|
PT/INR
|
Facility
OP
|
$43.00
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
1635510
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.49 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna of IA Commercial |
$38.70
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$38.70
|
| Rate for Payer: Aetna of IA Medicare |
$24.51
|
| Rate for Payer: Amerigroup Medicaid |
$21.70
|
| Rate for Payer: Amerigroup Medicare |
$21.72
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$32.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$21.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$21.49
|
| Rate for Payer: Medical Associates Commercial |
$32.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$21.50
|
| Rate for Payer: Midlands Choice Commercial |
$30.10
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$21.82
|
| Rate for Payer: Partners Health Alliance Commercial |
$32.25
|
| Rate for Payer: United Healthcare Commercial |
$38.70
|
| Rate for Payer: United Healthcare Managed Medicare |
$25.37
|
| Rate for Payer: Wellmark IA HMO |
$24.18
|
| Rate for Payer: Wellmark IA PPO |
$26.60
|
|
|
PTNM NEUROELTRD STIM POST TIBIAL
|
Facility
OP
|
$659.00
|
|
|
Service Code
|
CPT 64566
|
| Hospital Charge Code |
8588846
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$329.37 |
| Max. Negotiated Rate |
$703.14 |
| Rate for Payer: Aetna of IA Commercial |
$593.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$593.10
|
| Rate for Payer: Aetna of IA Medicare |
$375.63
|
| Rate for Payer: Amerigroup Medicaid |
$332.60
|
| Rate for Payer: Amerigroup Medicare |
$332.80
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$494.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$329.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$329.37
|
| Rate for Payer: Medical Associates Commercial |
$494.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$329.50
|
| Rate for Payer: Midlands Choice Commercial |
$461.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$334.44
|
| Rate for Payer: Partners Health Alliance Commercial |
$494.25
|
| Rate for Payer: United Healthcare Commercial |
$593.10
|
| Rate for Payer: United Healthcare Managed Medicare |
$388.81
|
| Rate for Payer: Wellmark IA HMO |
$639.22
|
| Rate for Payer: Wellmark IA PPO |
$703.14
|
|
|
PTNM NEUROELTRD STIM POST TIBIAL
|
Facility
IP
|
$659.00
|
|
|
Service Code
|
CPT 64566
|
| Hospital Charge Code |
8588846
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$461.30 |
| Max. Negotiated Rate |
$593.10 |
| Rate for Payer: Aetna of IA Commercial |
$593.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$593.10
|
| Rate for Payer: Cash Price |
$527.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$494.25
|
| Rate for Payer: Medical Associates Commercial |
$494.25
|
| Rate for Payer: Midlands Choice Commercial |
$461.30
|
| Rate for Payer: United Healthcare Commercial |
$593.10
|
|
|
PT RE-EVAL EST PLAN CARE
|
Facility
OP
|
$137.00
|
|
|
Service Code
|
CPT 97164 GP
|
| Hospital Charge Code |
8397249
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$68.47 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Aetna of IA Commercial |
$123.30
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$123.30
|
| Rate for Payer: Aetna of IA Medicare |
$78.09
|
| Rate for Payer: Amerigroup Medicaid |
$69.14
|
| Rate for Payer: Amerigroup Medicare |
$69.18
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$102.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$68.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$68.47
|
| Rate for Payer: Medical Associates Commercial |
$102.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$68.50
|
| Rate for Payer: Midlands Choice Commercial |
$95.90
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$69.53
|
| Rate for Payer: Partners Health Alliance Commercial |
$102.75
|
| Rate for Payer: United Healthcare Commercial |
$123.30
|
| Rate for Payer: United Healthcare Managed Medicare |
$80.83
|
|
|
PT RE-EVAL EST PLAN CARE
|
Facility
IP
|
$137.00
|
|
|
Service Code
|
CPT 97164 GP
|
| Hospital Charge Code |
8397249
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$95.90 |
| Max. Negotiated Rate |
$123.30 |
| Rate for Payer: Aetna of IA Commercial |
$123.30
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$123.30
|
| Rate for Payer: Cash Price |
$109.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$102.75
|
| Rate for Payer: Medical Associates Commercial |
$102.75
|
| Rate for Payer: Midlands Choice Commercial |
$95.90
|
| Rate for Payer: United Healthcare Commercial |
$123.30
|
|
|
PT RE-EVALUATION
|
Facility
OP
|
$92.00
|
|
| Hospital Charge Code |
5520784
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$45.98 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Aetna of IA Commercial |
$82.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$82.80
|
| Rate for Payer: Aetna of IA Medicare |
$52.44
|
| Rate for Payer: Amerigroup Medicaid |
$46.43
|
| Rate for Payer: Amerigroup Medicare |
$46.46
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$69.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$46.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$45.98
|
| Rate for Payer: Medical Associates Commercial |
$69.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$46.00
|
| Rate for Payer: Midlands Choice Commercial |
$64.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$46.69
|
| Rate for Payer: Partners Health Alliance Commercial |
$69.00
|
| Rate for Payer: United Healthcare Commercial |
$82.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$54.28
|
|
|
PT RE-EVALUATION
|
Facility
IP
|
$92.00
|
|
| Hospital Charge Code |
5520784
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$64.40 |
| Max. Negotiated Rate |
$82.80 |
| Rate for Payer: Aetna of IA Commercial |
$82.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$82.80
|
| Rate for Payer: Cash Price |
$73.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$69.00
|
| Rate for Payer: Medical Associates Commercial |
$69.00
|
| Rate for Payer: Midlands Choice Commercial |
$64.40
|
| Rate for Payer: United Healthcare Commercial |
$82.80
|
|
|
PTT
|
Facility
IP
|
$64.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
633794
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Aetna of IA Commercial |
$57.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$57.60
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$48.00
|
| Rate for Payer: Medical Associates Commercial |
$48.00
|
| Rate for Payer: Midlands Choice Commercial |
$44.80
|
| Rate for Payer: United Healthcare Commercial |
$57.60
|
|
|
PTT
|
Facility
OP
|
$64.00
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
633794
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.18 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Aetna of IA Commercial |
$57.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$57.60
|
| Rate for Payer: Aetna of IA Medicare |
$36.48
|
| Rate for Payer: Amerigroup Medicaid |
$32.30
|
| Rate for Payer: Amerigroup Medicare |
$32.32
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$48.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$32.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$31.99
|
| Rate for Payer: Medical Associates Commercial |
$48.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$32.00
|
| Rate for Payer: Midlands Choice Commercial |
$44.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$32.48
|
| Rate for Payer: Partners Health Alliance Commercial |
$48.00
|
| Rate for Payer: United Healthcare Commercial |
$57.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$37.76
|
| Rate for Payer: Wellmark IA HMO |
$24.18
|
| Rate for Payer: Wellmark IA PPO |
$26.60
|
|
|
PTT SUBSTITUTION, PLASMA FRACTIONS
|
Facility
OP
|
$64.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
8093944
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.18 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Aetna of IA Commercial |
$57.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$57.60
|
| Rate for Payer: Aetna of IA Medicare |
$36.48
|
| Rate for Payer: Amerigroup Medicaid |
$32.30
|
| Rate for Payer: Amerigroup Medicare |
$32.32
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$48.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$32.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$31.99
|
| Rate for Payer: Medical Associates Commercial |
$48.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$32.00
|
| Rate for Payer: Midlands Choice Commercial |
$44.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$32.48
|
| Rate for Payer: Partners Health Alliance Commercial |
$48.00
|
| Rate for Payer: United Healthcare Commercial |
$57.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$37.76
|
| Rate for Payer: Wellmark IA HMO |
$24.18
|
| Rate for Payer: Wellmark IA PPO |
$26.60
|
|
|
PTT SUBSTITUTION, PLASMA FRACTIONS
|
Facility
IP
|
$64.00
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
8093944
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Aetna of IA Commercial |
$57.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$57.60
|
| Rate for Payer: Cash Price |
$51.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$48.00
|
| Rate for Payer: Medical Associates Commercial |
$48.00
|
| Rate for Payer: Midlands Choice Commercial |
$44.80
|
| Rate for Payer: United Healthcare Commercial |
$57.60
|
|
|
PT Unattended E-Stim Units
|
Facility
IP
|
$85.00
|
|
|
Service Code
|
CPT G0283 GP
|
| Hospital Charge Code |
1374022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.50 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna of IA Commercial |
$76.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$76.50
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$63.75
|
| Rate for Payer: Medical Associates Commercial |
$63.75
|
| Rate for Payer: Midlands Choice Commercial |
$59.50
|
| Rate for Payer: United Healthcare Commercial |
$76.50
|
|
|
PT Unattended E-Stim Units
|
Facility
OP
|
$85.00
|
|
|
Service Code
|
CPT G0283 GP
|
| Hospital Charge Code |
1374022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.48 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna of IA Commercial |
$76.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$76.50
|
| Rate for Payer: Aetna of IA Medicare |
$48.45
|
| Rate for Payer: Amerigroup Medicaid |
$42.90
|
| Rate for Payer: Amerigroup Medicare |
$42.92
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$63.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$42.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$42.48
|
| Rate for Payer: Medical Associates Commercial |
$63.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$42.50
|
| Rate for Payer: Midlands Choice Commercial |
$59.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$43.14
|
| Rate for Payer: Partners Health Alliance Commercial |
$63.75
|
| Rate for Payer: United Healthcare Commercial |
$76.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$50.15
|
|
|
PULM FUNCTION TEST VOLUMES BY GAS
|
Facility
IP
|
$260.00
|
|
|
Service Code
|
CPT 94727
|
| Hospital Charge Code |
5338938
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$182.00 |
| Max. Negotiated Rate |
$234.00 |
| Rate for Payer: Aetna of IA Commercial |
$234.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.00
|
| Rate for Payer: Medical Associates Commercial |
$195.00
|
| Rate for Payer: Midlands Choice Commercial |
$182.00
|
| Rate for Payer: United Healthcare Commercial |
$234.00
|
|
|
PULM FUNCTION TEST VOLUMES BY GAS
|
Facility
OP
|
$260.00
|
|
|
Service Code
|
CPT 94727
|
| Hospital Charge Code |
5338938
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$129.95 |
| Max. Negotiated Rate |
$282.35 |
| Rate for Payer: Aetna of IA Commercial |
$234.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.00
|
| Rate for Payer: Aetna of IA Medicare |
$148.20
|
| Rate for Payer: Amerigroup Medicaid |
$131.22
|
| Rate for Payer: Amerigroup Medicare |
$131.30
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Cash Price |
$208.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$130.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$129.95
|
| Rate for Payer: Medical Associates Commercial |
$195.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$130.00
|
| Rate for Payer: Midlands Choice Commercial |
$182.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$131.95
|
| Rate for Payer: Partners Health Alliance Commercial |
$195.00
|
| Rate for Payer: United Healthcare Commercial |
$234.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.40
|
| Rate for Payer: Wellmark IA HMO |
$256.68
|
| Rate for Payer: Wellmark IA PPO |
$282.35
|
|
|
Pulmonary Edema and Respiratory Failure
|
Facility
IP
|
$10,865.05
|
|
|
Service Code
|
MS-DRG 189
|
| Hospital Charge Code |
60
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$10,865.05 |
| Rate for Payer: Amerigroup Medicaid |
$10,812.56
|
| 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 |
$10,707.58
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$10,865.05
|
|
|
Pulmonary Embolism With MCC or Acute Cor Pulmonale
|
Facility
IP
|
$11,792.20
|
|
|
Service Code
|
MS-DRG 175
|
| Hospital Charge Code |
46
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$11,792.20 |
| Rate for Payer: Amerigroup Medicaid |
$11,735.23
|
| 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 |
$11,621.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$11,792.20
|
|
|
Pulmonary Embolism Without MCC
|
Facility
IP
|
$7,528.47
|
|
|
Service Code
|
MS-DRG 176
|
| Hospital Charge Code |
47
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$7,528.47 |
| Rate for Payer: Amerigroup Medicaid |
$7,492.10
|
| 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 |
$7,419.36
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$7,528.47
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
OP
|
$156.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
8059084
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$77.97 |
| Max. Negotiated Rate |
$360.78 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Aetna of IA Medicare |
$88.92
|
| Rate for Payer: Amerigroup Medicaid |
$78.73
|
| Rate for Payer: Amerigroup Medicare |
$78.78
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$78.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$77.97
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$78.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$79.17
|
| Rate for Payer: Partners Health Alliance Commercial |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$92.04
|
| Rate for Payer: Wellmark IA HMO |
$327.98
|
| Rate for Payer: Wellmark IA PPO |
$360.78
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
OP
|
$156.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
8059082
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$77.97 |
| Max. Negotiated Rate |
$360.78 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Aetna of IA Medicare |
$88.92
|
| Rate for Payer: Amerigroup Medicaid |
$78.73
|
| Rate for Payer: Amerigroup Medicare |
$78.78
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$78.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$77.97
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$78.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$79.17
|
| Rate for Payer: Partners Health Alliance Commercial |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$92.04
|
| Rate for Payer: Wellmark IA HMO |
$327.98
|
| Rate for Payer: Wellmark IA PPO |
$360.78
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
IP
|
$156.00
|
|
|
Service Code
|
CPT G0238 KX
|
| Hospital Charge Code |
8059083
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
OP
|
$156.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
8059081
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$77.97 |
| Max. Negotiated Rate |
$360.78 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Aetna of IA Medicare |
$88.92
|
| Rate for Payer: Amerigroup Medicaid |
$78.73
|
| Rate for Payer: Amerigroup Medicare |
$78.78
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$78.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$77.97
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$78.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$79.17
|
| Rate for Payer: Partners Health Alliance Commercial |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$92.04
|
| Rate for Payer: Wellmark IA HMO |
$327.98
|
| Rate for Payer: Wellmark IA PPO |
$360.78
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
OP
|
$156.00
|
|
|
Service Code
|
CPT G0238 KX
|
| Hospital Charge Code |
8059083
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$77.97 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Aetna of IA Medicare |
$88.92
|
| Rate for Payer: Amerigroup Medicaid |
$78.73
|
| Rate for Payer: Amerigroup Medicare |
$78.78
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$78.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$77.97
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$78.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$79.17
|
| Rate for Payer: Partners Health Alliance Commercial |
$117.00
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$92.04
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
IP
|
$156.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
8059084
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
|
|
Pulmonary Rehab Non COPD Charge
|
Facility
IP
|
$156.00
|
|
|
Service Code
|
CPT G0238
|
| Hospital Charge Code |
8059081
|
|
Hospital Revenue Code
|
948
|
| Min. Negotiated Rate |
$109.20 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna of IA Commercial |
$140.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$140.40
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$117.00
|
| Rate for Payer: Medical Associates Commercial |
$117.00
|
| Rate for Payer: Midlands Choice Commercial |
$109.20
|
| Rate for Payer: United Healthcare Commercial |
$140.40
|
|
