Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

sotalol 120 mg Tab [VDMC]

Facility

$1.29

Service Code	HCPCS A9270
Hospital Charge Code	17311425
Hospital Revenue Code	259
Min. Negotiated Rate	$0.90
Max. Negotiated Rate	$1.16
Rate for Payer: Aetna of IA Commercial	$1.16
Rate for Payer: Aetna of IA Medical Rental Products	$1.16
Rate for Payer: Cash Price	$1.03
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.97
Rate for Payer: Medical Associates Commercial	$0.97
Rate for Payer: Midlands Choice Commercial	$0.90
Rate for Payer: United Healthcare Commercial	$1.16

sotalol 80 mg Tab [VDMC]

Facility

$1.19

Service Code	HCPCS A9270
Hospital Charge Code	10421958
Hospital Revenue Code	259
Min. Negotiated Rate	$0.83
Max. Negotiated Rate	$1.07
Rate for Payer: Aetna of IA Commercial	$1.07
Rate for Payer: Aetna of IA Medical Rental Products	$1.07
Rate for Payer: Cash Price	$0.95
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.89
Rate for Payer: Medical Associates Commercial	$0.89
Rate for Payer: Midlands Choice Commercial	$0.83
Rate for Payer: United Healthcare Commercial	$1.07

sotalol 80 mg Tab [VDMC]

Facility

$1.19

Service Code	HCPCS A9270
Hospital Charge Code	10421958
Hospital Revenue Code	259
Min. Negotiated Rate	$0.53
Max. Negotiated Rate	$1.07
Rate for Payer: Aetna of IA Commercial	$1.07
Rate for Payer: Aetna of IA Medical Rental Products	$1.07
Rate for Payer: Aetna of IA Medicare	$0.68
Rate for Payer: Amerigroup Medicaid	$0.68
Rate for Payer: Amerigroup Medicare	$0.54
Rate for Payer: Cash Price	$0.95
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.89
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.53
Rate for Payer: Iowa Total Care Managed Medicaid	$0.68
Rate for Payer: Medical Associates Commercial	$0.89
Rate for Payer: Medical Associates Managed Medicare	$0.53
Rate for Payer: Midlands Choice Commercial	$0.83
Rate for Payer: Molina Healthcare Managed Medicaid	$0.69
Rate for Payer: Partners Health Alliance Commercial	$0.61
Rate for Payer: United Healthcare Commercial	$1.07
Rate for Payer: United Healthcare Managed Medicare	$0.70

SPADE TWO-STEP HAMMER TOE IMPLANT 34.5MMX3.0MMX14MM

Facility

$2,223.00

Service Code	HCPCS C1713
Hospital Charge Code	8868035
Hospital Revenue Code	278
Min. Negotiated Rate	$1,556.10
Max. Negotiated Rate	$2,000.70
Rate for Payer: Aetna of IA Commercial	$2,000.70
Rate for Payer: Aetna of IA Medical Rental Products	$2,000.70
Rate for Payer: Cash Price	$1,778.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1,667.25
Rate for Payer: Medical Associates Commercial	$1,667.25
Rate for Payer: Midlands Choice Commercial	$1,556.10
Rate for Payer: United Healthcare Commercial	$2,000.70

SPADE TWO-STEP HAMMER TOE IMPLANT 34.5MMX3.0MMX14MM

Facility

$2,223.00

Service Code	HCPCS C1713
Hospital Charge Code	8868035
Hospital Revenue Code	278
Min. Negotiated Rate	$1,000.35
Max. Negotiated Rate	$2,000.70
Rate for Payer: Aetna of IA Commercial	$2,000.70
Rate for Payer: Aetna of IA Medical Rental Products	$2,000.70
Rate for Payer: Aetna of IA Medicare	$1,267.11
Rate for Payer: Amerigroup Medicaid	$1,282.23
Rate for Payer: Amerigroup Medicare	$1,010.35
Rate for Payer: Cash Price	$1,778.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1,667.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$1,000.35
Rate for Payer: Iowa Total Care Managed Medicaid	$1,269.78
Rate for Payer: Medical Associates Commercial	$1,667.25
Rate for Payer: Medical Associates Managed Medicare	$1,000.35
Rate for Payer: Midlands Choice Commercial	$1,556.10
Rate for Payer: Molina Healthcare Managed Medicaid	$1,288.45
Rate for Payer: Partners Health Alliance Commercial	$1,150.40
Rate for Payer: United Healthcare Commercial	$2,000.70
Rate for Payer: United Healthcare Managed Medicare	$1,311.57

SPADE TWO-STEP HAMMER TOE IMPLANT - 3.4MMX3.0MMX6MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	8788811
Hospital Revenue Code	278
Min. Negotiated Rate	$1,260.00
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna of IA Commercial	$1,620.00
Rate for Payer: Aetna of IA Medical Rental Products	$1,620.00
Rate for Payer: Cash Price	$1,440.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1,350.00
Rate for Payer: Medical Associates Commercial	$1,350.00
Rate for Payer: Midlands Choice Commercial	$1,260.00
Rate for Payer: United Healthcare Commercial	$1,620.00

SPADE TWO-STEP HAMMER TOE IMPLANT - 3.4MMX3.0MMX6MM

Facility

$1,800.00

Service Code	HCPCS C1713
Hospital Charge Code	8788811
Hospital Revenue Code	278
Min. Negotiated Rate	$810.00
Max. Negotiated Rate	$1,620.00
Rate for Payer: Aetna of IA Commercial	$1,620.00
Rate for Payer: Aetna of IA Medical Rental Products	$1,620.00
Rate for Payer: Aetna of IA Medicare	$1,026.00
Rate for Payer: Amerigroup Medicaid	$1,038.24
Rate for Payer: Amerigroup Medicare	$818.10
Rate for Payer: Cash Price	$1,440.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1,350.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$810.00
Rate for Payer: Iowa Total Care Managed Medicaid	$1,028.16
Rate for Payer: Medical Associates Commercial	$1,350.00
Rate for Payer: Medical Associates Managed Medicare	$810.00
Rate for Payer: Midlands Choice Commercial	$1,260.00
Rate for Payer: Molina Healthcare Managed Medicaid	$1,043.28
Rate for Payer: Partners Health Alliance Commercial	$931.50
Rate for Payer: United Healthcare Commercial	$1,620.00
Rate for Payer: United Healthcare Managed Medicare	$1,062.00

SPECIALTY CARE TRANSPORT

Facility

$1,334.00

Service Code	HCPCS A0434 QN
Hospital Charge Code	7932763
Hospital Revenue Code	540
Min. Negotiated Rate	$933.80
Max. Negotiated Rate	$1,200.60
Rate for Payer: Aetna of IA Commercial	$1,200.60
Rate for Payer: Aetna of IA Medical Rental Products	$1,200.60
Rate for Payer: Cash Price	$1,067.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1,000.50
Rate for Payer: Medical Associates Commercial	$1,000.50
Rate for Payer: Midlands Choice Commercial	$933.80
Rate for Payer: United Healthcare Commercial	$1,200.60

SPECIALTY CARE TRANSPORT

Facility

$1,334.00

Service Code	HCPCS A0434 QN
Hospital Charge Code	7932763
Hospital Revenue Code	540
Min. Negotiated Rate	$600.30
Max. Negotiated Rate	$1,200.60
Rate for Payer: Aetna of IA Commercial	$1,200.60
Rate for Payer: Aetna of IA Medical Rental Products	$1,200.60
Rate for Payer: Aetna of IA Medicare	$760.38
Rate for Payer: Amerigroup Medicaid	$769.45
Rate for Payer: Amerigroup Medicare	$606.30
Rate for Payer: Cash Price	$1,067.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1,000.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$600.30
Rate for Payer: Iowa Total Care Managed Medicaid	$761.98
Rate for Payer: Medical Associates Commercial	$1,000.50
Rate for Payer: Medical Associates Managed Medicare	$600.30
Rate for Payer: Midlands Choice Commercial	$933.80
Rate for Payer: Molina Healthcare Managed Medicaid	$773.19
Rate for Payer: Partners Health Alliance Commercial	$690.35
Rate for Payer: United Healthcare Commercial	$1,200.60
Rate for Payer: United Healthcare Managed Medicare	$1,133.90

Speech Language Pathology Video Swallow

Facility

$389.00

Service Code	CPT 74230
Hospital Charge Code	985772
Hospital Revenue Code	320
Min. Negotiated Rate	$175.05
Max. Negotiated Rate	$350.10
Rate for Payer: Aetna of IA Commercial	$350.10
Rate for Payer: Aetna of IA Medical Rental Products	$350.10
Rate for Payer: Aetna of IA Medicare	$221.73
Rate for Payer: Amerigroup Medicaid	$224.38
Rate for Payer: Amerigroup Medicare	$176.80
Rate for Payer: Cash Price	$311.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$291.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$175.05
Rate for Payer: Iowa Total Care Managed Medicaid	$222.20
Rate for Payer: Medical Associates Commercial	$291.75
Rate for Payer: Medical Associates Managed Medicare	$175.05
Rate for Payer: Midlands Choice Commercial	$272.30
Rate for Payer: Molina Healthcare Managed Medicaid	$225.46
Rate for Payer: Partners Health Alliance Commercial	$201.31
Rate for Payer: United Healthcare Commercial	$350.10
Rate for Payer: United Healthcare Managed Medicare	$229.51

Speech Language Pathology Video Swallow

Facility

$389.00

Service Code	CPT 74230
Hospital Charge Code	985772
Hospital Revenue Code	320
Min. Negotiated Rate	$272.30
Max. Negotiated Rate	$350.10
Rate for Payer: Aetna of IA Commercial	$350.10
Rate for Payer: Aetna of IA Medical Rental Products	$350.10
Rate for Payer: Cash Price	$311.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$291.75
Rate for Payer: Medical Associates Commercial	$291.75
Rate for Payer: Midlands Choice Commercial	$272.30
Rate for Payer: United Healthcare Commercial	$350.10

SPEECH/OTHR COMMUNCATE INDIVIDUAL TX

Facility

$230.00

Service Code	CPT 92507 GN
Hospital Charge Code	5526782
Hospital Revenue Code	440
Min. Negotiated Rate	$103.50
Max. Negotiated Rate	$207.00
Rate for Payer: Aetna of IA Commercial	$207.00
Rate for Payer: Aetna of IA Medical Rental Products	$207.00
Rate for Payer: Aetna of IA Medicare	$131.10
Rate for Payer: Amerigroup Medicaid	$132.66
Rate for Payer: Amerigroup Medicare	$104.53
Rate for Payer: Cash Price	$184.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$172.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$103.50
Rate for Payer: Iowa Total Care Managed Medicaid	$131.38
Rate for Payer: Medical Associates Commercial	$172.50
Rate for Payer: Medical Associates Managed Medicare	$103.50
Rate for Payer: Midlands Choice Commercial	$161.00
Rate for Payer: Molina Healthcare Managed Medicaid	$133.31
Rate for Payer: Partners Health Alliance Commercial	$119.03
Rate for Payer: United Healthcare Commercial	$207.00
Rate for Payer: United Healthcare Managed Medicare	$135.70

SPEECH/OTHR COMMUNCATE INDIVIDUAL TX

Facility

$230.00

Service Code	CPT 92507 GN
Hospital Charge Code	5526782
Hospital Revenue Code	440
Min. Negotiated Rate	$161.00
Max. Negotiated Rate	$207.00
Rate for Payer: Aetna of IA Commercial	$207.00
Rate for Payer: Aetna of IA Medical Rental Products	$207.00
Rate for Payer: Cash Price	$184.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$172.50
Rate for Payer: Medical Associates Commercial	$172.50
Rate for Payer: Midlands Choice Commercial	$161.00
Rate for Payer: United Healthcare Commercial	$207.00

SPHINCTEROTOMY ER CHARGE

Professional

Both

$530.00

Hospital Charge Code	8069012
Hospital Revenue Code	981
Min. Negotiated Rate	$371.00
Max. Negotiated Rate	$397.50
Rate for Payer: Cash Price	$424.00
Rate for Payer: Medical Associates Commercial	$397.50
Rate for Payer: Midlands Choice Commercial	$371.00
Rate for Payer: Partners Health Alliance Commercial	$397.50

SPIKED GRIDLOCK ANKLE WASHER

Facility

$288.00

Service Code	HCPCS C1713
Hospital Charge Code	8780887
Hospital Revenue Code	278
Min. Negotiated Rate	$201.60
Max. Negotiated Rate	$259.20
Rate for Payer: Aetna of IA Commercial	$259.20
Rate for Payer: Aetna of IA Medical Rental Products	$259.20
Rate for Payer: Cash Price	$230.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$216.00
Rate for Payer: Medical Associates Commercial	$216.00
Rate for Payer: Midlands Choice Commercial	$201.60
Rate for Payer: United Healthcare Commercial	$259.20

SPIKED GRIDLOCK ANKLE WASHER

Facility

$288.00

Service Code	HCPCS C1713
Hospital Charge Code	8780887
Hospital Revenue Code	278
Min. Negotiated Rate	$129.60
Max. Negotiated Rate	$259.20
Rate for Payer: Aetna of IA Commercial	$259.20
Rate for Payer: Aetna of IA Medical Rental Products	$259.20
Rate for Payer: Aetna of IA Medicare	$164.16
Rate for Payer: Amerigroup Medicaid	$166.12
Rate for Payer: Amerigroup Medicare	$130.90
Rate for Payer: Cash Price	$230.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$216.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$129.60
Rate for Payer: Iowa Total Care Managed Medicaid	$164.51
Rate for Payer: Medical Associates Commercial	$216.00
Rate for Payer: Medical Associates Managed Medicare	$129.60
Rate for Payer: Midlands Choice Commercial	$201.60
Rate for Payer: Molina Healthcare Managed Medicaid	$166.92
Rate for Payer: Partners Health Alliance Commercial	$149.04
Rate for Payer: United Healthcare Commercial	$259.20
Rate for Payer: United Healthcare Managed Medicare	$169.92

SPIKED GRIDLOCK SCREW WASHER LARGE

Facility

$288.00

Service Code	HCPCS C1713
Hospital Charge Code	8740441
Hospital Revenue Code	278
Min. Negotiated Rate	$129.60
Max. Negotiated Rate	$259.20
Rate for Payer: Aetna of IA Commercial	$259.20
Rate for Payer: Aetna of IA Medical Rental Products	$259.20
Rate for Payer: Aetna of IA Medicare	$164.16
Rate for Payer: Amerigroup Medicaid	$166.12
Rate for Payer: Amerigroup Medicare	$130.90
Rate for Payer: Cash Price	$230.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$216.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$129.60
Rate for Payer: Iowa Total Care Managed Medicaid	$164.51
Rate for Payer: Medical Associates Commercial	$216.00
Rate for Payer: Medical Associates Managed Medicare	$129.60
Rate for Payer: Midlands Choice Commercial	$201.60
Rate for Payer: Molina Healthcare Managed Medicaid	$166.92
Rate for Payer: Partners Health Alliance Commercial	$149.04
Rate for Payer: United Healthcare Commercial	$259.20
Rate for Payer: United Healthcare Managed Medicare	$169.92

SPIKED GRIDLOCK SCREW WASHER LARGE

Facility

$288.00

Service Code	HCPCS C1713
Hospital Charge Code	8740441
Hospital Revenue Code	278
Min. Negotiated Rate	$201.60
Max. Negotiated Rate	$259.20
Rate for Payer: Aetna of IA Commercial	$259.20
Rate for Payer: Aetna of IA Medical Rental Products	$259.20
Rate for Payer: Cash Price	$230.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$216.00
Rate for Payer: Medical Associates Commercial	$216.00
Rate for Payer: Midlands Choice Commercial	$201.60
Rate for Payer: United Healthcare Commercial	$259.20

SPIKED WASHER FOR 4.5 SCREW

Facility

$180.00

Service Code	HCPCS C1713
Hospital Charge Code	8047046
Hospital Revenue Code	278
Min. Negotiated Rate	$126.00
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna of IA Commercial	$162.00
Rate for Payer: Aetna of IA Medical Rental Products	$162.00
Rate for Payer: Cash Price	$144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$135.00
Rate for Payer: Medical Associates Commercial	$135.00
Rate for Payer: Midlands Choice Commercial	$126.00
Rate for Payer: United Healthcare Commercial	$162.00

SPIKED WASHER FOR 4.5 SCREW

Facility

$180.00

Service Code	HCPCS C1713
Hospital Charge Code	8047046
Hospital Revenue Code	278
Min. Negotiated Rate	$81.00
Max. Negotiated Rate	$162.00
Rate for Payer: Aetna of IA Commercial	$162.00
Rate for Payer: Aetna of IA Medical Rental Products	$162.00
Rate for Payer: Aetna of IA Medicare	$102.60
Rate for Payer: Amerigroup Medicaid	$103.82
Rate for Payer: Amerigroup Medicare	$81.81
Rate for Payer: Cash Price	$144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$81.00
Rate for Payer: Iowa Total Care Managed Medicaid	$102.82
Rate for Payer: Medical Associates Commercial	$135.00
Rate for Payer: Medical Associates Managed Medicare	$81.00
Rate for Payer: Midlands Choice Commercial	$126.00
Rate for Payer: Molina Healthcare Managed Medicaid	$104.33
Rate for Payer: Partners Health Alliance Commercial	$93.15
Rate for Payer: United Healthcare Commercial	$162.00
Rate for Payer: United Healthcare Managed Medicare	$106.20

SPINAL ANESTHESIA I

Facility

$789.00

Hospital Charge Code	8059078
Hospital Revenue Code	370
Min. Negotiated Rate	$552.30
Max. Negotiated Rate	$710.10
Rate for Payer: Aetna of IA Commercial	$710.10
Rate for Payer: Aetna of IA Medical Rental Products	$710.10
Rate for Payer: Cash Price	$631.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$591.75
Rate for Payer: Medical Associates Commercial	$591.75
Rate for Payer: Midlands Choice Commercial	$552.30
Rate for Payer: United Healthcare Commercial	$710.10

SPINAL ANESTHESIA I

Facility

$789.00

Hospital Charge Code	8059078
Hospital Revenue Code	370
Min. Negotiated Rate	$355.05
Max. Negotiated Rate	$710.10
Rate for Payer: Aetna of IA Commercial	$710.10
Rate for Payer: Aetna of IA Medical Rental Products	$710.10
Rate for Payer: Aetna of IA Medicare	$449.73
Rate for Payer: Amerigroup Medicaid	$455.10
Rate for Payer: Amerigroup Medicare	$358.60
Rate for Payer: Cash Price	$631.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$591.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$355.05
Rate for Payer: Iowa Total Care Managed Medicaid	$450.68
Rate for Payer: Medical Associates Commercial	$591.75
Rate for Payer: Medical Associates Managed Medicare	$355.05
Rate for Payer: Midlands Choice Commercial	$552.30
Rate for Payer: Molina Healthcare Managed Medicaid	$457.30
Rate for Payer: Partners Health Alliance Commercial	$408.31
Rate for Payer: United Healthcare Commercial	$710.10
Rate for Payer: United Healthcare Managed Medicare	$465.51

SPINAL ANESTHESIA II

Facility

$958.00

Hospital Charge Code	8059590
Hospital Revenue Code	370
Min. Negotiated Rate	$431.10
Max. Negotiated Rate	$862.20
Rate for Payer: Aetna of IA Commercial	$862.20
Rate for Payer: Aetna of IA Medical Rental Products	$862.20
Rate for Payer: Aetna of IA Medicare	$546.06
Rate for Payer: Amerigroup Medicaid	$552.57
Rate for Payer: Amerigroup Medicare	$435.41
Rate for Payer: Cash Price	$766.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$718.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$431.10
Rate for Payer: Iowa Total Care Managed Medicaid	$547.21
Rate for Payer: Medical Associates Commercial	$718.50
Rate for Payer: Medical Associates Managed Medicare	$431.10
Rate for Payer: Midlands Choice Commercial	$670.60
Rate for Payer: Molina Healthcare Managed Medicaid	$555.26
Rate for Payer: Partners Health Alliance Commercial	$495.76
Rate for Payer: United Healthcare Commercial	$862.20
Rate for Payer: United Healthcare Managed Medicare	$565.22

SPINAL ANESTHESIA II

Facility

$958.00

Hospital Charge Code	8059590
Hospital Revenue Code	370
Min. Negotiated Rate	$670.60
Max. Negotiated Rate	$862.20
Rate for Payer: Aetna of IA Commercial	$862.20
Rate for Payer: Aetna of IA Medical Rental Products	$862.20
Rate for Payer: Cash Price	$766.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$718.50
Rate for Payer: Medical Associates Commercial	$718.50
Rate for Payer: Midlands Choice Commercial	$670.60
Rate for Payer: United Healthcare Commercial	$862.20

SPINAL ANESTHESIA III

Facility

$459.00

Hospital Charge Code	8059079
Hospital Revenue Code	370
Min. Negotiated Rate	$321.30
Max. Negotiated Rate	$413.10
Rate for Payer: Aetna of IA Commercial	$413.10
Rate for Payer: Aetna of IA Medical Rental Products	$413.10
Rate for Payer: Cash Price	$367.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$344.25
Rate for Payer: Medical Associates Commercial	$344.25
Rate for Payer: Midlands Choice Commercial	$321.30
Rate for Payer: United Healthcare Commercial	$413.10

Know your out-of-pocket cost for care.

All Charges