Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

Restrata 1x2 soft tissue repair

Facility

$2,925.00

Service Code	CPT c1713
Hospital Charge Code	8874155
Hospital Revenue Code	278
Min. Negotiated Rate	$1,461.92
Max. Negotiated Rate	$2,632.50
Rate for Payer: Aetna of IA Commercial	$2,632.50
Rate for Payer: Aetna of IA Medical Rental Products	$2,632.50
Rate for Payer: Aetna of IA Medicare	$1,667.25
Rate for Payer: Amerigroup Medicaid	$1,476.25
Rate for Payer: Amerigroup Medicare	$1,477.12
Rate for Payer: Cash Price	$2,340.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2,193.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$1,462.50
Rate for Payer: Iowa Total Care Managed Medicaid	$1,461.92
Rate for Payer: Medical Associates Commercial	$2,193.75
Rate for Payer: Medical Associates Managed Medicare	$1,462.50
Rate for Payer: Midlands Choice Commercial	$2,047.50
Rate for Payer: Molina Healthcare Managed Medicaid	$1,484.44
Rate for Payer: Molina Healthcare Managed Medicare	$1,483.56
Rate for Payer: Oscar Health of IA Commercial	$2,193.75
Rate for Payer: Partners Health Alliance Commercial	$2,193.75
Rate for Payer: United Healthcare Commercial	$2,632.50
Rate for Payer: United Healthcare Managed Medicare	$1,725.75

Restrata 3x3 RMW1

Facility

$6,075.00

Service Code	CPT C1713
Hospital Charge Code	8942331
Hospital Revenue Code	278
Min. Negotiated Rate	$3,036.28
Max. Negotiated Rate	$5,467.50
Rate for Payer: Aetna of IA Commercial	$5,467.50
Rate for Payer: Aetna of IA Medical Rental Products	$5,467.50
Rate for Payer: Aetna of IA Medicare	$3,462.75
Rate for Payer: Amerigroup Medicaid	$3,066.05
Rate for Payer: Amerigroup Medicare	$3,067.88
Rate for Payer: Cash Price	$4,860.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$4,556.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$3,037.50
Rate for Payer: Iowa Total Care Managed Medicaid	$3,036.28
Rate for Payer: Medical Associates Commercial	$4,556.25
Rate for Payer: Medical Associates Managed Medicare	$3,037.50
Rate for Payer: Midlands Choice Commercial	$4,252.50
Rate for Payer: Molina Healthcare Managed Medicaid	$3,083.06
Rate for Payer: Molina Healthcare Managed Medicare	$3,081.24
Rate for Payer: Oscar Health of IA Commercial	$4,556.25
Rate for Payer: Partners Health Alliance Commercial	$4,556.25
Rate for Payer: United Healthcare Commercial	$5,467.50
Rate for Payer: United Healthcare Managed Medicare	$3,584.25

Restrata 3x3 RMW1

Facility

$6,075.00

Service Code	CPT C1713
Hospital Charge Code	8942331
Hospital Revenue Code	278
Min. Negotiated Rate	$4,252.50
Max. Negotiated Rate	$5,467.50
Rate for Payer: Aetna of IA Commercial	$5,467.50
Rate for Payer: Aetna of IA Medical Rental Products	$5,467.50
Rate for Payer: Cash Price	$4,860.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$4,556.25
Rate for Payer: Medical Associates Commercial	$4,556.25
Rate for Payer: Midlands Choice Commercial	$4,252.50
Rate for Payer: United Healthcare Commercial	$5,467.50

RESTRATA 5PK 1X1 5PK 1X2

Facility

$18,497.00

Service Code	CPT C1713
Hospital Charge Code	8943983
Hospital Revenue Code	278
Min. Negotiated Rate	$12,947.90
Max. Negotiated Rate	$16,647.30
Rate for Payer: Aetna of IA Commercial	$16,647.30
Rate for Payer: Aetna of IA Medical Rental Products	$16,647.30
Rate for Payer: Cash Price	$14,797.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$13,872.75
Rate for Payer: Medical Associates Commercial	$13,872.75
Rate for Payer: Midlands Choice Commercial	$12,947.90
Rate for Payer: United Healthcare Commercial	$16,647.30

RESTRATA 5PK 1X1 5PK 1X2

Facility

$18,497.00

Service Code	CPT C1713
Hospital Charge Code	8943983
Hospital Revenue Code	278
Min. Negotiated Rate	$9,244.80
Max. Negotiated Rate	$16,647.30
Rate for Payer: Aetna of IA Commercial	$16,647.30
Rate for Payer: Aetna of IA Medical Rental Products	$16,647.30
Rate for Payer: Aetna of IA Medicare	$10,543.29
Rate for Payer: Amerigroup Medicaid	$9,335.44
Rate for Payer: Amerigroup Medicare	$9,340.98
Rate for Payer: Cash Price	$14,797.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$13,872.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$9,248.50
Rate for Payer: Iowa Total Care Managed Medicaid	$9,244.80
Rate for Payer: Medical Associates Commercial	$13,872.75
Rate for Payer: Medical Associates Managed Medicare	$9,248.50
Rate for Payer: Midlands Choice Commercial	$12,947.90
Rate for Payer: Molina Healthcare Managed Medicaid	$9,387.23
Rate for Payer: Molina Healthcare Managed Medicare	$9,381.68
Rate for Payer: Oscar Health of IA Commercial	$13,872.75
Rate for Payer: Partners Health Alliance Commercial	$13,872.75
Rate for Payer: United Healthcare Commercial	$16,647.30
Rate for Payer: United Healthcare Managed Medicare	$10,913.23

Reticulocyte Count DMCL

Facility

$59.00

Service Code	CPT 85045
Hospital Charge Code	8037796
Hospital Revenue Code	305
Min. Negotiated Rate	$29.49
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna of IA Commercial	$53.10
Rate for Payer: Aetna of IA Medical Rental Products	$53.10
Rate for Payer: Aetna of IA Medicare	$33.63
Rate for Payer: Amerigroup Medicaid	$29.78
Rate for Payer: Amerigroup Medicare	$29.80
Rate for Payer: Cash Price	$47.20
Rate for Payer: Cash Price	$47.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$44.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$29.50
Rate for Payer: Iowa Total Care Managed Medicaid	$29.49
Rate for Payer: Medical Associates Commercial	$44.25
Rate for Payer: Medical Associates Managed Medicare	$29.50
Rate for Payer: Midlands Choice Commercial	$41.30
Rate for Payer: Molina Healthcare Managed Medicaid	$29.94
Rate for Payer: Molina Healthcare Managed Medicare	$29.92
Rate for Payer: Oscar Health of IA Commercial	$44.25
Rate for Payer: Partners Health Alliance Commercial	$44.25
Rate for Payer: United Healthcare Commercial	$53.10
Rate for Payer: United Healthcare Managed Medicare	$34.81
Rate for Payer: Wellmark IA HMO	$32.86
Rate for Payer: Wellmark IA PPO	$36.15

Reticulocyte Count DMCL

Facility

$59.00

Service Code	CPT 85045
Hospital Charge Code	8037796
Hospital Revenue Code	305
Min. Negotiated Rate	$41.30
Max. Negotiated Rate	$53.10
Rate for Payer: Aetna of IA Commercial	$53.10
Rate for Payer: Aetna of IA Medical Rental Products	$53.10
Rate for Payer: Cash Price	$47.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$44.25
Rate for Payer: Medical Associates Commercial	$44.25
Rate for Payer: Midlands Choice Commercial	$41.30
Rate for Payer: United Healthcare Commercial	$53.10

Reticuloendothelial and Immunity Disorders With CC

Facility

$8,002.87

Service Code	MS-DRG 815
Hospital Charge Code	557
Min. Negotiated Rate	$7,886.88
Max. Negotiated Rate	$8,002.87
Rate for Payer: Amerigroup Medicaid	$7,964.21
Rate for Payer: Iowa Total Care Managed Medicaid	$7,886.88
Rate for Payer: Molina Healthcare Managed Medicaid	$8,002.87

Reticuloendothelial and Immunity Disorders With MCC

Facility

$18,613.98

Service Code	MS-DRG 814
Hospital Charge Code	556
Min. Negotiated Rate	$18,344.21
Max. Negotiated Rate	$18,613.98
Rate for Payer: Amerigroup Medicaid	$18,524.06
Rate for Payer: Iowa Total Care Managed Medicaid	$18,344.21
Rate for Payer: Molina Healthcare Managed Medicaid	$18,613.98

Reticuloendothelial and Immunity Disorders Without CC/MCC

Facility

$6,789.30

Service Code	MS-DRG 816
Hospital Charge Code	558
Min. Negotiated Rate	$6,690.90
Max. Negotiated Rate	$6,789.30
Rate for Payer: Amerigroup Medicaid	$6,756.50
Rate for Payer: Iowa Total Care Managed Medicaid	$6,690.90
Rate for Payer: Molina Healthcare Managed Medicaid	$6,789.30

REVISE SPINE ELTRD PERQ ARAY

Professional

Both

$2,602.00

Service Code	CPT 63663
Hospital Charge Code	8015893
Hospital Revenue Code	975
Min. Negotiated Rate	$410.44
Max. Negotiated Rate	$1,821.40
Rate for Payer: Aetna of IA Medicare	$410.44
Rate for Payer: Amerigroup Medicaid	$424.39
Rate for Payer: Cash Price	$2,081.60
Rate for Payer: Cash Price	$2,081.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$492.53
Rate for Payer: Iowa Total Care Managed Medicaid	$418.65
Rate for Payer: Medical Associates Commercial	$779.84
Rate for Payer: Medical Associates Managed Medicare	$410.44
Rate for Payer: Midlands Choice Commercial	$1,821.40
Rate for Payer: Oscar Health of IA Commercial	$710.06
Rate for Payer: Partners Health Alliance Commercial	$615.66

REVISE SPINE ELTRD PLATE

Professional

Both

$2,930.00

Service Code	CPT 63664
Hospital Charge Code	8015888
Hospital Revenue Code	975
Min. Negotiated Rate	$779.82
Max. Negotiated Rate	$2,051.00
Rate for Payer: Aetna of IA Medicare	$779.82
Rate for Payer: Amerigroup Medicaid	$806.33
Rate for Payer: Cash Price	$2,344.00
Rate for Payer: Cash Price	$2,344.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$935.78
Rate for Payer: Iowa Total Care Managed Medicaid	$795.42
Rate for Payer: Medical Associates Commercial	$1,481.66
Rate for Payer: Medical Associates Managed Medicare	$779.82
Rate for Payer: Midlands Choice Commercial	$2,051.00
Rate for Payer: Oscar Health of IA Commercial	$1,349.09
Rate for Payer: Partners Health Alliance Commercial	$1,169.73

Revision of Hip or Knee Replacement With CC

Facility

$33,409.10

Service Code	MS-DRG 467
Hospital Charge Code	287
Min. Negotiated Rate	$32,924.91
Max. Negotiated Rate	$33,409.10
Rate for Payer: Amerigroup Medicaid	$33,247.70
Rate for Payer: Iowa Total Care Managed Medicaid	$32,924.91
Rate for Payer: Molina Healthcare Managed Medicaid	$33,409.10

Revision of Hip or Knee Replacement With MCC

Facility

$34,122.67

Service Code	MS-DRG 466
Hospital Charge Code	286
Min. Negotiated Rate	$33,628.14
Max. Negotiated Rate	$34,122.67
Rate for Payer: Amerigroup Medicaid	$33,957.82
Rate for Payer: Iowa Total Care Managed Medicaid	$33,628.14
Rate for Payer: Molina Healthcare Managed Medicaid	$34,122.67

Revision of Hip or Knee Replacement Without CC/MCC

Facility

$27,178.84

Service Code	MS-DRG 468
Hospital Charge Code	288
Min. Negotiated Rate	$26,784.94
Max. Negotiated Rate	$27,178.84
Rate for Payer: Amerigroup Medicaid	$27,047.54
Rate for Payer: Iowa Total Care Managed Medicaid	$26,784.94
Rate for Payer: Molina Healthcare Managed Medicaid	$27,178.84

REV OR REM IMPL SPINAL NS PG OR RECEIVER

Professional

Both

$1,249.00

Service Code	CPT 63688
Hospital Charge Code	8015878
Hospital Revenue Code	975
Min. Negotiated Rate	$269.06
Max. Negotiated Rate	$874.30
Rate for Payer: Aetna of IA Medicare	$269.06
Rate for Payer: Amerigroup Medicaid	$278.21
Rate for Payer: Cash Price	$999.20
Rate for Payer: Cash Price	$999.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$322.87
Rate for Payer: Iowa Total Care Managed Medicaid	$274.44
Rate for Payer: Medical Associates Commercial	$511.21
Rate for Payer: Medical Associates Managed Medicare	$269.06
Rate for Payer: Midlands Choice Commercial	$874.30
Rate for Payer: Oscar Health of IA Commercial	$465.47
Rate for Payer: Partners Health Alliance Commercial	$403.59

Rheumatoid Factor DMCL

Facility

$58.00

Service Code	CPT 86431
Hospital Charge Code	8037797
Hospital Revenue Code	302
Min. Negotiated Rate	$28.99
Max. Negotiated Rate	$52.20
Rate for Payer: Aetna of IA Commercial	$52.20
Rate for Payer: Aetna of IA Medical Rental Products	$52.20
Rate for Payer: Aetna of IA Medicare	$33.06
Rate for Payer: Amerigroup Medicaid	$29.27
Rate for Payer: Amerigroup Medicare	$29.29
Rate for Payer: Cash Price	$46.40
Rate for Payer: Cash Price	$46.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$43.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$29.00
Rate for Payer: Iowa Total Care Managed Medicaid	$28.99
Rate for Payer: Medical Associates Commercial	$43.50
Rate for Payer: Medical Associates Managed Medicare	$29.00
Rate for Payer: Midlands Choice Commercial	$40.60
Rate for Payer: Molina Healthcare Managed Medicaid	$29.44
Rate for Payer: Molina Healthcare Managed Medicare	$29.42
Rate for Payer: Oscar Health of IA Commercial	$43.50
Rate for Payer: Partners Health Alliance Commercial	$43.50
Rate for Payer: United Healthcare Commercial	$52.20
Rate for Payer: United Healthcare Managed Medicare	$34.22
Rate for Payer: Wellmark IA HMO	$47.12
Rate for Payer: Wellmark IA PPO	$51.83

Rheumatoid Factor DMCL

Facility

$58.00

Service Code	CPT 86431
Hospital Charge Code	8037797
Hospital Revenue Code	302
Min. Negotiated Rate	$40.60
Max. Negotiated Rate	$52.20
Rate for Payer: Aetna of IA Commercial	$52.20
Rate for Payer: Aetna of IA Medical Rental Products	$52.20
Rate for Payer: Cash Price	$46.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$43.50
Rate for Payer: Medical Associates Commercial	$43.50
Rate for Payer: Midlands Choice Commercial	$40.60
Rate for Payer: United Healthcare Commercial	$52.20

RHIG

Facility

$133.00

Service Code	CPT 90384
Hospital Charge Code	1378504
Hospital Revenue Code	636
Min. Negotiated Rate	$93.10
Max. Negotiated Rate	$119.70
Rate for Payer: Aetna of IA Commercial	$119.70
Rate for Payer: Aetna of IA Medical Rental Products	$119.70
Rate for Payer: Cash Price	$106.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$99.75
Rate for Payer: Medical Associates Commercial	$99.75
Rate for Payer: Midlands Choice Commercial	$93.10
Rate for Payer: United Healthcare Commercial	$119.70

RHIG

Facility

$133.00

Service Code	CPT 90384
Hospital Charge Code	1378504
Hospital Revenue Code	636
Min. Negotiated Rate	$66.47
Max. Negotiated Rate	$119.70
Rate for Payer: Aetna of IA Commercial	$119.70
Rate for Payer: Aetna of IA Medical Rental Products	$119.70
Rate for Payer: Aetna of IA Medicare	$75.81
Rate for Payer: Amerigroup Medicaid	$67.13
Rate for Payer: Amerigroup Medicare	$67.16
Rate for Payer: Cash Price	$106.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$99.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$66.50
Rate for Payer: Iowa Total Care Managed Medicaid	$66.47
Rate for Payer: Medical Associates Commercial	$99.75
Rate for Payer: Medical Associates Managed Medicare	$66.50
Rate for Payer: Midlands Choice Commercial	$93.10
Rate for Payer: Molina Healthcare Managed Medicaid	$67.50
Rate for Payer: Molina Healthcare Managed Medicare	$67.46
Rate for Payer: Oscar Health of IA Commercial	$99.75
Rate for Payer: Partners Health Alliance Commercial	$99.75
Rate for Payer: United Healthcare Commercial	$119.70
Rate for Payer: United Healthcare Managed Medicare	$78.47

RH TYPING

Facility

$52.00

Service Code	CPT 86901
Hospital Charge Code	8015194
Hospital Revenue Code	302
Min. Negotiated Rate	$36.40
Max. Negotiated Rate	$46.80
Rate for Payer: Aetna of IA Commercial	$46.80
Rate for Payer: Aetna of IA Medical Rental Products	$46.80
Rate for Payer: Cash Price	$41.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$39.00
Rate for Payer: Medical Associates Commercial	$39.00
Rate for Payer: Midlands Choice Commercial	$36.40
Rate for Payer: United Healthcare Commercial	$46.80

RH TYPING

Facility

$52.00

Service Code	CPT 86901
Hospital Charge Code	8015194
Hospital Revenue Code	302
Min. Negotiated Rate	$25.99
Max. Negotiated Rate	$46.80
Rate for Payer: Aetna of IA Commercial	$46.80
Rate for Payer: Aetna of IA Medical Rental Products	$46.80
Rate for Payer: Aetna of IA Medicare	$29.64
Rate for Payer: Amerigroup Medicaid	$26.24
Rate for Payer: Amerigroup Medicare	$26.26
Rate for Payer: Cash Price	$41.60
Rate for Payer: Cash Price	$41.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$39.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$26.00
Rate for Payer: Iowa Total Care Managed Medicaid	$25.99
Rate for Payer: Medical Associates Commercial	$39.00
Rate for Payer: Medical Associates Managed Medicare	$26.00
Rate for Payer: Midlands Choice Commercial	$36.40
Rate for Payer: Molina Healthcare Managed Medicaid	$26.39
Rate for Payer: Molina Healthcare Managed Medicare	$26.37
Rate for Payer: Oscar Health of IA Commercial	$39.00
Rate for Payer: Partners Health Alliance Commercial	$39.00
Rate for Payer: United Healthcare Commercial	$46.80
Rate for Payer: United Healthcare Managed Medicare	$30.68
Rate for Payer: Wellmark IA HMO	$31.00
Rate for Payer: Wellmark IA PPO	$34.10

Rhythm Strip

Facility

$104.00

Service Code	CPT 93041
Hospital Charge Code	7068798
Hospital Revenue Code	730
Min. Negotiated Rate	$72.80
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna of IA Commercial	$93.60
Rate for Payer: Aetna of IA Medical Rental Products	$93.60
Rate for Payer: Cash Price	$83.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$78.00
Rate for Payer: Medical Associates Commercial	$78.00
Rate for Payer: Midlands Choice Commercial	$72.80
Rate for Payer: United Healthcare Commercial	$93.60

Rhythm Strip

Facility

$104.00

Service Code	CPT 93041
Hospital Charge Code	7068798
Hospital Revenue Code	730
Min. Negotiated Rate	$51.98
Max. Negotiated Rate	$93.60
Rate for Payer: Aetna of IA Commercial	$93.60
Rate for Payer: Aetna of IA Medical Rental Products	$93.60
Rate for Payer: Aetna of IA Medicare	$59.28
Rate for Payer: Amerigroup Medicaid	$52.49
Rate for Payer: Amerigroup Medicare	$52.52
Rate for Payer: Cash Price	$83.20
Rate for Payer: Cash Price	$83.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$78.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$52.00
Rate for Payer: Iowa Total Care Managed Medicaid	$51.98
Rate for Payer: Medical Associates Commercial	$78.00
Rate for Payer: Medical Associates Managed Medicare	$52.00
Rate for Payer: Midlands Choice Commercial	$72.80
Rate for Payer: Molina Healthcare Managed Medicaid	$52.78
Rate for Payer: Molina Healthcare Managed Medicare	$52.75
Rate for Payer: Oscar Health of IA Commercial	$78.00
Rate for Payer: Partners Health Alliance Commercial	$78.00
Rate for Payer: United Healthcare Commercial	$93.60
Rate for Payer: United Healthcare Managed Medicare	$61.36
Rate for Payer: Wellmark IA HMO	$83.08
Rate for Payer: Wellmark IA PPO	$91.39

riboflavin 100 mg Tab [VDMC]

Facility

$1.22

Service Code	HCPCS A9270
Hospital Charge Code	10418882
Hospital Revenue Code	259
Min. Negotiated Rate	$0.61
Max. Negotiated Rate	$1.10
Rate for Payer: Aetna of IA Commercial	$1.10
Rate for Payer: Aetna of IA Medical Rental Products	$1.10
Rate for Payer: Aetna of IA Medicare	$0.70
Rate for Payer: Amerigroup Medicaid	$0.62
Rate for Payer: Amerigroup Medicare	$0.62
Rate for Payer: Cash Price	$0.97
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.92
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.61
Rate for Payer: Iowa Total Care Managed Medicaid	$0.61
Rate for Payer: Medical Associates Commercial	$0.92
Rate for Payer: Medical Associates Managed Medicare	$0.61
Rate for Payer: Midlands Choice Commercial	$0.85
Rate for Payer: Molina Healthcare Managed Medicaid	$0.62
Rate for Payer: Molina Healthcare Managed Medicare	$0.62
Rate for Payer: Oscar Health of IA Commercial	$0.92
Rate for Payer: Partners Health Alliance Commercial	$0.92
Rate for Payer: United Healthcare Commercial	$1.10
Rate for Payer: United Healthcare Managed Medicare	$0.72

Know your out-of-pocket cost for care.

All Charges