|
hydrOXYzine hydrochloride 25 mg Tab
|
Facility
IP
|
$1.56
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43701891
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna of IA Commercial |
$1.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1.40
|
| Rate for Payer: Cash Price |
$1.25
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1.17
|
| Rate for Payer: Medical Associates Commercial |
$1.17
|
| Rate for Payer: Midlands Choice Commercial |
$1.09
|
| Rate for Payer: United Healthcare Commercial |
$1.40
|
|
|
HYLAN G-F 20 1MG ( 48MG PER DOSE) CHARGE
|
Professional
|
$24.00
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
8068951
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.79 |
| Max. Negotiated Rate |
$75.00 |
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Medical Associates Commercial |
$75.00
|
| Rate for Payer: Midlands Choice Commercial |
$16.80
|
| Rate for Payer: Wellmark IA HMO |
$9.79
|
| Rate for Payer: Wellmark IA PPO |
$9.79
|
|
|
hylan G-F 20 48 mg/6 mL SDV syringe
|
Facility
OP
|
$1,824.20
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
43700239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$911.74 |
| Max. Negotiated Rate |
$1,641.78 |
| Rate for Payer: Aetna of IA Commercial |
$1,641.78
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,641.78
|
| Rate for Payer: Aetna of IA Medicare |
$1,039.79
|
| Rate for Payer: Amerigroup Medicaid |
$920.67
|
| Rate for Payer: Amerigroup Medicare |
$921.22
|
| Rate for Payer: Cash Price |
$1,459.36
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,368.15
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$912.10
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$911.74
|
| Rate for Payer: Medical Associates Commercial |
$1,368.15
|
| Rate for Payer: Medical Associates Managed Medicare |
$912.10
|
| Rate for Payer: Midlands Choice Commercial |
$1,276.94
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$925.78
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,368.15
|
| Rate for Payer: United Healthcare Commercial |
$1,641.78
|
| Rate for Payer: United Healthcare Managed Medicare |
$1,076.28
|
|
|
hylan G-F 20 48 mg/6 mL SDV syringe
|
Facility
IP
|
$1,824.20
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
43700239
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,276.94 |
| Max. Negotiated Rate |
$1,641.78 |
| Rate for Payer: Aetna of IA Commercial |
$1,641.78
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,641.78
|
| Rate for Payer: Cash Price |
$1,459.36
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,368.15
|
| Rate for Payer: Medical Associates Commercial |
$1,368.15
|
| Rate for Payer: Midlands Choice Commercial |
$1,276.94
|
| Rate for Payer: United Healthcare Commercial |
$1,641.78
|
|
|
hyoscyamine 0.125 mg Dis Tab
|
Facility
OP
|
$1.30
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43702200
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$1.17 |
| Rate for Payer: Aetna of IA Commercial |
$1.17
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1.17
|
| Rate for Payer: Aetna of IA Medicare |
$0.74
|
| Rate for Payer: Amerigroup Medicaid |
$0.66
|
| Rate for Payer: Amerigroup Medicare |
$0.66
|
| Rate for Payer: Cash Price |
$1.04
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$0.98
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$0.65
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$0.65
|
| Rate for Payer: Medical Associates Commercial |
$0.98
|
| Rate for Payer: Medical Associates Managed Medicare |
$0.65
|
| Rate for Payer: Midlands Choice Commercial |
$0.91
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$0.66
|
| Rate for Payer: Partners Health Alliance Commercial |
$0.98
|
| Rate for Payer: United Healthcare Commercial |
$1.17
|
| Rate for Payer: United Healthcare Managed Medicare |
$0.77
|
|
|
hyoscyamine 0.125 mg Dis Tab
|
Facility
IP
|
$1.30
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43702200
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.91 |
| Max. Negotiated Rate |
$1.17 |
| Rate for Payer: Aetna of IA Commercial |
$1.17
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1.17
|
| Rate for Payer: Cash Price |
$1.04
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$0.98
|
| Rate for Payer: Medical Associates Commercial |
$0.98
|
| Rate for Payer: Midlands Choice Commercial |
$0.91
|
| Rate for Payer: United Healthcare Commercial |
$1.17
|
|
|
Hypertension With MCC
|
Facility
IP
|
$8,093.42
|
|
|
Service Code
|
MS-DRG 304
|
| Hospital Charge Code |
161
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$8,093.42 |
| Rate for Payer: Amerigroup Medicaid |
$8,054.32
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$2,034.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$7,976.12
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$8,093.42
|
|
|
Hypertension Without MCC
|
Facility
IP
|
$6,236.15
|
|
|
Service Code
|
MS-DRG 305
|
| Hospital Charge Code |
162
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$6,236.15 |
| Rate for Payer: Amerigroup Medicaid |
$6,206.03
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$2,034.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$6,145.78
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$6,236.15
|
|
|
Hypertensive Encephalopathy With CC
|
Facility
IP
|
$7,560.94
|
|
|
Service Code
|
MS-DRG 078
|
| Hospital Charge Code |
758
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$7,560.94 |
| Rate for Payer: Amerigroup Medicaid |
$7,524.42
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$2,034.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$7,451.37
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$7,560.94
|
|
|
Hypertensive Encephalopathy With MCC
|
Facility
IP
|
$11,785.31
|
|
|
Service Code
|
MS-DRG 077
|
| Hospital Charge Code |
757
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$11,785.31 |
| Rate for Payer: Amerigroup Medicaid |
$11,728.37
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$2,034.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$11,614.51
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$11,785.31
|
|
|
Hypertensive Encephalopathy Without CC/MCC
|
Facility
IP
|
$7,560.94
|
|
|
Service Code
|
MS-DRG 079
|
| Hospital Charge Code |
759
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$7,560.94 |
| Rate for Payer: Amerigroup Medicaid |
$7,524.42
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$2,034.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$7,451.37
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$7,560.94
|
|
|
Hysteroscopy surgical with BX of endometrium
|
Professional
|
$4,492.00
|
|
|
Service Code
|
CPT 58558
|
| Hospital Charge Code |
8069167
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$208.15 |
| Max. Negotiated Rate |
$3,144.40 |
| Rate for Payer: Aetna of IA Medicare |
$208.15
|
| Rate for Payer: Amerigroup Medicaid |
$215.23
|
| Rate for Payer: Cash Price |
$3,593.60
|
| Rate for Payer: Cash Price |
$3,593.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$249.78
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$212.31
|
| Rate for Payer: Medical Associates Commercial |
$395.48
|
| Rate for Payer: Medical Associates Managed Medicare |
$208.15
|
| Rate for Payer: Midlands Choice Commercial |
$3,144.40
|
| Rate for Payer: Partners Health Alliance Commercial |
$312.22
|
| Rate for Payer: Wellmark IA HMO |
$439.00
|
| Rate for Payer: Wellmark IA PPO |
$515.00
|
|
|
ibandronate 1 mg/mL IV Sol
|
Facility
IP
|
$730.04
|
|
|
Service Code
|
CPT J1740
|
| Hospital Charge Code |
43700004
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$511.03 |
| Max. Negotiated Rate |
$657.04 |
| Rate for Payer: Aetna of IA Commercial |
$657.04
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$657.04
|
| Rate for Payer: Cash Price |
$584.03
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$547.53
|
| Rate for Payer: Medical Associates Commercial |
$547.53
|
| Rate for Payer: Midlands Choice Commercial |
$511.03
|
| Rate for Payer: United Healthcare Commercial |
$657.04
|
|
|
ibandronate 1 mg/mL IV Sol
|
Facility
OP
|
$730.04
|
|
|
Service Code
|
CPT J1740
|
| Hospital Charge Code |
43700004
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$364.87 |
| Max. Negotiated Rate |
$657.04 |
| Rate for Payer: Aetna of IA Commercial |
$657.04
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$657.04
|
| Rate for Payer: Aetna of IA Medicare |
$416.12
|
| Rate for Payer: Amerigroup Medicaid |
$368.45
|
| Rate for Payer: Amerigroup Medicare |
$368.67
|
| Rate for Payer: Cash Price |
$584.03
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$547.53
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$365.02
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$364.87
|
| Rate for Payer: Medical Associates Commercial |
$547.53
|
| Rate for Payer: Medical Associates Managed Medicare |
$365.02
|
| Rate for Payer: Midlands Choice Commercial |
$511.03
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$370.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$547.53
|
| Rate for Payer: United Healthcare Commercial |
$657.04
|
| Rate for Payer: United Healthcare Managed Medicare |
$430.72
|
|
|
IB KIT, BC, W/CC FT AND JUMPSTART
|
Facility
OP
|
$2,691.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8783232
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,344.96 |
| Max. Negotiated Rate |
$2,421.90 |
| Rate for Payer: Aetna of IA Commercial |
$2,421.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2,421.90
|
| Rate for Payer: Aetna of IA Medicare |
$1,533.87
|
| Rate for Payer: Amerigroup Medicaid |
$1,358.15
|
| Rate for Payer: Amerigroup Medicare |
$1,358.96
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,018.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$1,345.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,344.96
|
| Rate for Payer: Medical Associates Commercial |
$2,018.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,345.50
|
| Rate for Payer: Midlands Choice Commercial |
$1,883.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$1,365.68
|
| Rate for Payer: Partners Health Alliance Commercial |
$2,018.25
|
| Rate for Payer: United Healthcare Commercial |
$2,421.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$1,587.69
|
|
|
IB KIT, BC, W/CC FT AND JUMPSTART
|
Facility
IP
|
$2,691.00
|
|
|
Service Code
|
CPT C1713
|
| Hospital Charge Code |
8783232
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,883.70 |
| Max. Negotiated Rate |
$2,421.90 |
| Rate for Payer: Aetna of IA Commercial |
$2,421.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2,421.90
|
| Rate for Payer: Cash Price |
$2,152.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,018.25
|
| Rate for Payer: Medical Associates Commercial |
$2,018.25
|
| Rate for Payer: Midlands Choice Commercial |
$1,883.70
|
| Rate for Payer: United Healthcare Commercial |
$2,421.90
|
|
|
ibuprofen 100 mg/5 mL 120ml oral suspension [VDMC]
|
Facility
OP
|
$17.44
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43700043
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$15.70 |
| Rate for Payer: Aetna of IA Commercial |
$15.70
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$15.70
|
| Rate for Payer: Aetna of IA Medicare |
$9.94
|
| Rate for Payer: Amerigroup Medicaid |
$8.80
|
| Rate for Payer: Amerigroup Medicare |
$8.81
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$13.08
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$8.72
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$8.72
|
| Rate for Payer: Medical Associates Commercial |
$13.08
|
| Rate for Payer: Medical Associates Managed Medicare |
$8.72
|
| Rate for Payer: Midlands Choice Commercial |
$12.21
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$8.85
|
| Rate for Payer: Partners Health Alliance Commercial |
$13.08
|
| Rate for Payer: United Healthcare Commercial |
$15.70
|
| Rate for Payer: United Healthcare Managed Medicare |
$10.29
|
|
|
ibuprofen 100 mg/5 mL 120ml oral suspension [VDMC]
|
Facility
IP
|
$17.44
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43700043
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.21 |
| Max. Negotiated Rate |
$15.70 |
| Rate for Payer: Aetna of IA Commercial |
$15.70
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$15.70
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$13.08
|
| Rate for Payer: Medical Associates Commercial |
$13.08
|
| Rate for Payer: Midlands Choice Commercial |
$12.21
|
| Rate for Payer: United Healthcare Commercial |
$15.70
|
|
|
ibuprofen 100 mg/5 mL Cups Oral Susp
|
Facility
OP
|
$2.78
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43789161
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.39 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna of IA Commercial |
$2.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2.50
|
| Rate for Payer: Aetna of IA Medicare |
$1.58
|
| Rate for Payer: Amerigroup Medicaid |
$1.40
|
| Rate for Payer: Amerigroup Medicare |
$1.40
|
| Rate for Payer: Cash Price |
$2.22
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2.08
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$1.39
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1.39
|
| Rate for Payer: Medical Associates Commercial |
$2.08
|
| Rate for Payer: Medical Associates Managed Medicare |
$1.39
|
| Rate for Payer: Midlands Choice Commercial |
$1.95
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$1.41
|
| Rate for Payer: Partners Health Alliance Commercial |
$2.08
|
| Rate for Payer: United Healthcare Commercial |
$2.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$1.64
|
|
|
ibuprofen 100 mg/5 mL Cups Oral Susp
|
Facility
IP
|
$2.78
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43789161
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna of IA Commercial |
$2.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2.50
|
| Rate for Payer: Cash Price |
$2.22
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2.08
|
| Rate for Payer: Medical Associates Commercial |
$2.08
|
| Rate for Payer: Midlands Choice Commercial |
$1.95
|
| Rate for Payer: United Healthcare Commercial |
$2.50
|
|
|
ID ABSCESS PERIRECTAL CHARGE
|
Professional
|
$1,362.00
|
|
| Hospital Charge Code |
8068983
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$953.40 |
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Cash Price |
$1,089.60
|
| Rate for Payer: Medical Associates Commercial |
$75.00
|
| Rate for Payer: Midlands Choice Commercial |
$953.40
|
|
|
ID ABSCESS SIMPLE SNGL ER CHARGE
|
Professional
|
$316.00
|
|
| Hospital Charge Code |
8068971
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$221.20 |
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Cash Price |
$252.80
|
| Rate for Payer: Medical Associates Commercial |
$75.00
|
| Rate for Payer: Midlands Choice Commercial |
$221.20
|
|
|
ID ABSCESS SUBFASCIAL
|
Professional
|
$1,036.00
|
|
|
Service Code
|
CPT 20005
|
| Hospital Charge Code |
7982741
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$725.20 |
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Cash Price |
$828.80
|
| Rate for Payer: Medical Associates Commercial |
$75.00
|
| Rate for Payer: Midlands Choice Commercial |
$725.20
|
| Rate for Payer: Wellmark IA HMO |
$405.00
|
| Rate for Payer: Wellmark IA PPO |
$494.00
|
|
|
ID COMPLEX POSTOP WOUND ER CHARGE
|
Professional
|
$702.00
|
|
| Hospital Charge Code |
8068968
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$75.00 |
| Max. Negotiated Rate |
$491.40 |
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Cash Price |
$561.60
|
| Rate for Payer: Medical Associates Commercial |
$75.00
|
| Rate for Payer: Midlands Choice Commercial |
$491.40
|
|
|
ID Now COVID-19 Test
|
Facility
OP
|
$128.00
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
8787912
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.97 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna of IA Commercial |
$115.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$115.20
|
| Rate for Payer: Aetna of IA Medicare |
$72.96
|
| Rate for Payer: Amerigroup Medicaid |
$64.60
|
| Rate for Payer: Amerigroup Medicare |
$64.64
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$96.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$64.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$63.97
|
| Rate for Payer: Medical Associates Commercial |
$96.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$64.00
|
| Rate for Payer: Midlands Choice Commercial |
$89.60
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$64.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$96.00
|
| Rate for Payer: United Healthcare Commercial |
$115.20
|
| Rate for Payer: United Healthcare Managed Medicare |
$75.52
|
| Rate for Payer: Wellmark IA HMO |
$68.82
|
| Rate for Payer: Wellmark IA PPO |
$75.70
|
|
