|
indapamide 2.5 mg Tab
|
Facility
IP
|
$1.39
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43702736
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.97 |
| Max. Negotiated Rate |
$1.25 |
| Rate for Payer: Aetna of IA Commercial |
$1.25
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1.25
|
| Rate for Payer: Cash Price |
$1.11
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1.04
|
| Rate for Payer: Medical Associates Commercial |
$1.04
|
| Rate for Payer: Midlands Choice Commercial |
$0.97
|
| Rate for Payer: United Healthcare Commercial |
$1.25
|
|
|
indocyanine green 25 mg Pow SDV
|
Facility
OP
|
$514.76
|
|
|
Service Code
|
CPT C9776
|
| Hospital Charge Code |
43799944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$257.28 |
| Max. Negotiated Rate |
$463.28 |
| Rate for Payer: Aetna of IA Commercial |
$463.28
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$463.28
|
| Rate for Payer: Aetna of IA Medicare |
$293.41
|
| Rate for Payer: Amerigroup Medicaid |
$259.80
|
| Rate for Payer: Amerigroup Medicare |
$259.95
|
| Rate for Payer: Cash Price |
$411.81
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$386.07
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$257.38
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$257.28
|
| Rate for Payer: Medical Associates Commercial |
$386.07
|
| Rate for Payer: Medical Associates Managed Medicare |
$257.38
|
| Rate for Payer: Midlands Choice Commercial |
$360.33
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$261.24
|
| Rate for Payer: Partners Health Alliance Commercial |
$386.07
|
| Rate for Payer: United Healthcare Commercial |
$463.28
|
| Rate for Payer: United Healthcare Managed Medicare |
$303.71
|
|
|
indocyanine green 25 mg Pow SDV
|
Facility
IP
|
$514.76
|
|
|
Service Code
|
CPT C9776
|
| Hospital Charge Code |
43799944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$360.33 |
| Max. Negotiated Rate |
$463.28 |
| Rate for Payer: Aetna of IA Commercial |
$463.28
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$463.28
|
| Rate for Payer: Cash Price |
$411.81
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$386.07
|
| Rate for Payer: Medical Associates Commercial |
$386.07
|
| Rate for Payer: Midlands Choice Commercial |
$360.33
|
| Rate for Payer: United Healthcare Commercial |
$463.28
|
|
|
indomethacin 25 mg Cap
|
Facility
IP
|
$1.25
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43702735
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.88 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna of IA Commercial |
$1.12
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1.12
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$0.94
|
| Rate for Payer: Medical Associates Commercial |
$0.94
|
| Rate for Payer: Midlands Choice Commercial |
$0.88
|
| Rate for Payer: United Healthcare Commercial |
$1.12
|
|
|
indomethacin 25 mg Cap
|
Facility
OP
|
$1.25
|
|
|
Service Code
|
CPT A9270
|
| Hospital Charge Code |
43702735
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$1.12 |
| Rate for Payer: Aetna of IA Commercial |
$1.12
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1.12
|
| Rate for Payer: Aetna of IA Medicare |
$0.71
|
| Rate for Payer: Amerigroup Medicaid |
$0.63
|
| Rate for Payer: Amerigroup Medicare |
$0.63
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$0.94
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$0.63
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$0.62
|
| Rate for Payer: Medical Associates Commercial |
$0.94
|
| Rate for Payer: Medical Associates Managed Medicare |
$0.63
|
| Rate for Payer: Midlands Choice Commercial |
$0.88
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$0.63
|
| Rate for Payer: Partners Health Alliance Commercial |
$0.94
|
| Rate for Payer: United Healthcare Commercial |
$1.12
|
| Rate for Payer: United Healthcare Managed Medicare |
$0.74
|
|
|
Infections, Female Reproductive System With CC
|
Facility
IP
|
$7,964.48
|
|
|
Service Code
|
MS-DRG 758
|
| Hospital Charge Code |
516
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$7,964.48 |
| Rate for Payer: Amerigroup Medicaid |
$7,926.00
|
| 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 |
$7,849.05
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$7,964.48
|
|
|
Infections, Female Reproductive System With MCC
|
Facility
IP
|
$14,985.08
|
|
|
Service Code
|
MS-DRG 757
|
| Hospital Charge Code |
515
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$14,985.08 |
| Rate for Payer: Amerigroup Medicaid |
$14,912.69
|
| 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 |
$14,767.91
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$14,985.08
|
|
|
Infections, Female Reproductive System Without CC/MCC
|
Facility
IP
|
$6,254.86
|
|
|
Service Code
|
MS-DRG 759
|
| Hospital Charge Code |
517
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$6,254.86 |
| Rate for Payer: Amerigroup Medicaid |
$6,224.64
|
| 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 |
$6,164.21
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$6,254.86
|
|
|
Infectious and Parasitic Diseases With O.R. Procedures With CC
|
Facility
IP
|
$15,720.30
|
|
|
Service Code
|
MS-DRG 854
|
| Hospital Charge Code |
593
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$15,720.30 |
| Rate for Payer: Amerigroup Medicaid |
$15,644.36
|
| 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 |
$15,492.47
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$15,720.30
|
|
|
Infectious and Parasitic Diseases With O.R. Procedures With MCC
|
Facility
IP
|
$36,175.80
|
|
|
Service Code
|
MS-DRG 853
|
| Hospital Charge Code |
592
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$36,175.80 |
| Rate for Payer: Amerigroup Medicaid |
$36,001.03
|
| 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 |
$35,651.51
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$36,175.80
|
|
|
Infectious and Parasitic Diseases With O.R. Procedures Without CC/MCC
|
Facility
IP
|
$9,321.75
|
|
|
Service Code
|
MS-DRG 855
|
| Hospital Charge Code |
594
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$9,321.75 |
| Rate for Payer: Amerigroup Medicaid |
$9,276.72
|
| 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 |
$9,186.65
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$9,321.75
|
|
|
Inflammation of the Male Reproductive System With MCC
|
Facility
IP
|
$8,470.38
|
|
|
Service Code
|
MS-DRG 727
|
| Hospital Charge Code |
491
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$8,470.38 |
| Rate for Payer: Amerigroup Medicaid |
$8,429.46
|
| 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 |
$8,347.62
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$8,470.38
|
|
|
Inflammation of the Male Reproductive System Without MCC
|
Facility
IP
|
$7,811.92
|
|
|
Service Code
|
MS-DRG 728
|
| Hospital Charge Code |
492
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$7,811.92 |
| Rate for Payer: Amerigroup Medicaid |
$7,774.18
|
| 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 |
$7,698.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$7,811.92
|
|
|
Inflammatory Bowel Disease With CC
|
Facility
IP
|
$10,177.06
|
|
|
Service Code
|
MS-DRG 386
|
| Hospital Charge Code |
227
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$10,177.06 |
| Rate for Payer: Amerigroup Medicaid |
$10,127.90
|
| 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 |
$10,029.57
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$10,177.06
|
|
|
Inflammatory Bowel Disease With MCC
|
Facility
IP
|
$12,506.75
|
|
|
Service Code
|
MS-DRG 385
|
| Hospital Charge Code |
226
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$12,506.75 |
| Rate for Payer: Amerigroup Medicaid |
$12,446.33
|
| 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 |
$12,325.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$12,506.75
|
|
|
Inflammatory Bowel Disease Without CC/MCC
|
Facility
IP
|
$8,430.03
|
|
|
Service Code
|
MS-DRG 387
|
| Hospital Charge Code |
228
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$8,430.03 |
| Rate for Payer: Amerigroup Medicaid |
$8,389.31
|
| 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 |
$8,307.86
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$8,430.03
|
|
|
inFLIXimab 100 mg SDV Pow
|
Facility
OP
|
$973.38
|
|
|
Service Code
|
CPT J1745
|
| Hospital Charge Code |
43700311
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$486.50 |
| Max. Negotiated Rate |
$876.04 |
| Rate for Payer: Aetna of IA Commercial |
$876.04
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$876.04
|
| Rate for Payer: Aetna of IA Medicare |
$554.83
|
| Rate for Payer: Amerigroup Medicaid |
$491.26
|
| Rate for Payer: Amerigroup Medicare |
$491.56
|
| Rate for Payer: Cash Price |
$778.70
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$730.04
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$486.69
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$486.50
|
| Rate for Payer: Medical Associates Commercial |
$730.04
|
| Rate for Payer: Medical Associates Managed Medicare |
$486.69
|
| Rate for Payer: Midlands Choice Commercial |
$681.37
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$493.99
|
| Rate for Payer: Partners Health Alliance Commercial |
$730.04
|
| Rate for Payer: United Healthcare Commercial |
$876.04
|
| Rate for Payer: United Healthcare Managed Medicare |
$574.29
|
|
|
inFLIXimab 100 mg SDV Pow
|
Facility
IP
|
$973.38
|
|
|
Service Code
|
CPT J1745
|
| Hospital Charge Code |
43700311
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$681.37 |
| Max. Negotiated Rate |
$876.04 |
| Rate for Payer: Aetna of IA Commercial |
$876.04
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$876.04
|
| Rate for Payer: Cash Price |
$778.70
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$730.04
|
| Rate for Payer: Medical Associates Commercial |
$730.04
|
| Rate for Payer: Midlands Choice Commercial |
$681.37
|
| Rate for Payer: United Healthcare Commercial |
$876.04
|
|
|
inFLIXimab-abda 100 mg SDV Pow
|
Facility
OP
|
$1,482.96
|
|
|
Service Code
|
CPT Q5104
|
| Hospital Charge Code |
43799921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$741.18 |
| Max. Negotiated Rate |
$1,334.66 |
| Rate for Payer: Aetna of IA Commercial |
$1,334.66
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,334.66
|
| Rate for Payer: Aetna of IA Medicare |
$845.29
|
| Rate for Payer: Amerigroup Medicaid |
$748.45
|
| Rate for Payer: Amerigroup Medicare |
$748.89
|
| Rate for Payer: Cash Price |
$1,186.37
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,112.22
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$741.48
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$741.18
|
| Rate for Payer: Medical Associates Commercial |
$1,112.22
|
| Rate for Payer: Medical Associates Managed Medicare |
$741.48
|
| Rate for Payer: Midlands Choice Commercial |
$1,038.07
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$752.60
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,112.22
|
| Rate for Payer: United Healthcare Commercial |
$1,334.66
|
| Rate for Payer: United Healthcare Managed Medicare |
$874.95
|
|
|
inFLIXimab-abda 100 mg SDV Pow
|
Facility
IP
|
$1,482.96
|
|
|
Service Code
|
CPT Q5104
|
| Hospital Charge Code |
43799921
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,038.07 |
| Max. Negotiated Rate |
$1,334.66 |
| Rate for Payer: Aetna of IA Commercial |
$1,334.66
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,334.66
|
| Rate for Payer: Cash Price |
$1,186.37
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,112.22
|
| Rate for Payer: Medical Associates Commercial |
$1,112.22
|
| Rate for Payer: Midlands Choice Commercial |
$1,038.07
|
| Rate for Payer: United Healthcare Commercial |
$1,334.66
|
|
|
inFLIXimab axxq 100 mg Pow
|
Facility
OP
|
$1,045.70
|
|
|
Service Code
|
CPT Q5121
|
| Hospital Charge Code |
43702485
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$522.64 |
| Max. Negotiated Rate |
$941.13 |
| Rate for Payer: Aetna of IA Commercial |
$941.13
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$941.13
|
| Rate for Payer: Aetna of IA Medicare |
$596.05
|
| Rate for Payer: Amerigroup Medicaid |
$527.76
|
| Rate for Payer: Amerigroup Medicare |
$528.08
|
| Rate for Payer: Cash Price |
$836.56
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$784.28
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$522.85
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$522.64
|
| Rate for Payer: Medical Associates Commercial |
$784.28
|
| Rate for Payer: Medical Associates Managed Medicare |
$522.85
|
| Rate for Payer: Midlands Choice Commercial |
$731.99
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$530.69
|
| Rate for Payer: Partners Health Alliance Commercial |
$784.28
|
| Rate for Payer: United Healthcare Commercial |
$941.13
|
| Rate for Payer: United Healthcare Managed Medicare |
$616.96
|
|
|
inFLIXimab axxq 100 mg Pow
|
Facility
IP
|
$1,045.70
|
|
|
Service Code
|
CPT Q5121
|
| Hospital Charge Code |
43702485
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$731.99 |
| Max. Negotiated Rate |
$941.13 |
| Rate for Payer: Aetna of IA Commercial |
$941.13
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$941.13
|
| Rate for Payer: Cash Price |
$836.56
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$784.28
|
| Rate for Payer: Medical Associates Commercial |
$784.28
|
| Rate for Payer: Midlands Choice Commercial |
$731.99
|
| Rate for Payer: United Healthcare Commercial |
$941.13
|
|
|
inFLIXimab-dyyb 100 mg Pow SDV
|
Facility
IP
|
$1,016.76
|
|
|
Service Code
|
CPT Q5103
|
| Hospital Charge Code |
43700388
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$711.73 |
| Max. Negotiated Rate |
$915.08 |
| Rate for Payer: Aetna of IA Commercial |
$915.08
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$915.08
|
| Rate for Payer: Cash Price |
$813.41
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$762.57
|
| Rate for Payer: Medical Associates Commercial |
$762.57
|
| Rate for Payer: Midlands Choice Commercial |
$711.73
|
| Rate for Payer: United Healthcare Commercial |
$915.08
|
|
|
inFLIXimab-dyyb 100 mg Pow SDV
|
Facility
OP
|
$1,016.76
|
|
|
Service Code
|
CPT Q5103
|
| Hospital Charge Code |
43700388
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$508.18 |
| Max. Negotiated Rate |
$915.08 |
| Rate for Payer: Aetna of IA Commercial |
$915.08
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$915.08
|
| Rate for Payer: Aetna of IA Medicare |
$579.55
|
| Rate for Payer: Amerigroup Medicaid |
$513.16
|
| Rate for Payer: Amerigroup Medicare |
$513.46
|
| Rate for Payer: Cash Price |
$813.41
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$762.57
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$508.38
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$508.18
|
| Rate for Payer: Medical Associates Commercial |
$762.57
|
| Rate for Payer: Medical Associates Managed Medicare |
$508.38
|
| Rate for Payer: Midlands Choice Commercial |
$711.73
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$516.01
|
| Rate for Payer: Partners Health Alliance Commercial |
$762.57
|
| Rate for Payer: United Healthcare Commercial |
$915.08
|
| Rate for Payer: United Healthcare Managed Medicare |
$599.89
|
|
|
INFLUENZA AB
|
Facility
OP
|
$82.00
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
4110785
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna of IA Commercial |
$73.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$73.80
|
| Rate for Payer: Aetna of IA Medicare |
$46.74
|
| Rate for Payer: Amerigroup Medicaid |
$41.39
|
| Rate for Payer: Amerigroup Medicare |
$41.41
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$61.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$41.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$40.98
|
| Rate for Payer: Medical Associates Commercial |
$61.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$41.00
|
| Rate for Payer: Midlands Choice Commercial |
$57.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$41.62
|
| Rate for Payer: Partners Health Alliance Commercial |
$61.50
|
| Rate for Payer: United Healthcare Commercial |
$73.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$48.38
|
| Rate for Payer: Wellmark IA HMO |
$31.00
|
| Rate for Payer: Wellmark IA PPO |
$34.10
|
|
