|
93225 Holter - up to 48hr Recording
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
8998406
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93225 Holter - up to 48hr Recording
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
8998406
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$183.63
|
| Rate for Payer: Wellmark IA PPO |
$202.28
|
|
|
93226 HOLTER MONITOR UP TO 48 HOURS
|
Facility
|
IP
|
$380.00
|
|
|
Service Code
|
CPT 93226 TC
|
| Hospital Charge Code |
8398130
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$266.00 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Aetna of IA Commercial |
$342.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$342.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$285.00
|
| Rate for Payer: Medical Associates Commercial |
$285.00
|
| Rate for Payer: Midlands Choice Commercial |
$266.00
|
| Rate for Payer: United Healthcare Commercial |
$342.00
|
|
|
93226 HOLTER MONITOR UP TO 48 HOURS
|
Facility
|
OP
|
$380.00
|
|
|
Service Code
|
CPT 93226 TC
|
| Hospital Charge Code |
8398130
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$171.00 |
| Max. Negotiated Rate |
$342.00 |
| Rate for Payer: Aetna of IA Commercial |
$342.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$342.00
|
| Rate for Payer: Aetna of IA Medicare |
$216.60
|
| Rate for Payer: Amerigroup Medicaid |
$219.18
|
| Rate for Payer: Amerigroup Medicare |
$172.71
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Cash Price |
$304.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$285.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$171.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$217.06
|
| Rate for Payer: Medical Associates Commercial |
$285.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$171.00
|
| Rate for Payer: Midlands Choice Commercial |
$266.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$220.25
|
| Rate for Payer: Partners Health Alliance Commercial |
$196.65
|
| Rate for Payer: United Healthcare Commercial |
$342.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$224.20
|
| Rate for Payer: Wellmark IA HMO WHPI |
$183.63
|
| Rate for Payer: Wellmark IA PPO |
$202.28
|
|
|
93242 Holter Monitor More than 48 hours up to 7 days by cont
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93242
|
| Hospital Charge Code |
8937055
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$183.63
|
| Rate for Payer: Wellmark IA PPO |
$202.28
|
|
|
93242 Holter Monitor More than 48 hours up to 7 days by cont
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93242
|
| Hospital Charge Code |
8937055
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93243 Holter - up to 7 day Scanning Analysis w Report
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93243
|
| Hospital Charge Code |
8998705
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$183.63
|
| Rate for Payer: Wellmark IA PPO |
$202.28
|
|
|
93243 Holter - up to 7 day Scanning Analysis w Report
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93243
|
| Hospital Charge Code |
8998705
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93246 Holter Monitor, for more than 7 days up to 15 days by
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93246
|
| Hospital Charge Code |
8937043
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93246 Holter Monitor, for more than 7 days up to 15 days by
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93246
|
| Hospital Charge Code |
8937043
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$183.63
|
| Rate for Payer: Wellmark IA PPO |
$202.28
|
|
|
93247 Holter - >7 day <15 day Scanning Analysis w Report
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93247
|
| Hospital Charge Code |
8998706
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$112.50 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$183.63
|
| Rate for Payer: Wellmark IA PPO |
$202.28
|
|
|
93247 Holter - >7 day <15 day Scanning Analysis w Report
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93247
|
| Hospital Charge Code |
8998706
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93260 Sub-Q Lead - Program
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 93260
|
| Hospital Charge Code |
8998398
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna of IA Commercial |
$180.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$180.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$150.00
|
| Rate for Payer: Medical Associates Commercial |
$150.00
|
| Rate for Payer: Midlands Choice Commercial |
$140.00
|
| Rate for Payer: United Healthcare Commercial |
$180.00
|
|
|
93260 Sub-Q Lead - Program
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 93260
|
| Hospital Charge Code |
8998398
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna of IA Commercial |
$180.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$180.00
|
| Rate for Payer: Aetna of IA Medicare |
$114.00
|
| Rate for Payer: Amerigroup Medicaid |
$115.36
|
| Rate for Payer: Amerigroup Medicare |
$90.90
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$150.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$90.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$114.24
|
| Rate for Payer: Medical Associates Commercial |
$150.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$90.00
|
| Rate for Payer: Midlands Choice Commercial |
$140.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$115.92
|
| Rate for Payer: Partners Health Alliance Commercial |
$103.50
|
| Rate for Payer: United Healthcare Commercial |
$180.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$118.00
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
|
93261 Sub-Q Lead - Interrogation
|
Facility
|
IP
|
$175.00
|
|
|
Service Code
|
CPT 93261
|
| Hospital Charge Code |
8998399
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$122.50 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna of IA Commercial |
$157.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$157.50
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$131.25
|
| Rate for Payer: Medical Associates Commercial |
$131.25
|
| Rate for Payer: Midlands Choice Commercial |
$122.50
|
| Rate for Payer: United Healthcare Commercial |
$157.50
|
|
|
93261 Sub-Q Lead - Interrogation
|
Facility
|
OP
|
$175.00
|
|
|
Service Code
|
CPT 93261
|
| Hospital Charge Code |
8998399
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$78.75 |
| Max. Negotiated Rate |
$157.50 |
| Rate for Payer: Aetna of IA Commercial |
$157.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$157.50
|
| Rate for Payer: Aetna of IA Medicare |
$99.75
|
| Rate for Payer: Amerigroup Medicaid |
$100.94
|
| Rate for Payer: Amerigroup Medicare |
$79.54
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Cash Price |
$140.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$131.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$78.75
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$99.96
|
| Rate for Payer: Medical Associates Commercial |
$131.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$78.75
|
| Rate for Payer: Midlands Choice Commercial |
$122.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$101.43
|
| Rate for Payer: Partners Health Alliance Commercial |
$90.56
|
| Rate for Payer: United Healthcare Commercial |
$157.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$103.25
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
|
93279 PM - Programming
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
8998400
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$140.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna of IA Commercial |
$180.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$180.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$150.00
|
| Rate for Payer: Medical Associates Commercial |
$150.00
|
| Rate for Payer: Midlands Choice Commercial |
$140.00
|
| Rate for Payer: United Healthcare Commercial |
$180.00
|
|
|
93279 PM - Programming
|
Facility
|
OP
|
$200.00
|
|
|
Service Code
|
CPT 93279
|
| Hospital Charge Code |
8998400
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$180.00 |
| Rate for Payer: Aetna of IA Commercial |
$180.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$180.00
|
| Rate for Payer: Aetna of IA Medicare |
$114.00
|
| Rate for Payer: Amerigroup Medicaid |
$115.36
|
| Rate for Payer: Amerigroup Medicare |
$90.90
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$150.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$90.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$114.24
|
| Rate for Payer: Medical Associates Commercial |
$150.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$90.00
|
| Rate for Payer: Midlands Choice Commercial |
$140.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$115.92
|
| Rate for Payer: Partners Health Alliance Commercial |
$103.50
|
| Rate for Payer: United Healthcare Commercial |
$180.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$118.00
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
|
93280 Dual PM - Programming
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
8998401
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$157.50 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna of IA Commercial |
$202.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$202.50
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$168.75
|
| Rate for Payer: Medical Associates Commercial |
$168.75
|
| Rate for Payer: Midlands Choice Commercial |
$157.50
|
| Rate for Payer: United Healthcare Commercial |
$202.50
|
|
|
93280 Dual PM - Programming
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
CPT 93280
|
| Hospital Charge Code |
8998401
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna of IA Commercial |
$202.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$202.50
|
| Rate for Payer: Aetna of IA Medicare |
$128.25
|
| Rate for Payer: Amerigroup Medicaid |
$129.78
|
| Rate for Payer: Amerigroup Medicare |
$102.26
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$168.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$101.25
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$128.52
|
| Rate for Payer: Medical Associates Commercial |
$168.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$101.25
|
| Rate for Payer: Midlands Choice Commercial |
$157.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$130.41
|
| Rate for Payer: Partners Health Alliance Commercial |
$116.44
|
| Rate for Payer: United Healthcare Commercial |
$202.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$132.75
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
|
93281 Multi PM - Programming
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
8998697
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
|
93281 Multi PM - Programming
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93281
|
| Hospital Charge Code |
8998697
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93283 Dual ICD - Programming
|
Facility
|
IP
|
$250.00
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
8998403
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$175.00 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
|
|
93283 Dual ICD - Programming
|
Facility
|
OP
|
$250.00
|
|
|
Service Code
|
CPT 93283
|
| Hospital Charge Code |
8998403
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$225.00 |
| Rate for Payer: Aetna of IA Commercial |
$225.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$225.00
|
| Rate for Payer: Aetna of IA Medicare |
$142.50
|
| Rate for Payer: Amerigroup Medicaid |
$144.20
|
| Rate for Payer: Amerigroup Medicare |
$113.62
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Cash Price |
$200.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$187.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$112.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$142.80
|
| Rate for Payer: Medical Associates Commercial |
$187.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$112.50
|
| Rate for Payer: Midlands Choice Commercial |
$175.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$144.90
|
| Rate for Payer: Partners Health Alliance Commercial |
$129.38
|
| Rate for Payer: United Healthcare Commercial |
$225.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$147.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
|
93284 Multi ICD - Programming
|
Facility
|
OP
|
$275.00
|
|
|
Service Code
|
CPT 93284
|
| Hospital Charge Code |
8998698
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$97.13 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna of IA Commercial |
$247.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$247.50
|
| Rate for Payer: Aetna of IA Medicare |
$156.75
|
| Rate for Payer: Amerigroup Medicaid |
$158.62
|
| Rate for Payer: Amerigroup Medicare |
$124.99
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$206.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$123.75
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$157.08
|
| Rate for Payer: Medical Associates Commercial |
$206.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$123.75
|
| Rate for Payer: Midlands Choice Commercial |
$192.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$159.39
|
| Rate for Payer: Partners Health Alliance Commercial |
$142.31
|
| Rate for Payer: United Healthcare Commercial |
$247.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$162.25
|
| Rate for Payer: Wellmark IA HMO WHPI |
$97.13
|
| Rate for Payer: Wellmark IA PPO |
$107.00
|
|
