Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

11406 Excision benign lesion- trunk arms legs over 4.0 cm

Professional

Both

$1,052.00

Service Code	CPT 11406
Hospital Charge Code	8799087
Hospital Revenue Code	975
Min. Negotiated Rate	$189.59
Max. Negotiated Rate	$789.00
Rate for Payer: Amerigroup Medicaid	$191.45
Rate for Payer: Cash Price	$841.60
Rate for Payer: Cash Price	$841.60
Rate for Payer: Iowa Total Care Managed Medicaid	$189.59
Rate for Payer: Medical Associates Commercial	$789.00
Rate for Payer: Midlands Choice Commercial	$736.40
Rate for Payer: Molina Healthcare Managed Medicaid	$190.52
Rate for Payer: Partners Health Alliance Commercial	$789.00
Rate for Payer: United Healthcare Commercial	$476.08
Rate for Payer: Wellmark IA HMO WHPI	$585.30
Rate for Payer: Wellmark IA PPO	$688.50

11420 Excision benign lesion; scalp neck hands feet 0.5cm or less

Professional

Both

$420.00

Service Code	CPT 11420
Hospital Charge Code	8799088
Hospital Revenue Code	975
Min. Negotiated Rate	$81.13
Max. Negotiated Rate	$315.00
Rate for Payer: Amerigroup Medicaid	$81.93
Rate for Payer: Cash Price	$336.00
Rate for Payer: Cash Price	$336.00
Rate for Payer: Iowa Total Care Managed Medicaid	$81.13
Rate for Payer: Medical Associates Commercial	$315.00
Rate for Payer: Midlands Choice Commercial	$294.00
Rate for Payer: Molina Healthcare Managed Medicaid	$81.53
Rate for Payer: Partners Health Alliance Commercial	$315.00
Rate for Payer: United Healthcare Commercial	$191.01
Rate for Payer: Wellmark IA HMO WHPI	$232.20
Rate for Payer: Wellmark IA PPO	$273.10

11421 Excision B9 tumor incl margins scalp neck feet - 0.6-1.0 cm

Professional

Both

$524.00

Service Code	CPT 11421
Hospital Charge Code	8799089
Hospital Revenue Code	975
Min. Negotiated Rate	$107.51
Max. Negotiated Rate	$393.00
Rate for Payer: Amerigroup Medicaid	$108.56
Rate for Payer: Cash Price	$419.20
Rate for Payer: Cash Price	$419.20
Rate for Payer: Iowa Total Care Managed Medicaid	$107.51
Rate for Payer: Medical Associates Commercial	$393.00
Rate for Payer: Midlands Choice Commercial	$366.80
Rate for Payer: Molina Healthcare Managed Medicaid	$108.04
Rate for Payer: Partners Health Alliance Commercial	$393.00
Rate for Payer: United Healthcare Commercial	$240.66
Rate for Payer: Wellmark IA HMO WHPI	$292.90
Rate for Payer: Wellmark IA PPO	$344.60

11422 Excision benign lesion scalp neck genitalia 1.1-2.0 cm

Professional

Both

$590.00

Service Code	CPT 11422
Hospital Charge Code	8799090
Hospital Revenue Code	975
Min. Negotiated Rate	$122.84
Max. Negotiated Rate	$442.50
Rate for Payer: Amerigroup Medicaid	$124.04
Rate for Payer: Cash Price	$472.00
Rate for Payer: Cash Price	$472.00
Rate for Payer: Iowa Total Care Managed Medicaid	$122.84
Rate for Payer: Medical Associates Commercial	$442.50
Rate for Payer: Midlands Choice Commercial	$413.00
Rate for Payer: Molina Healthcare Managed Medicaid	$123.44
Rate for Payer: Partners Health Alliance Commercial	$442.50
Rate for Payer: United Healthcare Commercial	$270.24
Rate for Payer: Wellmark IA HMO WHPI	$328.80
Rate for Payer: Wellmark IA PPO	$386.80

11423 Excision benign lesion incl margins 2.1-3.0cm

Professional

Both

$673.00

Service Code	CPT 11423
Hospital Charge Code	8799091
Hospital Revenue Code	975
Min. Negotiated Rate	$150.18
Max. Negotiated Rate	$504.75
Rate for Payer: Amerigroup Medicaid	$151.66
Rate for Payer: Cash Price	$538.40
Rate for Payer: Cash Price	$538.40
Rate for Payer: Iowa Total Care Managed Medicaid	$150.18
Rate for Payer: Medical Associates Commercial	$504.75
Rate for Payer: Midlands Choice Commercial	$471.10
Rate for Payer: Molina Healthcare Managed Medicaid	$150.92
Rate for Payer: Partners Health Alliance Commercial	$504.75
Rate for Payer: United Healthcare Commercial	$307.54
Rate for Payer: Wellmark IA HMO WHPI	$376.80
Rate for Payer: Wellmark IA PPO	$443.30

11424 Excision benign lesion incl margins 3.1-4.0cm

Professional

Both

$775.00

Service Code	CPT 11424
Hospital Charge Code	8799092
Hospital Revenue Code	975
Min. Negotiated Rate	$170.90
Max. Negotiated Rate	$581.25
Rate for Payer: Amerigroup Medicaid	$172.58
Rate for Payer: Cash Price	$620.00
Rate for Payer: Cash Price	$620.00
Rate for Payer: Iowa Total Care Managed Medicaid	$170.90
Rate for Payer: Medical Associates Commercial	$581.25
Rate for Payer: Midlands Choice Commercial	$542.50
Rate for Payer: Molina Healthcare Managed Medicaid	$171.74
Rate for Payer: Partners Health Alliance Commercial	$581.25
Rate for Payer: United Healthcare Commercial	$354.42
Rate for Payer: Wellmark IA HMO WHPI	$436.40
Rate for Payer: Wellmark IA PPO	$513.40

11426 Excision benign lesion neck over 4 cm

Professional

Both

$1,115.00

Service Code	CPT 11426
Hospital Charge Code	8799093
Hospital Revenue Code	975
Min. Negotiated Rate	$233.91
Max. Negotiated Rate	$836.25
Rate for Payer: Amerigroup Medicaid	$236.20
Rate for Payer: Cash Price	$892.00
Rate for Payer: Cash Price	$892.00
Rate for Payer: Iowa Total Care Managed Medicaid	$233.91
Rate for Payer: Medical Associates Commercial	$836.25
Rate for Payer: Midlands Choice Commercial	$780.50
Rate for Payer: Molina Healthcare Managed Medicaid	$235.05
Rate for Payer: Partners Health Alliance Commercial	$836.25
Rate for Payer: United Healthcare Commercial	$507.36
Rate for Payer: Wellmark IA HMO WHPI	$601.10
Rate for Payer: Wellmark IA PPO	$707.10

11443 Excision- B9 lesion: face ears eyelids nose lips 2.1-3.0 cm

Professional

Both

$752.00

Service Code	CPT 11443
Hospital Charge Code	8799094
Hospital Revenue Code	975
Min. Negotiated Rate	$170.71
Max. Negotiated Rate	$564.00
Rate for Payer: Amerigroup Medicaid	$172.38
Rate for Payer: Cash Price	$601.60
Rate for Payer: Cash Price	$601.60
Rate for Payer: Iowa Total Care Managed Medicaid	$170.71
Rate for Payer: Medical Associates Commercial	$564.00
Rate for Payer: Midlands Choice Commercial	$526.40
Rate for Payer: Molina Healthcare Managed Medicaid	$171.54
Rate for Payer: Partners Health Alliance Commercial	$564.00
Rate for Payer: United Healthcare Commercial	$341.46
Rate for Payer: Wellmark IA HMO WHPI	$418.10
Rate for Payer: Wellmark IA PPO	$491.90

11603 Excision malignant lesion trunk- 2.1- 3.0 cm

Professional

Both

$993.00

Service Code	CPT 11603
Hospital Charge Code	8799095
Hospital Revenue Code	975
Min. Negotiated Rate	$173.85
Max. Negotiated Rate	$744.75
Rate for Payer: Amerigroup Medicaid	$175.55
Rate for Payer: Cash Price	$794.40
Rate for Payer: Cash Price	$794.40
Rate for Payer: Iowa Total Care Managed Medicaid	$173.85
Rate for Payer: Medical Associates Commercial	$744.75
Rate for Payer: Midlands Choice Commercial	$695.10
Rate for Payer: Molina Healthcare Managed Medicaid	$174.70
Rate for Payer: Partners Health Alliance Commercial	$744.75
Rate for Payer: United Healthcare Commercial	$425.20
Rate for Payer: Wellmark IA HMO WHPI	$509.90
Rate for Payer: Wellmark IA PPO	$599.90

11623 Excision malignant lesion-scalp neck hands feet 2.1-3.0 cm

Professional

Both

$997.00

Service Code	CPT 11623
Hospital Charge Code	8799096
Hospital Revenue Code	975
Min. Negotiated Rate	$200.02
Max. Negotiated Rate	$747.75
Rate for Payer: Amerigroup Medicaid	$201.98
Rate for Payer: Cash Price	$797.60
Rate for Payer: Cash Price	$797.60
Rate for Payer: Iowa Total Care Managed Medicaid	$200.02
Rate for Payer: Medical Associates Commercial	$747.75
Rate for Payer: Midlands Choice Commercial	$697.90
Rate for Payer: Molina Healthcare Managed Medicaid	$201.00
Rate for Payer: Partners Health Alliance Commercial	$747.75
Rate for Payer: United Healthcare Commercial	$452.05
Rate for Payer: Wellmark IA HMO WHPI	$541.50
Rate for Payer: Wellmark IA PPO	$637.10

11643 Excision malignant lesion-face ears eyelids nose lips- 2.1-3.0 cm

Professional

Both

$1,060.00

Service Code	CPT 11643
Hospital Charge Code	8799097
Hospital Revenue Code	975
Min. Negotiated Rate	$235.79
Max. Negotiated Rate	$795.00
Rate for Payer: Amerigroup Medicaid	$238.11
Rate for Payer: Cash Price	$848.00
Rate for Payer: Cash Price	$848.00
Rate for Payer: Iowa Total Care Managed Medicaid	$235.79
Rate for Payer: Medical Associates Commercial	$795.00
Rate for Payer: Midlands Choice Commercial	$742.00
Rate for Payer: Molina Healthcare Managed Medicaid	$236.95
Rate for Payer: Partners Health Alliance Commercial	$795.00
Rate for Payer: United Healthcare Commercial	$480.59
Rate for Payer: Wellmark IA HMO WHPI	$576.10
Rate for Payer: Wellmark IA PPO	$677.80

11730 Avulsion of nail plate partial or complete simple; single

Professional

Both

$366.00

Service Code	CPT 11730
Hospital Charge Code	8799098
Hospital Revenue Code	975
Min. Negotiated Rate	$61.71
Max. Negotiated Rate	$274.50
Rate for Payer: Amerigroup Medicaid	$62.32
Rate for Payer: Cash Price	$292.80
Rate for Payer: Cash Price	$292.80
Rate for Payer: Iowa Total Care Managed Medicaid	$61.71
Rate for Payer: Medical Associates Commercial	$274.50
Rate for Payer: Midlands Choice Commercial	$256.20
Rate for Payer: Molina Healthcare Managed Medicaid	$62.01
Rate for Payer: Partners Health Alliance Commercial	$274.50
Rate for Payer: United Healthcare Commercial	$167.58
Rate for Payer: Wellmark IA HMO WHPI	$210.30
Rate for Payer: Wellmark IA PPO	$247.40

11770 EXC PILONID CYST SIMPLE

Professional

Both

$1,040.00

Service Code	CPT 11770
Hospital Charge Code	8069078
Hospital Revenue Code	975
Min. Negotiated Rate	$194.16
Max. Negotiated Rate	$780.00
Rate for Payer: Amerigroup Medicaid	$196.06
Rate for Payer: Cash Price	$832.00
Rate for Payer: Cash Price	$832.00
Rate for Payer: Iowa Total Care Managed Medicaid	$194.16
Rate for Payer: Medical Associates Commercial	$780.00
Rate for Payer: Midlands Choice Commercial	$728.00
Rate for Payer: Molina Healthcare Managed Medicaid	$195.11
Rate for Payer: Partners Health Alliance Commercial	$780.00
Rate for Payer: United Healthcare Commercial	$465.84
Rate for Payer: Wellmark IA HMO WHPI	$648.50
Rate for Payer: Wellmark IA PPO	$762.90

11772 Excision of pilonidal cyst/sinus; complicated

Professional

Both

$2,444.00

Service Code	CPT 11772
Hospital Charge Code	8799099
Hospital Revenue Code	975
Min. Negotiated Rate	$450.55
Max. Negotiated Rate	$1,833.00
Rate for Payer: Amerigroup Medicaid	$454.97
Rate for Payer: Cash Price	$1,955.20
Rate for Payer: Cash Price	$1,955.20
Rate for Payer: Iowa Total Care Managed Medicaid	$450.55
Rate for Payer: Medical Associates Commercial	$1,833.00
Rate for Payer: Midlands Choice Commercial	$1,710.80
Rate for Payer: Molina Healthcare Managed Medicaid	$452.76
Rate for Payer: Partners Health Alliance Commercial	$1,833.00
Rate for Payer: United Healthcare Commercial	$1,091.79
Rate for Payer: Wellmark IA HMO WHPI	$1,414.20
Rate for Payer: Wellmark IA PPO	$1,663.80

12011 Simple repair/superficial wound of face ears etc 2.5cm or less

Professional

Both

$369.00

Service Code	CPT 12011
Hospital Charge Code	8799100
Hospital Revenue Code	975
Min. Negotiated Rate	$118.88
Max. Negotiated Rate	$276.75
Rate for Payer: Amerigroup Medicaid	$120.05
Rate for Payer: Cash Price	$295.20
Rate for Payer: Cash Price	$295.20
Rate for Payer: Iowa Total Care Managed Medicaid	$118.88
Rate for Payer: Medical Associates Commercial	$276.75
Rate for Payer: Midlands Choice Commercial	$258.30
Rate for Payer: Molina Healthcare Managed Medicaid	$119.46
Rate for Payer: Partners Health Alliance Commercial	$276.75
Rate for Payer: United Healthcare Commercial	$164.86
Rate for Payer: Wellmark IA HMO WHPI	$205.40
Rate for Payer: Wellmark IA PPO	$241.70

12034 Repair intermediate wounds of scalp trunk extremities- 7.6-12.5 cm

Professional

Both

$1,058.00

Service Code	CPT 12034
Hospital Charge Code	8799101
Hospital Revenue Code	975
Min. Negotiated Rate	$185.54
Max. Negotiated Rate	$793.50
Rate for Payer: Amerigroup Medicaid	$187.36
Rate for Payer: Cash Price	$846.40
Rate for Payer: Cash Price	$846.40
Rate for Payer: Iowa Total Care Managed Medicaid	$185.54
Rate for Payer: Medical Associates Commercial	$793.50
Rate for Payer: Midlands Choice Commercial	$740.60
Rate for Payer: Molina Healthcare Managed Medicaid	$186.45
Rate for Payer: Partners Health Alliance Commercial	$793.50
Rate for Payer: United Healthcare Commercial	$488.45
Rate for Payer: Wellmark IA HMO WHPI	$612.00
Rate for Payer: Wellmark IA PPO	$720.00

12 HOLE LATERAL FIBULA PLATE SYMMETRIC

Facility

$3,141.00

Service Code	HCPCS C1713
Hospital Charge Code	8986277
Hospital Revenue Code	278
Min. Negotiated Rate	$1,413.45
Max. Negotiated Rate	$2,826.90
Rate for Payer: Aetna of IA Commercial	$2,826.90
Rate for Payer: Aetna of IA Medical Rental Products	$2,826.90
Rate for Payer: Aetna of IA Medicare	$1,790.37
Rate for Payer: Amerigroup Medicaid	$1,811.73
Rate for Payer: Amerigroup Medicare	$1,427.58
Rate for Payer: Cash Price	$2,512.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2,355.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$1,413.45
Rate for Payer: Iowa Total Care Managed Medicaid	$1,794.14
Rate for Payer: Medical Associates Commercial	$2,355.75
Rate for Payer: Medical Associates Managed Medicare	$1,413.45
Rate for Payer: Midlands Choice Commercial	$2,198.70
Rate for Payer: Molina Healthcare Managed Medicaid	$1,820.52
Rate for Payer: Partners Health Alliance Commercial	$1,625.47
Rate for Payer: United Healthcare Commercial	$2,826.90
Rate for Payer: United Healthcare Managed Medicare	$1,853.19

12 HOLE LATERAL FIBULA PLATE SYMMETRIC

Facility

$3,141.00

Service Code	HCPCS C1713
Hospital Charge Code	8986277
Hospital Revenue Code	278
Min. Negotiated Rate	$2,198.70
Max. Negotiated Rate	$2,826.90
Rate for Payer: Aetna of IA Commercial	$2,826.90
Rate for Payer: Aetna of IA Medical Rental Products	$2,826.90
Rate for Payer: Cash Price	$2,512.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2,355.75
Rate for Payer: Medical Associates Commercial	$2,355.75
Rate for Payer: Midlands Choice Commercial	$2,198.70
Rate for Payer: United Healthcare Commercial	$2,826.90

13121 Repair complex scalp arms and/or legs 2.6-7.5 cm

Professional

Both

$1,430.00

Service Code	CPT 13121
Hospital Charge Code	8799102
Hospital Revenue Code	975
Min. Negotiated Rate	$270.08
Max. Negotiated Rate	$1,072.50
Rate for Payer: Amerigroup Medicaid	$272.72
Rate for Payer: Cash Price	$1,144.00
Rate for Payer: Cash Price	$1,144.00
Rate for Payer: Iowa Total Care Managed Medicaid	$270.08
Rate for Payer: Medical Associates Commercial	$1,072.50
Rate for Payer: Midlands Choice Commercial	$1,001.00
Rate for Payer: Molina Healthcare Managed Medicaid	$271.40
Rate for Payer: Partners Health Alliance Commercial	$1,072.50
Rate for Payer: United Healthcare Commercial	$650.54
Rate for Payer: Wellmark IA HMO WHPI	$775.50
Rate for Payer: Wellmark IA PPO	$912.30

13132 Repair complex forehead cheeks neck 2.6 to 7.5 cm

Professional

Both

$1,582.00

Service Code	CPT 13132
Hospital Charge Code	8799103
Hospital Revenue Code	975
Min. Negotiated Rate	$375.53
Max. Negotiated Rate	$1,186.50
Rate for Payer: Amerigroup Medicaid	$379.22
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Cash Price	$1,265.60
Rate for Payer: Iowa Total Care Managed Medicaid	$375.53
Rate for Payer: Medical Associates Commercial	$1,186.50
Rate for Payer: Midlands Choice Commercial	$1,107.40
Rate for Payer: Molina Healthcare Managed Medicaid	$377.37
Rate for Payer: Partners Health Alliance Commercial	$1,186.50
Rate for Payer: United Healthcare Commercial	$723.20
Rate for Payer: Wellmark IA HMO WHPI	$858.10
Rate for Payer: Wellmark IA PPO	$1,009.60

14000 Adjacent tissue transfer/rearrangement; trunk; 10 sq cm or less

Professional

Both

$2,087.00

Service Code	CPT 14000
Hospital Charge Code	8799104
Hospital Revenue Code	975
Min. Negotiated Rate	$394.70
Max. Negotiated Rate	$1,565.25
Rate for Payer: Amerigroup Medicaid	$398.57
Rate for Payer: Cash Price	$1,669.60
Rate for Payer: Cash Price	$1,669.60
Rate for Payer: Iowa Total Care Managed Medicaid	$394.70
Rate for Payer: Medical Associates Commercial	$1,565.25
Rate for Payer: Midlands Choice Commercial	$1,460.90
Rate for Payer: Molina Healthcare Managed Medicaid	$396.63
Rate for Payer: Partners Health Alliance Commercial	$1,565.25
Rate for Payer: United Healthcare Commercial	$942.43
Rate for Payer: Wellmark IA HMO WHPI	$1,168.10
Rate for Payer: Wellmark IA PPO	$1,374.20

14301 Adjacent tissue transfer any area 30.1 sq cm - 60 sq cm

Professional

Both

$3,600.00

Service Code	CPT 14301
Hospital Charge Code	8799106
Hospital Revenue Code	975
Min. Negotiated Rate	$894.84
Max. Negotiated Rate	$2,700.00
Rate for Payer: Amerigroup Medicaid	$903.61
Rate for Payer: Cash Price	$2,880.00
Rate for Payer: Cash Price	$2,880.00
Rate for Payer: Iowa Total Care Managed Medicaid	$894.84
Rate for Payer: Medical Associates Commercial	$2,700.00
Rate for Payer: Midlands Choice Commercial	$2,520.00
Rate for Payer: Molina Healthcare Managed Medicaid	$899.22
Rate for Payer: Partners Health Alliance Commercial	$2,700.00
Rate for Payer: United Healthcare Commercial	$1,632.29
Rate for Payer: Wellmark IA HMO WHPI	$1,980.70
Rate for Payer: Wellmark IA PPO	$2,330.20

15275 Application of skin substitute to face feet etc 1st 25 sq cm

Professional

Both

$523.00

Service Code	CPT 15275
Hospital Charge Code	8799107
Hospital Revenue Code	975
Min. Negotiated Rate	$136.87
Max. Negotiated Rate	$392.25
Rate for Payer: Amerigroup Medicaid	$138.22
Rate for Payer: Cash Price	$418.40
Rate for Payer: Cash Price	$418.40
Rate for Payer: Iowa Total Care Managed Medicaid	$136.87
Rate for Payer: Medical Associates Commercial	$392.25
Rate for Payer: Midlands Choice Commercial	$366.10
Rate for Payer: Molina Healthcare Managed Medicaid	$137.54
Rate for Payer: Partners Health Alliance Commercial	$392.25
Rate for Payer: United Healthcare Commercial	$239.17
Rate for Payer: Wellmark IA HMO WHPI	$289.90
Rate for Payer: Wellmark IA PPO	$341.10

15830 PANNICULECTOMY, EXCESSIVE SKIN/TISSUE REMOVAL

Professional

Both

$3,939.00

Service Code	CPT 15830
Hospital Charge Code	8068900
Hospital Revenue Code	975
Min. Negotiated Rate	$1,063.43
Max. Negotiated Rate	$2,954.25
Rate for Payer: Amerigroup Medicaid	$1,073.86
Rate for Payer: Cash Price	$3,151.20
Rate for Payer: Cash Price	$3,151.20
Rate for Payer: Iowa Total Care Managed Medicaid	$1,063.43
Rate for Payer: Medical Associates Commercial	$2,954.25
Rate for Payer: Midlands Choice Commercial	$2,757.30
Rate for Payer: Molina Healthcare Managed Medicaid	$1,068.64
Rate for Payer: Partners Health Alliance Commercial	$2,954.25
Rate for Payer: United Healthcare Commercial	$1,780.88
Rate for Payer: Wellmark IA HMO WHPI	$2,138.70
Rate for Payer: Wellmark IA PPO	$2,516.10

1.6MM COMPRESSION WIRE X 150MM

Facility

$71.00

Service Code	HCPCS C1763
Hospital Charge Code	8748467
Hospital Revenue Code	278
Min. Negotiated Rate	$31.95
Max. Negotiated Rate	$63.90
Rate for Payer: Aetna of IA Commercial	$63.90
Rate for Payer: Aetna of IA Medical Rental Products	$63.90
Rate for Payer: Aetna of IA Medicare	$40.47
Rate for Payer: Amerigroup Medicaid	$40.95
Rate for Payer: Amerigroup Medicare	$32.27
Rate for Payer: Cash Price	$56.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$53.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$31.95
Rate for Payer: Iowa Total Care Managed Medicaid	$40.56
Rate for Payer: Medical Associates Commercial	$53.25
Rate for Payer: Medical Associates Managed Medicare	$31.95
Rate for Payer: Midlands Choice Commercial	$49.70
Rate for Payer: Molina Healthcare Managed Medicaid	$41.15
Rate for Payer: Partners Health Alliance Commercial	$36.74
Rate for Payer: United Healthcare Commercial	$63.90
Rate for Payer: United Healthcare Managed Medicare	$41.89

Know your out-of-pocket cost for care.

All Charges