Payer: Midlands Choice Commercial |
$199.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$110.13
|
| Rate for Payer: Wellmark IA HMO |
$158.00
|
| Rate for Payer: Wellmark IA PPO |
$185.00
|
|
|
44960 APPENDECTOMY OPEN RUPTURED
|
Professional
|
$2,953.00
|
|
|
Service Code
|
CPT 44960
|
| Hospital Charge Code |
8069094
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$774.85 |
| Max. Negotiated Rate |
$2,067.10 |
| Rate for Payer: Aetna of IA Medicare |
$774.85
|
| Rate for Payer: Amerigroup Medicaid |
$801.19
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Cash Price |
$2,362.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$929.82
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$790.35
|
| Rate for Payer: Medical Associates Commercial |
$1,472.22
|
| Rate for Payer: Medical Associates Managed Medicare |
$774.85
|
| Rate for Payer: Midlands Choice Commercial |
$2,067.10
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,162.28
|
| Rate for Payer: Wellmark IA HMO |
$1,670.00
|
| Rate for Payer: Wellmark IA PPO |
$1,961.00
|
|
|
44970 APPENDECTOMY LAPAROSCOPIC
|
Professional
|
$2,027.00
|
|
|
Service Code
|
CPT 44970
|
| Hospital Charge Code |
8069095
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$535.48 |
| Max. Negotiated Rate |
$1,418.90 |
| Rate for Payer: Aetna of IA Medicare |
$535.48
|
| Rate for Payer: Amerigroup Medicaid |
$553.69
|
| Rate for Payer: Cash Price |
$1,621.60
|
| Rate for Payer: Cash Price |
$1,621.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$642.58
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$546.19
|
| Rate for Payer: Medical Associates Commercial |
$1,017.41
|
| Rate for Payer: Medical Associates Managed Medicare |
$535.48
|
| Rate for Payer: Midlands Choice Commercial |
$1,418.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$803.22
|
| Rate for Payer: Wellmark IA HMO |
$1,151.00
|
| Rate for Payer: Wellmark IA PPO |
$1,351.00
|
|
|
45110 ABDOMINAL PERINIAL RESECTION
|
Professional
|
$6,244.00
|
|
|
Service Code
|
CPT 45110
|
| Hospital Charge Code |
8069103
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$1,622.40 |
| Max. Negotiated Rate |
$4,370.80 |
| Rate for Payer: Aetna of IA Medicare |
$1,622.40
|
| Rate for Payer: Amerigroup Medicaid |
$1,677.56
|
| Rate for Payer: Cash Price |
$4,995.20
|
| Rate for Payer: Cash Price |
$4,995.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,946.88
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,654.85
|
| Rate for Payer: Medical Associates Commercial |
$3,082.56
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,622.40
|
| Rate for Payer: Midlands Choice Commercial |
$4,370.80
|
| Rate for Payer: Partners Health Alliance Commercial |
$2,433.60
|
| Rate for Payer: Wellmark IA HMO |
$3,442.00
|
| Rate for Payer: Wellmark IA PPO |
$4,040.00
|
|
|
45330 SIGMOIDOSCOPY DX
|
Professional
|
$336.00
|
|
|
Service Code
|
CPT 45330
|
| Hospital Charge Code |
8384949
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$235.20 |
| Rate for Payer: Aetna of IA Medicare |
$51.12
|
| Rate for Payer: Amerigroup Medicaid |
$52.86
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Cash Price |
$268.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$61.34
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$52.14
|
| Rate for Payer: Medical Associates Commercial |
$97.13
|
| Rate for Payer: Medical Associates Managed Medicare |
$51.12
|
| Rate for Payer: Midlands Choice Commercial |
$235.20
|
| Rate for Payer: Partners Health Alliance Commercial |
$76.68
|
| Rate for Payer: Wellmark IA HMO |
$106.00
|
| Rate for Payer: Wellmark IA PPO |
$124.00
|
|
|
45331 SIGMOIDOSCOPY W/ BX (COLD FORECPS)
|
Professional
|
$848.00
|
|
|
Service Code
|
CPT 45331
|
| Hospital Charge Code |
8384950
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$65.28 |
| Max. Negotiated Rate |
$593.60 |
| Rate for Payer: Aetna of IA Medicare |
$65.28
|
| Rate for Payer: Amerigroup Medicaid |
$67.50
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Cash Price |
$678.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$78.34
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$66.59
|
| Rate for Payer: Medical Associates Commercial |
$124.03
|
| Rate for Payer: Medical Associates Managed Medicare |
$65.28
|
| Rate for Payer: Midlands Choice Commercial |
$593.60
|
| Rate for Payer: Partners Health Alliance Commercial |
$97.92
|
| Rate for Payer: Wellmark IA HMO |
$135.00
|
| Rate for Payer: Wellmark IA PPO |
$159.00
|
|
|
45333 SIGMOIDOSCOPY POLYPECTOMY
|
Professional
|
$972.00
|
|
|
Service Code
|
CPT 45333
|
| Hospital Charge Code |
8384948
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$84.54 |
| Max. Negotiated Rate |
$680.40 |
| Rate for Payer: Aetna of IA Medicare |
$84.54
|
| Rate for Payer: Amerigroup Medicaid |
$87.41
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Cash Price |
$777.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$101.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$86.23
|
| Rate for Payer: Medical Associates Commercial |
$160.63
|
| Rate for Payer: Medical Associates Managed Medicare |
$84.54
|
| Rate for Payer: Midlands Choice Commercial |
$680.40
|
| Rate for Payer: Partners Health Alliance Commercial |
$126.81
|
| Rate for Payer: Wellmark IA HMO |
$176.00
|
| Rate for Payer: Wellmark IA PPO |
$206.00
|
|
|
45334 Sigmoidoscopy w/ control of bleeding (any method)
|
Professional
|
$1,793.00
|
|
|
Service Code
|
CPT 45334
|
| Hospital Charge Code |
8799178
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$106.15 |
| Max. Negotiated Rate |
$1,255.10 |
| Rate for Payer: Aetna of IA Medicare |
$106.15
|
| Rate for Payer: Amerigroup Medicaid |
$109.76
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Cash Price |
$1,434.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$127.38
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$108.27
|
| Rate for Payer: Medical Associates Commercial |
$201.68
|
| Rate for Payer: Medical Associates Managed Medicare |
$106.15
|
| Rate for Payer: Midlands Choice Commercial |
$1,255.10
|
| Rate for Payer: Partners Health Alliance Commercial |
$159.22
|
| Rate for Payer: Wellmark IA HMO |
$220.00
|
| Rate for Payer: Wellmark IA PPO |
$259.00
|
|
|
45338 SIGMOIDOSCOPY W/ SNARE POLYPECTOMY (HOT OR COLD SNARE)
|
Professional
|
$890.00
|
|
|
Service Code
|
CPT 45338
|
| Hospital Charge Code |
8384951
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$108.39 |
| Max. Negotiated Rate |
$623.00 |
| Rate for Payer: Aetna of IA Medicare |
$108.39
|
| Rate for Payer: Amerigroup Medicaid |
$112.08
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$130.07
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$110.56
|
| Rate for Payer: Medical Associates Commercial |
$205.94
|
| Rate for Payer: Medical Associates Managed Medicare |
$108.39
|
| Rate for Payer: Midlands Choice Commercial |
$623.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$162.58
|
| Rate for Payer: Wellmark IA HMO |
$225.00
|
| Rate for Payer: Wellmark IA PPO |
$264.00
|
|
|
45378 COLONOSCOPY DX (NO BX)
|
Professional
|
$1,049.00
|
|
|
Service Code
|
CPT 45378
|
| Hospital Charge Code |
8051989
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$165.95 |
| Max. Negotiated Rate |
$734.30 |
| Rate for Payer: Aetna of IA Medicare |
$165.95
|
| Rate for Payer: Amerigroup Medicaid |
$171.59
|
| Rate for Payer: Cash Price |
$839.20
|
| Rate for Payer: Cash Price |
$839.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$199.14
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$169.27
|
| Rate for Payer: Medical Associates Commercial |
$315.30
|
| Rate for Payer: Medical Associates Managed Medicare |
$165.95
|
| Rate for Payer: Midlands Choice Commercial |
$734.30
|
| Rate for Payer: Partners Health Alliance Commercial |
$248.92
|
| Rate for Payer: United Healthcare Commercial |
$488.84
|
| Rate for Payer: Wellmark IA HMO |
$360.00
|
| Rate for Payer: Wellmark IA PPO |
$422.00
|
|
|
45380 COLONOSCOPY W/ BX (COLD FORCEPS)
|
Professional
|
$1,341.00
|
|
|
Service Code
|
CPT 45380
|
| Hospital Charge Code |
8069193
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$180.55 |
| Max. Negotiated Rate |
$938.70 |
| Rate for Payer: Aetna of IA Medicare |
$180.55
|
| Rate for Payer: Amerigroup Medicaid |
$186.69
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Cash Price |
$1,072.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$216.66
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$184.16
|
| Rate for Payer: Medical Associates Commercial |
$343.04
|
| Rate for Payer: Medical Associates Managed Medicare |
$180.55
|
| Rate for Payer: Midlands Choice Commercial |
$938.70
|
| Rate for Payer: Partners Health Alliance Commercial |
$270.82
|
| Rate for Payer: United Healthcare Commercial |
$578.02
|
| Rate for Payer: Wellmark IA HMO |
$391.00
|
| Rate for Payer: Wellmark IA PPO |
$459.00
|
|
|
45381 COLONOSCOPY W/ DIRECT SUBMUCOSAL INJ (TATTOOING)
|
Professional
|
$1,282.00
|
|
|
Service Code
|
CPT 45381
|
| Hospital Charge Code |
8069152
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$180.25 |
| Max. Negotiated Rate |
$897.40 |
| Rate for Payer: Aetna of IA Medicare |
$180.25
|
| Rate for Payer: Amerigroup Medicaid |
$186.38
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Cash Price |
$1,025.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$216.30
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$183.86
|
| Rate for Payer: Medical Associates Commercial |
$342.48
|
| Rate for Payer: Medical Associates Managed Medicare |
$180.25
|
| Rate for Payer: Midlands Choice Commercial |
$897.40
|
| Rate for Payer: Partners Health Alliance Commercial |
$270.38
|
| Rate for Payer: Wellmark IA HMO |
$390.00
|
| Rate for Payer: Wellmark IA PPO |
$458.00
|
|
