Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

K-WIRE 1.5 MM

Facility

$16.00

Service Code	CPT C1713
Hospital Charge Code	8046398
Hospital Revenue Code	278
Min. Negotiated Rate	$8.00
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna of IA Commercial	$14.40
Rate for Payer: Aetna of IA Medical Rental Products	$14.40
Rate for Payer: Aetna of IA Medicare	$9.12
Rate for Payer: Amerigroup Medicaid	$8.08
Rate for Payer: Amerigroup Medicare	$8.08
Rate for Payer: Cash Price	$12.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$12.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$8.00
Rate for Payer: Iowa Total Care Managed Medicaid	$8.00
Rate for Payer: Medical Associates Commercial	$12.00
Rate for Payer: Medical Associates Managed Medicare	$8.00
Rate for Payer: Midlands Choice Commercial	$11.20
Rate for Payer: Molina Healthcare Managed Medicaid	$8.12
Rate for Payer: Molina Healthcare Managed Medicare	$8.12
Rate for Payer: Oscar Health of IA Commercial	$12.00
Rate for Payer: Partners Health Alliance Commercial	$12.00
Rate for Payer: United Healthcare Commercial	$14.40
Rate for Payer: United Healthcare Managed Medicare	$9.44

K-WIRE 1.5 MM

Facility

$16.00

Service Code	CPT C1713
Hospital Charge Code	8046398
Hospital Revenue Code	278
Min. Negotiated Rate	$11.20
Max. Negotiated Rate	$14.40
Rate for Payer: Aetna of IA Commercial	$14.40
Rate for Payer: Aetna of IA Medical Rental Products	$14.40
Rate for Payer: Cash Price	$12.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$12.00
Rate for Payer: Medical Associates Commercial	$12.00
Rate for Payer: Midlands Choice Commercial	$11.20
Rate for Payer: United Healthcare Commercial	$14.40

K-WIRE, 1.60MM, TROCAR TIP

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8047149
Hospital Revenue Code	278
Min. Negotiated Rate	$6.50
Max. Negotiated Rate	$11.70
Rate for Payer: Aetna of IA Commercial	$11.70
Rate for Payer: Aetna of IA Medical Rental Products	$11.70
Rate for Payer: Aetna of IA Medicare	$7.41
Rate for Payer: Amerigroup Medicaid	$6.56
Rate for Payer: Amerigroup Medicare	$6.56
Rate for Payer: Cash Price	$10.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$9.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$6.50
Rate for Payer: Iowa Total Care Managed Medicaid	$6.50
Rate for Payer: Medical Associates Commercial	$9.75
Rate for Payer: Medical Associates Managed Medicare	$6.50
Rate for Payer: Midlands Choice Commercial	$9.10
Rate for Payer: Molina Healthcare Managed Medicaid	$6.60
Rate for Payer: Molina Healthcare Managed Medicare	$6.59
Rate for Payer: Oscar Health of IA Commercial	$9.75
Rate for Payer: Partners Health Alliance Commercial	$9.75
Rate for Payer: United Healthcare Commercial	$11.70
Rate for Payer: United Healthcare Managed Medicare	$7.67

K-WIRE, 1.60MM, TROCAR TIP

Facility

$13.00

Service Code	CPT C1713
Hospital Charge Code	8047149
Hospital Revenue Code	278
Min. Negotiated Rate	$9.10
Max. Negotiated Rate	$11.70
Rate for Payer: Medical Associates Commercial	$9.75
Rate for Payer: Aetna of IA Commercial	$11.70
Rate for Payer: Aetna of IA Medical Rental Products	$11.70
Rate for Payer: Cash Price	$10.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$9.75
Rate for Payer: Midlands Choice Commercial	$9.10
Rate for Payer: United Healthcare Commercial	$11.70

K-WIRE, 1.60MM, TROCAR TIP-1

Facility

$18.00

Service Code	CPT C1713
Hospital Charge Code	8047217
Hospital Revenue Code	278
Min. Negotiated Rate	$9.00
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna of IA Commercial	$16.20
Rate for Payer: Aetna of IA Medical Rental Products	$16.20
Rate for Payer: Aetna of IA Medicare	$10.26
Rate for Payer: Amerigroup Medicaid	$9.08
Rate for Payer: Amerigroup Medicare	$9.09
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$13.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$9.00
Rate for Payer: Iowa Total Care Managed Medicaid	$9.00
Rate for Payer: Medical Associates Commercial	$13.50
Rate for Payer: Medical Associates Managed Medicare	$9.00
Rate for Payer: Midlands Choice Commercial	$12.60
Rate for Payer: Molina Healthcare Managed Medicaid	$9.14
Rate for Payer: Molina Healthcare Managed Medicare	$9.13
Rate for Payer: Oscar Health of IA Commercial	$13.50
Rate for Payer: Partners Health Alliance Commercial	$13.50
Rate for Payer: United Healthcare Commercial	$16.20
Rate for Payer: United Healthcare Managed Medicare	$10.62

K-WIRE, 1.60MM, TROCAR TIP-1

Facility

$18.00

Service Code	CPT C1713
Hospital Charge Code	8047217
Hospital Revenue Code	278
Min. Negotiated Rate	$12.60
Max. Negotiated Rate	$16.20
Rate for Payer: Aetna of IA Commercial	$16.20
Rate for Payer: Aetna of IA Medical Rental Products	$16.20
Rate for Payer: Cash Price	$14.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$13.50
Rate for Payer: Medical Associates Commercial	$13.50
Rate for Payer: Midlands Choice Commercial	$12.60
Rate for Payer: United Healthcare Commercial	$16.20

K-WIRE 1.6MM

Facility

$37.00

Service Code	CPT C1713
Hospital Charge Code	8047369
Hospital Revenue Code	278
Min. Negotiated Rate	$25.90
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna of IA Commercial	$33.30
Rate for Payer: Aetna of IA Medical Rental Products	$33.30
Rate for Payer: Cash Price	$29.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.75
Rate for Payer: Medical Associates Commercial	$27.75
Rate for Payer: Midlands Choice Commercial	$25.90
Rate for Payer: United Healthcare Commercial	$33.30

K-WIRE 1.6MM

Facility

$37.00

Service Code	CPT C1713
Hospital Charge Code	8047369
Hospital Revenue Code	278
Min. Negotiated Rate	$18.49
Max. Negotiated Rate	$33.30
Rate for Payer: Aetna of IA Commercial	$33.30
Rate for Payer: Aetna of IA Medical Rental Products	$33.30
Rate for Payer: Aetna of IA Medicare	$21.09
Rate for Payer: Amerigroup Medicaid	$18.67
Rate for Payer: Amerigroup Medicare	$18.68
Rate for Payer: Cash Price	$29.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$27.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$18.50
Rate for Payer: Iowa Total Care Managed Medicaid	$18.49
Rate for Payer: Medical Associates Commercial	$27.75
Rate for Payer: Medical Associates Managed Medicare	$18.50
Rate for Payer: Midlands Choice Commercial	$25.90
Rate for Payer: Molina Healthcare Managed Medicaid	$18.78
Rate for Payer: Molina Healthcare Managed Medicare	$18.77
Rate for Payer: Oscar Health of IA Commercial	$27.75
Rate for Payer: Partners Health Alliance Commercial	$27.75
Rate for Payer: United Healthcare Commercial	$33.30
Rate for Payer: United Healthcare Managed Medicare	$21.83

K-WIRE 1.8X310MM IMPLANT

Facility

$284.00

Service Code	CPT C1713
Hospital Charge Code	8025848
Hospital Revenue Code	278
Min. Negotiated Rate	$141.94
Max. Negotiated Rate	$255.60
Rate for Payer: Aetna of IA Commercial	$255.60
Rate for Payer: Aetna of IA Medical Rental Products	$255.60
Rate for Payer: Aetna of IA Medicare	$161.88
Rate for Payer: Amerigroup Medicaid	$143.33
Rate for Payer: Amerigroup Medicare	$143.42
Rate for Payer: Cash Price	$227.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$213.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$142.00
Rate for Payer: Iowa Total Care Managed Medicaid	$141.94
Rate for Payer: Medical Associates Commercial	$213.00
Rate for Payer: Medical Associates Managed Medicare	$142.00
Rate for Payer: Midlands Choice Commercial	$198.80
Rate for Payer: Molina Healthcare Managed Medicaid	$144.13
Rate for Payer: Molina Healthcare Managed Medicare	$144.04
Rate for Payer: Oscar Health of IA Commercial	$213.00
Rate for Payer: Partners Health Alliance Commercial	$213.00
Rate for Payer: United Healthcare Commercial	$255.60
Rate for Payer: United Healthcare Managed Medicare	$167.56

K-WIRE 1.8X310MM IMPLANT

Facility

$284.00

Service Code	CPT C1713
Hospital Charge Code	8025848
Hospital Revenue Code	278
Min. Negotiated Rate	$198.80
Max. Negotiated Rate	$255.60
Rate for Payer: Aetna of IA Commercial	$255.60
Rate for Payer: Aetna of IA Medical Rental Products	$255.60
Rate for Payer: Cash Price	$227.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$213.00
Rate for Payer: Medical Associates Commercial	$213.00
Rate for Payer: Midlands Choice Commercial	$198.80
Rate for Payer: United Healthcare Commercial	$255.60

K-WIRE 4X.028 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046945
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 4X.028 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046945
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 4X.035 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046725
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 4X.035 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046725
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 4X.045 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046790
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 4X.045 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046790
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 4X.054 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046313
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 4X.054 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046313
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 4X.062 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046625
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 4X.062 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046625
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 6X.028 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046328
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 6X.028 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046328
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 6X.035 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046980
Hospital Revenue Code	278
Min. Negotiated Rate	$24.50
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: United Healthcare Commercial	$31.50

K-WIRE 6X.035 TROCAR POINTS STERILE

Facility

$35.00

Service Code	CPT C1713
Hospital Charge Code	8046980
Hospital Revenue Code	278
Min. Negotiated Rate	$17.49
Max. Negotiated Rate	$31.50
Rate for Payer: Aetna of IA Commercial	$31.50
Rate for Payer: Aetna of IA Medical Rental Products	$31.50
Rate for Payer: Aetna of IA Medicare	$19.95
Rate for Payer: Amerigroup Medicaid	$17.66
Rate for Payer: Amerigroup Medicare	$17.68
Rate for Payer: Cash Price	$28.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$26.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$17.50
Rate for Payer: Iowa Total Care Managed Medicaid	$17.49
Rate for Payer: Medical Associates Commercial	$26.25
Rate for Payer: Medical Associates Managed Medicare	$17.50
Rate for Payer: Midlands Choice Commercial	$24.50
Rate for Payer: Molina Healthcare Managed Medicaid	$17.76
Rate for Payer: Molina Healthcare Managed Medicare	$17.75
Rate for Payer: Oscar Health of IA Commercial	$26.25
Rate for Payer: Partners Health Alliance Commercial	$26.25
Rate for Payer: United Healthcare Commercial	$31.50
Rate for Payer: United Healthcare Managed Medicare	$20.65

K-WIRE 6X.045 TROCAR POINTS STERILE

Facility

$33.00

Service Code	CPT C1713
Hospital Charge Code	8046383
Hospital Revenue Code	278
Min. Negotiated Rate	$16.49
Max. Negotiated Rate	$29.70
Rate for Payer: Aetna of IA Commercial	$29.70
Rate for Payer: Aetna of IA Medical Rental Products	$29.70
Rate for Payer: Aetna of IA Medicare	$18.81
Rate for Payer: Amerigroup Medicaid	$16.66
Rate for Payer: Amerigroup Medicare	$16.66
Rate for Payer: Cash Price	$26.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$24.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$16.50
Rate for Payer: Iowa Total Care Managed Medicaid	$16.49
Rate for Payer: Medical Associates Commercial	$24.75
Rate for Payer: Medical Associates Managed Medicare	$16.50
Rate for Payer: Midlands Choice Commercial	$23.10
Rate for Payer: Molina Healthcare Managed Medicaid	$16.75
Rate for Payer: Molina Healthcare Managed Medicare	$16.74
Rate for Payer: Oscar Health of IA Commercial	$24.75
Rate for Payer: Partners Health Alliance Commercial	$24.75
Rate for Payer: United Healthcare Commercial	$29.70
Rate for Payer: United Healthcare Managed Medicare	$19.47

Know your out-of-pocket cost for care.

All Charges