|
URIC ACID
|
Facility
OP
|
$46.00
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
633858
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna of IA Commercial |
$41.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$41.40
|
| Rate for Payer: Aetna of IA Medicare |
$26.22
|
| Rate for Payer: Amerigroup Medicaid |
$23.22
|
| Rate for Payer: Amerigroup Medicare |
$23.23
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$34.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$23.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$22.99
|
| Rate for Payer: Medical Associates Commercial |
$34.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$23.00
|
| Rate for Payer: Midlands Choice Commercial |
$32.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$23.34
|
| Rate for Payer: Partners Health Alliance Commercial |
$34.50
|
| Rate for Payer: United Healthcare Commercial |
$41.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$27.14
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
Uric Acid Urine Timed DMCL
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
8037740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
Uric Acid Urine Timed DMCL
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
8037740
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
URINALYSIS BY DIPSTICK, AUTO W/O MICRO
|
Facility
OP
|
$31.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
4006797
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna of IA Commercial |
$27.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$27.90
|
| Rate for Payer: Aetna of IA Medicare |
$17.67
|
| Rate for Payer: Amerigroup Medicaid |
$15.65
|
| Rate for Payer: Amerigroup Medicare |
$15.66
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$23.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$15.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$15.49
|
| Rate for Payer: Medical Associates Commercial |
$23.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$15.50
|
| Rate for Payer: Midlands Choice Commercial |
$21.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$15.73
|
| Rate for Payer: Partners Health Alliance Commercial |
$23.25
|
| Rate for Payer: United Healthcare Commercial |
$27.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$18.29
|
| Rate for Payer: Wellmark IA HMO |
$22.32
|
| Rate for Payer: Wellmark IA PPO |
$24.55
|
|
|
URINALYSIS BY DIPSTICK, AUTO W/O MICRO
|
Facility
IP
|
$31.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
4006797
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$21.70 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna of IA Commercial |
$27.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$27.90
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$23.25
|
| Rate for Payer: Medical Associates Commercial |
$23.25
|
| Rate for Payer: Midlands Choice Commercial |
$21.70
|
| Rate for Payer: United Healthcare Commercial |
$27.90
|
|
|
URINALYSIS BY DIPSTICK, AUTO W/O MICRO
|
Facility
IP
|
$31.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
4006795
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$21.70 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna of IA Commercial |
$27.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$27.90
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$23.25
|
| Rate for Payer: Medical Associates Commercial |
$23.25
|
| Rate for Payer: Midlands Choice Commercial |
$21.70
|
| Rate for Payer: United Healthcare Commercial |
$27.90
|
|
|
URINALYSIS BY DIPSTICK, AUTO W/O MICRO
|
Facility
OP
|
$31.00
|
|
|
Service Code
|
CPT 81003
|
| Hospital Charge Code |
4006795
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$27.90 |
| Rate for Payer: Aetna of IA Commercial |
$27.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$27.90
|
| Rate for Payer: Aetna of IA Medicare |
$17.67
|
| Rate for Payer: Amerigroup Medicaid |
$15.65
|
| Rate for Payer: Amerigroup Medicare |
$15.66
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$23.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$15.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$15.49
|
| Rate for Payer: Medical Associates Commercial |
$23.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$15.50
|
| Rate for Payer: Midlands Choice Commercial |
$21.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$15.73
|
| Rate for Payer: Partners Health Alliance Commercial |
$23.25
|
| Rate for Payer: United Healthcare Commercial |
$27.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$18.29
|
| Rate for Payer: Wellmark IA HMO |
$22.32
|
| Rate for Payer: Wellmark IA PPO |
$24.55
|
|
|
Urinary Stones With MCC
|
Facility
IP
|
$8,477.27
|
|
|
Service Code
|
MS-DRG 693
|
| Hospital Charge Code |
466
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$8,477.27 |
| Rate for Payer: Amerigroup Medicaid |
$8,436.32
|
| 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 |
$8,354.41
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$8,477.27
|
|
|
Urinary Stones Without MCC
|
Facility
IP
|
$5,644.62
|
|
|
Service Code
|
MS-DRG 694
|
| Hospital Charge Code |
467
|
| Min. Negotiated Rate |
$2,034.00 |
| Max. Negotiated Rate |
$5,644.62 |
| Rate for Payer: Amerigroup Medicaid |
$5,617.35
|
| 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 |
$5,562.81
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$5,644.62
|
|
|
URINE CHLORIDE
|
Facility
IP
|
$48.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
4006802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.60 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna of IA Commercial |
$43.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$43.20
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$36.00
|
| Rate for Payer: Medical Associates Commercial |
$36.00
|
| Rate for Payer: Midlands Choice Commercial |
$33.60
|
| Rate for Payer: United Healthcare Commercial |
$43.20
|
|
|
URINE CHLORIDE
|
Facility
OP
|
$48.00
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
4006802
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Aetna of IA Commercial |
$43.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$43.20
|
| Rate for Payer: Aetna of IA Medicare |
$27.36
|
| Rate for Payer: Amerigroup Medicaid |
$24.23
|
| Rate for Payer: Amerigroup Medicare |
$24.24
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Cash Price |
$38.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$36.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$24.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$23.99
|
| Rate for Payer: Medical Associates Commercial |
$36.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$24.00
|
| Rate for Payer: Midlands Choice Commercial |
$33.60
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$24.36
|
| Rate for Payer: Partners Health Alliance Commercial |
$36.00
|
| Rate for Payer: United Healthcare Commercial |
$43.20
|
| Rate for Payer: United Healthcare Managed Medicare |
$28.32
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
URINE CREAT
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
8419061
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
URINE CREAT
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
1930782
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
URINE CREAT
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
1930782
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
URINE CREAT
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
8419061
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
URINE CULTURE ID
|
Facility
IP
|
$66.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
7836071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$46.20 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Aetna of IA Commercial |
$59.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$59.40
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$49.50
|
| Rate for Payer: Medical Associates Commercial |
$49.50
|
| Rate for Payer: Midlands Choice Commercial |
$46.20
|
| Rate for Payer: United Healthcare Commercial |
$59.40
|
|
|
URINE CULTURE ID
|
Facility
OP
|
$66.00
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
7836071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.00 |
| Max. Negotiated Rate |
$59.40 |
| Rate for Payer: Aetna of IA Commercial |
$59.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$59.40
|
| Rate for Payer: Aetna of IA Medicare |
$37.62
|
| Rate for Payer: Amerigroup Medicaid |
$33.31
|
| Rate for Payer: Amerigroup Medicare |
$33.33
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Cash Price |
$52.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$49.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$33.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$32.99
|
| Rate for Payer: Medical Associates Commercial |
$49.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$33.00
|
| Rate for Payer: Midlands Choice Commercial |
$46.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$33.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$49.50
|
| Rate for Payer: United Healthcare Commercial |
$59.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$38.94
|
| Rate for Payer: Wellmark IA HMO |
$31.00
|
| Rate for Payer: Wellmark IA PPO |
$34.10
|
|
|
URINE K (POTASSIUM)
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 84133
|
| Hospital Charge Code |
4021240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
URINE K (POTASSIUM)
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 84133
|
| Hospital Charge Code |
4021240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
URINE MICROALBUMIN
|
Facility
IP
|
$55.00
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
4019304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna of IA Commercial |
$49.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$49.50
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$41.25
|
| Rate for Payer: Medical Associates Commercial |
$41.25
|
| Rate for Payer: Midlands Choice Commercial |
$38.50
|
| Rate for Payer: United Healthcare Commercial |
$49.50
|
|
|
URINE MICROALBUMIN
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
4019304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.32 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna of IA Commercial |
$49.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$49.50
|
| Rate for Payer: Aetna of IA Medicare |
$31.35
|
| Rate for Payer: Amerigroup Medicaid |
$27.76
|
| Rate for Payer: Amerigroup Medicare |
$27.78
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$41.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$27.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$27.49
|
| Rate for Payer: Medical Associates Commercial |
$41.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$27.50
|
| Rate for Payer: Midlands Choice Commercial |
$38.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$27.91
|
| Rate for Payer: Partners Health Alliance Commercial |
$41.25
|
| Rate for Payer: United Healthcare Commercial |
$49.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$32.45
|
| Rate for Payer: Wellmark IA HMO |
$22.32
|
| Rate for Payer: Wellmark IA PPO |
$24.55
|
|
|
URINE MICROALBUMIN
|
Facility
IP
|
$55.00
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
8093947
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.50 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna of IA Commercial |
$49.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$49.50
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$41.25
|
| Rate for Payer: Medical Associates Commercial |
$41.25
|
| Rate for Payer: Midlands Choice Commercial |
$38.50
|
| Rate for Payer: United Healthcare Commercial |
$49.50
|
|
|
URINE MICROALBUMIN
|
Facility
OP
|
$55.00
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
8093947
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.32 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Aetna of IA Commercial |
$49.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$49.50
|
| Rate for Payer: Aetna of IA Medicare |
$31.35
|
| Rate for Payer: Amerigroup Medicaid |
$27.76
|
| Rate for Payer: Amerigroup Medicare |
$27.78
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Cash Price |
$44.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$41.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$27.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$27.49
|
| Rate for Payer: Medical Associates Commercial |
$41.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$27.50
|
| Rate for Payer: Midlands Choice Commercial |
$38.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$27.91
|
| Rate for Payer: Partners Health Alliance Commercial |
$41.25
|
| Rate for Payer: United Healthcare Commercial |
$49.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$32.45
|
| Rate for Payer: Wellmark IA HMO |
$22.32
|
| Rate for Payer: Wellmark IA PPO |
$24.55
|
|
|
Urine Protein
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
7942974
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
Urine Protein
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
7942974
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
