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Service Code HCPCS A9270
Hospital Charge Code 11361372
Hospital Revenue Code 259
Min. Negotiated Rate $0.50
Max. Negotiated Rate $1.00
Rate for Payer: Aetna of IA Commercial $1.00
Rate for Payer: Aetna of IA Medical Rental Products $1.00
Rate for Payer: Aetna of IA Medicare $0.63
Rate for Payer: Amerigroup Medicaid $0.64
Rate for Payer: Amerigroup Medicare $0.51
Rate for Payer: Cash Price $0.89
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $0.83
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $0.50
Rate for Payer: Iowa Total Care Managed Medicaid $0.64
Rate for Payer: Medical Associates Commercial $0.83
Rate for Payer: Medical Associates Managed Medicare $0.50
Rate for Payer: Midlands Choice Commercial $0.78
Rate for Payer: Molina Healthcare Managed Medicaid $0.64
Rate for Payer: Partners Health Alliance Commercial $0.58
Rate for Payer: United Healthcare Commercial $1.00
Rate for Payer: United Healthcare Managed Medicare $0.66
Service Code HCPCS A9270
Hospital Charge Code 11361372
Hospital Revenue Code 259
Min. Negotiated Rate $0.78
Max. Negotiated Rate $1.00
Rate for Payer: Aetna of IA Commercial $1.00
Rate for Payer: Aetna of IA Medical Rental Products $1.00
Rate for Payer: Cash Price $0.89
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $0.83
Rate for Payer: Medical Associates Commercial $0.83
Rate for Payer: Midlands Choice Commercial $0.78
Rate for Payer: United Healthcare Commercial $1.00
Service Code CPT 86735
Hospital Charge Code 8037744
Hospital Revenue Code 302
Min. Negotiated Rate $41.83
Max. Negotiated Rate $111.60
Rate for Payer: Aetna of IA Commercial $111.60
Rate for Payer: Aetna of IA Medical Rental Products $111.60
Rate for Payer: Aetna of IA Medicare $70.68
Rate for Payer: Amerigroup Medicaid $71.52
Rate for Payer: Amerigroup Medicare $56.36
Rate for Payer: Cash Price $99.20
Rate for Payer: Cash Price $99.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $93.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $55.80
Rate for Payer: Iowa Total Care Managed Medicaid $70.83
Rate for Payer: Medical Associates Commercial $93.00
Rate for Payer: Medical Associates Managed Medicare $55.80
Rate for Payer: Midlands Choice Commercial $86.80
Rate for Payer: Molina Healthcare Managed Medicaid $71.87
Rate for Payer: Partners Health Alliance Commercial $64.17
Rate for Payer: United Healthcare Commercial $111.60
Rate for Payer: United Healthcare Managed Medicare $73.16
Rate for Payer: Wellmark IA HMO WHPI $41.83
Rate for Payer: Wellmark IA PPO $46.08
Service Code CPT 86735
Hospital Charge Code 8037744
Hospital Revenue Code 302
Min. Negotiated Rate $86.80
Max. Negotiated Rate $111.60
Rate for Payer: Aetna of IA Commercial $111.60
Rate for Payer: Aetna of IA Medical Rental Products $111.60
Rate for Payer: Cash Price $99.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $93.00
Rate for Payer: Medical Associates Commercial $93.00
Rate for Payer: Midlands Choice Commercial $86.80
Rate for Payer: United Healthcare Commercial $111.60
Hospital Charge Code 8013713
Hospital Revenue Code 637
Min. Negotiated Rate $18.45
Max. Negotiated Rate $36.90
Rate for Payer: Aetna of IA Commercial $36.90
Rate for Payer: Aetna of IA Medical Rental Products $36.90
Rate for Payer: Aetna of IA Medicare $23.37
Rate for Payer: Amerigroup Medicaid $23.65
Rate for Payer: Amerigroup Medicare $18.63
Rate for Payer: Cash Price $32.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $30.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $18.45
Rate for Payer: Iowa Total Care Managed Medicaid $23.42
Rate for Payer: Medical Associates Commercial $30.75
Rate for Payer: Medical Associates Managed Medicare $18.45
Rate for Payer: Midlands Choice Commercial $28.70
Rate for Payer: Molina Healthcare Managed Medicaid $23.76
Rate for Payer: Partners Health Alliance Commercial $21.22
Rate for Payer: United Healthcare Commercial $36.90
Rate for Payer: United Healthcare Managed Medicare $24.19
Hospital Charge Code 8013713
Hospital Revenue Code 637
Min. Negotiated Rate $28.70
Max. Negotiated Rate $36.90
Rate for Payer: Aetna of IA Commercial $36.90
Rate for Payer: Aetna of IA Medical Rental Products $36.90
Rate for Payer: Cash Price $32.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $30.75
Rate for Payer: Medical Associates Commercial $30.75
Rate for Payer: Midlands Choice Commercial $28.70
Rate for Payer: United Healthcare Commercial $36.90
Service Code HCPCS A9270
Hospital Charge Code 10436449
Hospital Revenue Code 259
Min. Negotiated Rate $22.37
Max. Negotiated Rate $28.76
Rate for Payer: Aetna of IA Commercial $28.76
Rate for Payer: Aetna of IA Medical Rental Products $28.76
Rate for Payer: Cash Price $25.57
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $23.97
Rate for Payer: Medical Associates Commercial $23.97
Rate for Payer: Midlands Choice Commercial $22.37
Rate for Payer: United Healthcare Commercial $28.76
Service Code HCPCS A9270
Hospital Charge Code 10436449
Hospital Revenue Code 259
Min. Negotiated Rate $14.38
Max. Negotiated Rate $28.76
Rate for Payer: Aetna of IA Commercial $28.76
Rate for Payer: Aetna of IA Medical Rental Products $28.76
Rate for Payer: Aetna of IA Medicare $18.22
Rate for Payer: Amerigroup Medicaid $18.43
Rate for Payer: Amerigroup Medicare $14.53
Rate for Payer: Cash Price $25.57
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $23.97
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $14.38
Rate for Payer: Iowa Total Care Managed Medicaid $18.26
Rate for Payer: Medical Associates Commercial $23.97
Rate for Payer: Medical Associates Managed Medicare $14.38
Rate for Payer: Midlands Choice Commercial $22.37
Rate for Payer: Molina Healthcare Managed Medicaid $18.52
Rate for Payer: Partners Health Alliance Commercial $16.54
Rate for Payer: United Healthcare Commercial $28.76
Rate for Payer: United Healthcare Managed Medicare $18.86
Service Code HCPCS A9270
Hospital Charge Code 10407718
Hospital Revenue Code 259
Min. Negotiated Rate $1.71
Max. Negotiated Rate $2.20
Rate for Payer: Aetna of IA Commercial $2.20
Rate for Payer: Aetna of IA Medical Rental Products $2.20
Rate for Payer: Cash Price $1.96
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1.84
Rate for Payer: Medical Associates Commercial $1.84
Rate for Payer: Midlands Choice Commercial $1.71
Rate for Payer: United Healthcare Commercial $2.20
Service Code HCPCS A9270
Hospital Charge Code 10407718
Hospital Revenue Code 259
Min. Negotiated Rate $1.10
Max. Negotiated Rate $2.20
Rate for Payer: Aetna of IA Commercial $2.20
Rate for Payer: Aetna of IA Medical Rental Products $2.20
Rate for Payer: Aetna of IA Medicare $1.39
Rate for Payer: Amerigroup Medicaid $1.41
Rate for Payer: Amerigroup Medicare $1.11
Rate for Payer: Cash Price $1.96
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1.84
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $1.10
Rate for Payer: Iowa Total Care Managed Medicaid $1.40
Rate for Payer: Medical Associates Commercial $1.84
Rate for Payer: Medical Associates Managed Medicare $1.10
Rate for Payer: Midlands Choice Commercial $1.71
Rate for Payer: Molina Healthcare Managed Medicaid $1.42
Rate for Payer: Partners Health Alliance Commercial $1.27
Rate for Payer: United Healthcare Commercial $2.20
Rate for Payer: United Healthcare Managed Medicare $1.44
Service Code CPT 86738
Hospital Charge Code 4108792
Hospital Revenue Code 302
Min. Negotiated Rate $41.83
Max. Negotiated Rate $102.60
Rate for Payer: Aetna of IA Commercial $102.60
Rate for Payer: Aetna of IA Medical Rental Products $102.60
Rate for Payer: Aetna of IA Medicare $64.98
Rate for Payer: Amerigroup Medicaid $65.76
Rate for Payer: Amerigroup Medicare $51.81
Rate for Payer: Cash Price $91.20
Rate for Payer: Cash Price $91.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $85.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $51.30
Rate for Payer: Iowa Total Care Managed Medicaid $65.12
Rate for Payer: Medical Associates Commercial $85.50
Rate for Payer: Medical Associates Managed Medicare $51.30
Rate for Payer: Midlands Choice Commercial $79.80
Rate for Payer: Molina Healthcare Managed Medicaid $66.07
Rate for Payer: Partners Health Alliance Commercial $59.00
Rate for Payer: United Healthcare Commercial $102.60
Rate for Payer: United Healthcare Managed Medicare $67.26
Rate for Payer: Wellmark IA HMO WHPI $41.83
Rate for Payer: Wellmark IA PPO $46.08
Service Code CPT 86738
Hospital Charge Code 4108792
Hospital Revenue Code 302
Min. Negotiated Rate $79.80
Max. Negotiated Rate $102.60
Rate for Payer: Aetna of IA Commercial $102.60
Rate for Payer: Aetna of IA Medical Rental Products $102.60
Rate for Payer: Cash Price $91.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $85.50
Rate for Payer: Medical Associates Commercial $85.50
Rate for Payer: Midlands Choice Commercial $79.80
Rate for Payer: United Healthcare Commercial $102.60
Service Code MSDRG 827
Min. Negotiated Rate $23,211.83
Max. Negotiated Rate $23,553.19
Rate for Payer: Amerigroup Medicaid $23,439.39
Rate for Payer: Iowa Total Care Managed Medicaid $23,211.83
Rate for Payer: Molina Healthcare Managed Medicaid $23,553.19
Service Code MSDRG 826
Min. Negotiated Rate $55,905.68
Max. Negotiated Rate $56,727.85
Rate for Payer: Amerigroup Medicaid $56,453.77
Rate for Payer: Iowa Total Care Managed Medicaid $55,905.68
Rate for Payer: Molina Healthcare Managed Medicaid $56,727.85
Service Code MSDRG 828
Min. Negotiated Rate $15,651.73
Max. Negotiated Rate $15,881.91
Rate for Payer: Amerigroup Medicaid $15,805.17
Rate for Payer: Iowa Total Care Managed Medicaid $15,651.73
Rate for Payer: Molina Healthcare Managed Medicaid $15,881.91
Service Code MSDRG 829
Min. Negotiated Rate $22,332.98
Max. Negotiated Rate $22,661.41
Rate for Payer: Amerigroup Medicaid $22,551.93
Rate for Payer: Iowa Total Care Managed Medicaid $22,332.98
Rate for Payer: Molina Healthcare Managed Medicaid $22,661.41
Service Code MSDRG 830
Min. Negotiated Rate $15,586.26
Max. Negotiated Rate $15,815.47
Rate for Payer: Amerigroup Medicaid $15,739.06
Rate for Payer: Iowa Total Care Managed Medicaid $15,586.26
Rate for Payer: Molina Healthcare Managed Medicaid $15,815.47
Service Code HCPCS A9270
Hospital Charge Code 10407789
Hospital Revenue Code 259
Min. Negotiated Rate $0.60
Max. Negotiated Rate $1.20
Rate for Payer: Aetna of IA Commercial $1.20
Rate for Payer: Aetna of IA Medical Rental Products $1.20
Rate for Payer: Aetna of IA Medicare $0.76
Rate for Payer: Amerigroup Medicaid $0.77
Rate for Payer: Amerigroup Medicare $0.61
Rate for Payer: Cash Price $1.07
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $0.60
Rate for Payer: Iowa Total Care Managed Medicaid $0.76
Rate for Payer: Medical Associates Commercial $1.00
Rate for Payer: Medical Associates Managed Medicare $0.60
Rate for Payer: Midlands Choice Commercial $0.94
Rate for Payer: Molina Healthcare Managed Medicaid $0.77
Rate for Payer: Partners Health Alliance Commercial $0.69
Rate for Payer: United Healthcare Commercial $1.20
Rate for Payer: United Healthcare Managed Medicare $0.79
Service Code HCPCS A9270
Hospital Charge Code 10407789
Hospital Revenue Code 259
Min. Negotiated Rate $0.94
Max. Negotiated Rate $1.20
Rate for Payer: Aetna of IA Commercial $1.20
Rate for Payer: Aetna of IA Medical Rental Products $1.20
Rate for Payer: Cash Price $1.07
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1.00
Rate for Payer: Medical Associates Commercial $1.00
Rate for Payer: Midlands Choice Commercial $0.94
Rate for Payer: United Healthcare Commercial $1.20
Service Code HCPCS J2310
Hospital Charge Code 10408193
Hospital Revenue Code 259
Min. Negotiated Rate $13.80
Max. Negotiated Rate $27.60
Rate for Payer: Aetna of IA Commercial $27.60
Rate for Payer: Aetna of IA Medical Rental Products $27.60
Rate for Payer: Aetna of IA Medicare $17.48
Rate for Payer: Amerigroup Medicaid $17.69
Rate for Payer: Amerigroup Medicare $13.94
Rate for Payer: Cash Price $24.54
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $23.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $13.80
Rate for Payer: Iowa Total Care Managed Medicaid $17.52
Rate for Payer: Medical Associates Commercial $23.00
Rate for Payer: Medical Associates Managed Medicare $13.80
Rate for Payer: Midlands Choice Commercial $21.47
Rate for Payer: Molina Healthcare Managed Medicaid $17.78
Rate for Payer: Partners Health Alliance Commercial $15.87
Rate for Payer: United Healthcare Commercial $27.60
Rate for Payer: United Healthcare Managed Medicare $18.10
Service Code HCPCS J2310
Hospital Charge Code 10408193
Hospital Revenue Code 259
Min. Negotiated Rate $21.47
Max. Negotiated Rate $27.60
Rate for Payer: Aetna of IA Commercial $27.60
Rate for Payer: Aetna of IA Medical Rental Products $27.60
Rate for Payer: Cash Price $24.54
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $23.00
Rate for Payer: Medical Associates Commercial $23.00
Rate for Payer: Midlands Choice Commercial $21.47
Rate for Payer: United Healthcare Commercial $27.60
Service Code HCPCS J2310
Hospital Charge Code 10408262
Hospital Revenue Code 259
Min. Negotiated Rate $63.64
Max. Negotiated Rate $127.27
Rate for Payer: Aetna of IA Commercial $127.27
Rate for Payer: Aetna of IA Medical Rental Products $127.27
Rate for Payer: Aetna of IA Medicare $80.61
Rate for Payer: Amerigroup Medicaid $81.57
Rate for Payer: Amerigroup Medicare $64.27
Rate for Payer: Cash Price $113.13
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $106.06
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $63.64
Rate for Payer: Iowa Total Care Managed Medicaid $80.78
Rate for Payer: Medical Associates Commercial $106.06
Rate for Payer: Medical Associates Managed Medicare $63.64
Rate for Payer: Midlands Choice Commercial $98.99
Rate for Payer: Molina Healthcare Managed Medicaid $81.96
Rate for Payer: Partners Health Alliance Commercial $73.18
Rate for Payer: United Healthcare Commercial $127.27
Rate for Payer: United Healthcare Managed Medicare $83.44
Service Code HCPCS J2310
Hospital Charge Code 10408262
Hospital Revenue Code 259
Min. Negotiated Rate $98.99
Max. Negotiated Rate $127.27
Rate for Payer: Aetna of IA Commercial $127.27
Rate for Payer: Aetna of IA Medical Rental Products $127.27
Rate for Payer: Cash Price $113.13
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $106.06
Rate for Payer: Medical Associates Commercial $106.06
Rate for Payer: Midlands Choice Commercial $98.99
Rate for Payer: United Healthcare Commercial $127.27
Service Code HCPCS A9270
Hospital Charge Code 11391896
Hospital Revenue Code 259
Min. Negotiated Rate $4.30
Max. Negotiated Rate $8.60
Rate for Payer: Aetna of IA Commercial $8.60
Rate for Payer: Aetna of IA Medical Rental Products $8.60
Rate for Payer: Aetna of IA Medicare $5.44
Rate for Payer: Amerigroup Medicaid $5.51
Rate for Payer: Amerigroup Medicare $4.34
Rate for Payer: Cash Price $7.64
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $7.16
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $4.30
Rate for Payer: Iowa Total Care Managed Medicaid $5.46
Rate for Payer: Medical Associates Commercial $7.16
Rate for Payer: Medical Associates Managed Medicare $4.30
Rate for Payer: Midlands Choice Commercial $6.69
Rate for Payer: Molina Healthcare Managed Medicaid $5.54
Rate for Payer: Partners Health Alliance Commercial $4.94
Rate for Payer: United Healthcare Commercial $8.60
Rate for Payer: United Healthcare Managed Medicare $5.64
Service Code HCPCS A9270
Hospital Charge Code 11391896
Hospital Revenue Code 259
Min. Negotiated Rate $6.69
Max. Negotiated Rate $8.60
Rate for Payer: Aetna of IA Commercial $8.60
Rate for Payer: Aetna of IA Medical Rental Products $8.60
Rate for Payer: Cash Price $7.64
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $7.16
Rate for Payer: Medical Associates Commercial $7.16
Rate for Payer: Midlands Choice Commercial $6.69
Rate for Payer: United Healthcare Commercial $8.60