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Service Code CPT 76706
Hospital Charge Code 8606883
Hospital Revenue Code 402
Min. Negotiated Rate $191.58
Max. Negotiated Rate $468.90
Rate for Payer: Aetna of IA Commercial $468.90
Rate for Payer: Aetna of IA Medical Rental Products $468.90
Rate for Payer: Aetna of IA Medicare $296.97
Rate for Payer: Amerigroup Medicaid $262.95
Rate for Payer: Amerigroup Medicare $263.10
Rate for Payer: Cash Price $416.80
Rate for Payer: Cash Price $416.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $390.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $260.50
Rate for Payer: Iowa Total Care Managed Medicaid $260.40
Rate for Payer: Medical Associates Commercial $390.75
Rate for Payer: Medical Associates Managed Medicare $260.50
Rate for Payer: Midlands Choice Commercial $364.70
Rate for Payer: Molina Healthcare Managed Medicaid $264.41
Rate for Payer: Molina Healthcare Managed Medicare $264.25
Rate for Payer: Oscar Health of IA Commercial $390.75
Rate for Payer: Partners Health Alliance Commercial $390.75
Rate for Payer: United Healthcare Commercial $468.90
Rate for Payer: United Healthcare Managed Medicare $307.39
Rate for Payer: Wellmark IA HMO $191.58
Rate for Payer: Wellmark IA PPO $210.74
Service Code CPT 76700
Hospital Charge Code 1169567
Hospital Revenue Code 402
Min. Negotiated Rate $264.39
Max. Negotiated Rate $476.10
Rate for Payer: Aetna of IA Commercial $476.10
Rate for Payer: Aetna of IA Medical Rental Products $476.10
Rate for Payer: Aetna of IA Medicare $301.53
Rate for Payer: Amerigroup Medicaid $266.99
Rate for Payer: Amerigroup Medicare $267.14
Rate for Payer: Cash Price $423.20
Rate for Payer: Cash Price $423.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $396.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $264.50
Rate for Payer: Iowa Total Care Managed Medicaid $264.39
Rate for Payer: Medical Associates Commercial $396.75
Rate for Payer: Medical Associates Managed Medicare $264.50
Rate for Payer: Midlands Choice Commercial $370.30
Rate for Payer: Molina Healthcare Managed Medicaid $268.47
Rate for Payer: Molina Healthcare Managed Medicare $268.31
Rate for Payer: Oscar Health of IA Commercial $396.75
Rate for Payer: Partners Health Alliance Commercial $396.75
Rate for Payer: United Healthcare Commercial $476.10
Rate for Payer: United Healthcare Managed Medicare $312.11
Rate for Payer: Wellmark IA HMO $302.56
Rate for Payer: Wellmark IA PPO $332.82
Service Code CPT 76700
Hospital Charge Code 1169567
Hospital Revenue Code 402
Min. Negotiated Rate $370.30
Max. Negotiated Rate $476.10
Rate for Payer: Aetna of IA Commercial $476.10
Rate for Payer: Aetna of IA Medical Rental Products $476.10
Rate for Payer: Cash Price $423.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $396.75
Rate for Payer: Medical Associates Commercial $396.75
Rate for Payer: Midlands Choice Commercial $370.30
Rate for Payer: United Healthcare Commercial $476.10
Service Code CPT 76705
Hospital Charge Code 1169569
Hospital Revenue Code 402
Min. Negotiated Rate $263.90
Max. Negotiated Rate $339.30
Rate for Payer: Aetna of IA Commercial $339.30
Rate for Payer: Aetna of IA Medical Rental Products $339.30
Rate for Payer: Cash Price $301.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $282.75
Rate for Payer: Medical Associates Commercial $282.75
Rate for Payer: Midlands Choice Commercial $263.90
Rate for Payer: United Healthcare Commercial $339.30
Service Code CPT 76705
Hospital Charge Code 1169569
Hospital Revenue Code 402
Min. Negotiated Rate $188.42
Max. Negotiated Rate $339.30
Rate for Payer: Aetna of IA Commercial $339.30
Rate for Payer: Aetna of IA Medical Rental Products $339.30
Rate for Payer: Aetna of IA Medicare $214.89
Rate for Payer: Amerigroup Medicaid $190.27
Rate for Payer: Amerigroup Medicare $190.38
Rate for Payer: Cash Price $301.60
Rate for Payer: Cash Price $301.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $282.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $188.50
Rate for Payer: Iowa Total Care Managed Medicaid $188.42
Rate for Payer: Medical Associates Commercial $282.75
Rate for Payer: Medical Associates Managed Medicare $188.50
Rate for Payer: Midlands Choice Commercial $263.90
Rate for Payer: Molina Healthcare Managed Medicaid $191.33
Rate for Payer: Molina Healthcare Managed Medicare $191.21
Rate for Payer: Oscar Health of IA Commercial $282.75
Rate for Payer: Partners Health Alliance Commercial $282.75
Rate for Payer: United Healthcare Commercial $339.30
Rate for Payer: United Healthcare Managed Medicare $222.43
Rate for Payer: Wellmark IA HMO $191.58
Rate for Payer: Wellmark IA PPO $210.74
Service Code CPT 76705
Hospital Charge Code 625610
Hospital Revenue Code 920
Min. Negotiated Rate $263.90
Max. Negotiated Rate $339.30
Rate for Payer: Aetna of IA Commercial $339.30
Rate for Payer: Aetna of IA Medical Rental Products $339.30
Rate for Payer: Cash Price $301.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $282.75
Rate for Payer: Medical Associates Commercial $282.75
Rate for Payer: Midlands Choice Commercial $263.90
Rate for Payer: United Healthcare Commercial $339.30
Service Code CPT 76705
Hospital Charge Code 625610
Hospital Revenue Code 920
Min. Negotiated Rate $188.42
Max. Negotiated Rate $339.30
Rate for Payer: Wellmark IA PPO $210.74
Rate for Payer: Aetna of IA Commercial $339.30
Rate for Payer: Aetna of IA Medical Rental Products $339.30
Rate for Payer: Aetna of IA Medicare $214.89
Rate for Payer: Amerigroup Medicaid $190.27
Rate for Payer: Amerigroup Medicare $190.38
Rate for Payer: Cash Price $301.60
Rate for Payer: Cash Price $301.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $282.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $188.50
Rate for Payer: Iowa Total Care Managed Medicaid $188.42
Rate for Payer: Medical Associates Commercial $282.75
Rate for Payer: Medical Associates Managed Medicare $188.50
Rate for Payer: Midlands Choice Commercial $263.90
Rate for Payer: Molina Healthcare Managed Medicaid $191.33
Rate for Payer: Molina Healthcare Managed Medicare $191.21
Rate for Payer: Oscar Health of IA Commercial $282.75
Rate for Payer: Partners Health Alliance Commercial $282.75
Rate for Payer: United Healthcare Commercial $339.30
Rate for Payer: United Healthcare Managed Medicare $222.43
Rate for Payer: Wellmark IA HMO $191.58
Service Code CPT 93978
Hospital Charge Code 1169577
Hospital Revenue Code 920
Min. Negotiated Rate $448.70
Max. Negotiated Rate $576.90
Rate for Payer: Aetna of IA Commercial $576.90
Rate for Payer: Aetna of IA Medical Rental Products $576.90
Rate for Payer: Cash Price $512.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $480.75
Rate for Payer: Medical Associates Commercial $480.75
Rate for Payer: Midlands Choice Commercial $448.70
Rate for Payer: United Healthcare Commercial $576.90
Service Code CPT 93978
Hospital Charge Code 1169577
Hospital Revenue Code 920
Min. Negotiated Rate $302.56
Max. Negotiated Rate $576.90
Rate for Payer: Aetna of IA Commercial $576.90
Rate for Payer: Aetna of IA Medical Rental Products $576.90
Rate for Payer: Aetna of IA Medicare $365.37
Rate for Payer: Amerigroup Medicaid $323.51
Rate for Payer: Amerigroup Medicare $323.70
Rate for Payer: Cash Price $512.80
Rate for Payer: Cash Price $512.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $480.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $320.50
Rate for Payer: Iowa Total Care Managed Medicaid $320.37
Rate for Payer: Medical Associates Commercial $480.75
Rate for Payer: Medical Associates Managed Medicare $320.50
Rate for Payer: Midlands Choice Commercial $448.70
Rate for Payer: Molina Healthcare Managed Medicaid $325.31
Rate for Payer: Molina Healthcare Managed Medicare $325.12
Rate for Payer: Oscar Health of IA Commercial $480.75
Rate for Payer: Partners Health Alliance Commercial $480.75
Rate for Payer: United Healthcare Commercial $576.90
Rate for Payer: United Healthcare Managed Medicare $378.19
Rate for Payer: Wellmark IA HMO $302.56
Rate for Payer: Wellmark IA PPO $332.82
Service Code CPT 93975
Hospital Charge Code 1169581
Hospital Revenue Code 921
Min. Negotiated Rate $355.60
Max. Negotiated Rate $457.20
Rate for Payer: Aetna of IA Commercial $457.20
Rate for Payer: Aetna of IA Medical Rental Products $457.20
Rate for Payer: Cash Price $406.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $381.00
Rate for Payer: Medical Associates Commercial $381.00
Rate for Payer: Midlands Choice Commercial $355.60
Rate for Payer: United Healthcare Commercial $457.20
Service Code CPT 93975
Hospital Charge Code 1169581
Hospital Revenue Code 921
Min. Negotiated Rate $253.90
Max. Negotiated Rate $457.20
Rate for Payer: Aetna of IA Commercial $457.20
Rate for Payer: Aetna of IA Medical Rental Products $457.20
Rate for Payer: Aetna of IA Medicare $289.56
Rate for Payer: Amerigroup Medicaid $256.39
Rate for Payer: Amerigroup Medicare $256.54
Rate for Payer: Cash Price $406.40
Rate for Payer: Cash Price $406.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $381.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $254.00
Rate for Payer: Iowa Total Care Managed Medicaid $253.90
Rate for Payer: Medical Associates Commercial $381.00
Rate for Payer: Medical Associates Managed Medicare $254.00
Rate for Payer: Midlands Choice Commercial $355.60
Rate for Payer: Molina Healthcare Managed Medicaid $257.81
Rate for Payer: Molina Healthcare Managed Medicare $257.66
Rate for Payer: Oscar Health of IA Commercial $381.00
Rate for Payer: Partners Health Alliance Commercial $381.00
Rate for Payer: United Healthcare Commercial $457.20
Rate for Payer: United Healthcare Managed Medicare $299.72
Rate for Payer: Wellmark IA HMO $302.56
Rate for Payer: Wellmark IA PPO $332.82
Service Code CPT 93976
Hospital Charge Code 1169583
Hospital Revenue Code 921
Min. Negotiated Rate $180.43
Max. Negotiated Rate $332.82
Rate for Payer: Aetna of IA Commercial $324.90
Rate for Payer: Aetna of IA Medical Rental Products $324.90
Rate for Payer: Aetna of IA Medicare $205.77
Rate for Payer: Amerigroup Medicaid $182.20
Rate for Payer: Amerigroup Medicare $182.30
Rate for Payer: Cash Price $288.80
Rate for Payer: Cash Price $288.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $270.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $180.50
Rate for Payer: Iowa Total Care Managed Medicaid $180.43
Rate for Payer: Medical Associates Commercial $270.75
Rate for Payer: Medical Associates Managed Medicare $180.50
Rate for Payer: Midlands Choice Commercial $252.70
Rate for Payer: Molina Healthcare Managed Medicaid $183.21
Rate for Payer: Molina Healthcare Managed Medicare $183.10
Rate for Payer: Oscar Health of IA Commercial $270.75
Rate for Payer: Partners Health Alliance Commercial $270.75
Rate for Payer: United Healthcare Commercial $324.90
Rate for Payer: United Healthcare Managed Medicare $212.99
Rate for Payer: Wellmark IA HMO $302.56
Rate for Payer: Wellmark IA PPO $332.82
Service Code CPT 93976
Hospital Charge Code 1169583
Hospital Revenue Code 921
Min. Negotiated Rate $252.70
Max. Negotiated Rate $324.90
Rate for Payer: Aetna of IA Commercial $324.90
Rate for Payer: Aetna of IA Medical Rental Products $324.90
Rate for Payer: Cash Price $288.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $270.75
Rate for Payer: Medical Associates Commercial $270.75
Rate for Payer: Midlands Choice Commercial $252.70
Rate for Payer: United Healthcare Commercial $324.90
Service Code CPT 76942 50
Hospital Charge Code 1169585
Hospital Revenue Code 402
Min. Negotiated Rate $357.70
Max. Negotiated Rate $459.90
Rate for Payer: Aetna of IA Commercial $459.90
Rate for Payer: Aetna of IA Medical Rental Products $459.90
Rate for Payer: Cash Price $408.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $383.25
Rate for Payer: Medical Associates Commercial $383.25
Rate for Payer: Midlands Choice Commercial $357.70
Rate for Payer: United Healthcare Commercial $459.90
Service Code CPT 76942 50
Hospital Charge Code 1169585
Hospital Revenue Code 402
Min. Negotiated Rate $255.40
Max. Negotiated Rate $459.90
Rate for Payer: Aetna of IA Commercial $459.90
Rate for Payer: Aetna of IA Medical Rental Products $459.90
Rate for Payer: Aetna of IA Medicare $291.27
Rate for Payer: Amerigroup Medicaid $257.90
Rate for Payer: Amerigroup Medicare $258.06
Rate for Payer: Cash Price $408.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $383.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $255.50
Rate for Payer: Iowa Total Care Managed Medicaid $255.40
Rate for Payer: Medical Associates Commercial $383.25
Rate for Payer: Medical Associates Managed Medicare $255.50
Rate for Payer: Midlands Choice Commercial $357.70
Rate for Payer: Molina Healthcare Managed Medicaid $259.33
Rate for Payer: Molina Healthcare Managed Medicare $259.18
Rate for Payer: Oscar Health of IA Commercial $383.25
Rate for Payer: Partners Health Alliance Commercial $383.25
Rate for Payer: United Healthcare Commercial $459.90
Rate for Payer: United Healthcare Managed Medicare $301.49
Service Code CPT 76942 LT
Hospital Charge Code 1169587
Hospital Revenue Code 402
Min. Negotiated Rate $357.70
Max. Negotiated Rate $459.90
Rate for Payer: Aetna of IA Commercial $459.90
Rate for Payer: Aetna of IA Medical Rental Products $459.90
Rate for Payer: Cash Price $408.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $383.25
Rate for Payer: Medical Associates Commercial $383.25
Rate for Payer: Midlands Choice Commercial $357.70
Rate for Payer: United Healthcare Commercial $459.90
Service Code CPT 76942 LT
Hospital Charge Code 1169587
Hospital Revenue Code 402
Min. Negotiated Rate $255.40
Max. Negotiated Rate $459.90
Rate for Payer: Aetna of IA Commercial $459.90
Rate for Payer: Aetna of IA Medical Rental Products $459.90
Rate for Payer: Aetna of IA Medicare $291.27
Rate for Payer: Amerigroup Medicaid $257.90
Rate for Payer: Amerigroup Medicare $258.06
Rate for Payer: Cash Price $408.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $383.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $255.50
Rate for Payer: Iowa Total Care Managed Medicaid $255.40
Rate for Payer: Medical Associates Commercial $383.25
Rate for Payer: Medical Associates Managed Medicare $255.50
Rate for Payer: Midlands Choice Commercial $357.70
Rate for Payer: Molina Healthcare Managed Medicaid $259.33
Rate for Payer: Molina Healthcare Managed Medicare $259.18
Rate for Payer: Oscar Health of IA Commercial $383.25
Rate for Payer: Partners Health Alliance Commercial $383.25
Rate for Payer: United Healthcare Commercial $459.90
Rate for Payer: United Healthcare Managed Medicare $301.49
Service Code CPT 76942 RT
Hospital Charge Code 1169589
Hospital Revenue Code 402
Min. Negotiated Rate $255.40
Max. Negotiated Rate $459.90
Rate for Payer: Aetna of IA Commercial $459.90
Rate for Payer: Aetna of IA Medical Rental Products $459.90
Rate for Payer: Aetna of IA Medicare $291.27
Rate for Payer: Amerigroup Medicaid $257.90
Rate for Payer: Amerigroup Medicare $258.06
Rate for Payer: Cash Price $408.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $383.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $255.50
Rate for Payer: Iowa Total Care Managed Medicaid $255.40
Rate for Payer: Medical Associates Commercial $383.25
Rate for Payer: Medical Associates Managed Medicare $255.50
Rate for Payer: Midlands Choice Commercial $357.70
Rate for Payer: Molina Healthcare Managed Medicaid $259.33
Rate for Payer: Molina Healthcare Managed Medicare $259.18
Rate for Payer: Oscar Health of IA Commercial $383.25
Rate for Payer: Partners Health Alliance Commercial $383.25
Rate for Payer: United Healthcare Commercial $459.90
Rate for Payer: United Healthcare Managed Medicare $301.49
Service Code CPT 76942 RT
Hospital Charge Code 1169589
Hospital Revenue Code 402
Min. Negotiated Rate $357.70
Max. Negotiated Rate $459.90
Rate for Payer: Aetna of IA Commercial $459.90
Rate for Payer: Aetna of IA Medical Rental Products $459.90
Rate for Payer: Cash Price $408.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $383.25
Rate for Payer: Medical Associates Commercial $383.25
Rate for Payer: Midlands Choice Commercial $357.70
Rate for Payer: United Healthcare Commercial $459.90
Service Code CPT 76641 50
Hospital Charge Code 6800927
Hospital Revenue Code 402
Min. Negotiated Rate $179.93
Max. Negotiated Rate $324.00
Rate for Payer: Aetna of IA Commercial $324.00
Rate for Payer: Aetna of IA Medical Rental Products $324.00
Rate for Payer: Aetna of IA Medicare $205.20
Rate for Payer: Amerigroup Medicaid $181.69
Rate for Payer: Amerigroup Medicare $181.80
Rate for Payer: Cash Price $288.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $270.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $180.00
Rate for Payer: Iowa Total Care Managed Medicaid $179.93
Rate for Payer: Medical Associates Commercial $270.00
Rate for Payer: Medical Associates Managed Medicare $180.00
Rate for Payer: Midlands Choice Commercial $252.00
Rate for Payer: Molina Healthcare Managed Medicaid $182.70
Rate for Payer: Molina Healthcare Managed Medicare $182.59
Rate for Payer: Oscar Health of IA Commercial $270.00
Rate for Payer: Partners Health Alliance Commercial $270.00
Rate for Payer: United Healthcare Commercial $324.00
Rate for Payer: United Healthcare Managed Medicare $212.40
Service Code CPT 76641 50
Hospital Charge Code 6800927
Hospital Revenue Code 402
Min. Negotiated Rate $252.00
Max. Negotiated Rate $324.00
Rate for Payer: Aetna of IA Commercial $324.00
Rate for Payer: Aetna of IA Medical Rental Products $324.00
Rate for Payer: Cash Price $288.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $270.00
Rate for Payer: Medical Associates Commercial $270.00
Rate for Payer: Midlands Choice Commercial $252.00
Rate for Payer: United Healthcare Commercial $324.00
Service Code CPT 76642 50
Hospital Charge Code 1169621
Hospital Revenue Code 402
Min. Negotiated Rate $125.95
Max. Negotiated Rate $226.80
Rate for Payer: Aetna of IA Commercial $226.80
Rate for Payer: Aetna of IA Medical Rental Products $226.80
Rate for Payer: Aetna of IA Medicare $143.64
Rate for Payer: Amerigroup Medicaid $127.18
Rate for Payer: Amerigroup Medicare $127.26
Rate for Payer: Cash Price $201.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $189.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $126.00
Rate for Payer: Iowa Total Care Managed Medicaid $125.95
Rate for Payer: Medical Associates Commercial $189.00
Rate for Payer: Medical Associates Managed Medicare $126.00
Rate for Payer: Midlands Choice Commercial $176.40
Rate for Payer: Molina Healthcare Managed Medicaid $127.89
Rate for Payer: Molina Healthcare Managed Medicare $127.81
Rate for Payer: Oscar Health of IA Commercial $189.00
Rate for Payer: Partners Health Alliance Commercial $189.00
Rate for Payer: United Healthcare Commercial $226.80
Rate for Payer: United Healthcare Managed Medicare $148.68
Service Code CPT 76642 50
Hospital Charge Code 1169621
Hospital Revenue Code 402
Min. Negotiated Rate $176.40
Max. Negotiated Rate $226.80
Rate for Payer: Aetna of IA Commercial $226.80
Rate for Payer: Aetna of IA Medical Rental Products $226.80
Rate for Payer: Cash Price $201.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $189.00
Rate for Payer: Medical Associates Commercial $189.00
Rate for Payer: Midlands Choice Commercial $176.40
Rate for Payer: United Healthcare Commercial $226.80
Service Code CPT 76641 LT
Hospital Charge Code 6800930
Hospital Revenue Code 402
Min. Negotiated Rate $252.00
Max. Negotiated Rate $324.00
Rate for Payer: Aetna of IA Commercial $324.00
Rate for Payer: Aetna of IA Medical Rental Products $324.00
Rate for Payer: Cash Price $288.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $270.00
Rate for Payer: Medical Associates Commercial $270.00
Rate for Payer: Midlands Choice Commercial $252.00
Rate for Payer: United Healthcare Commercial $324.00
Service Code CPT 76641 LT
Hospital Charge Code 6800930
Hospital Revenue Code 402
Min. Negotiated Rate $179.93
Max. Negotiated Rate $324.00
Rate for Payer: Aetna of IA Commercial $324.00
Rate for Payer: Aetna of IA Medical Rental Products $324.00
Rate for Payer: Aetna of IA Medicare $205.20
Rate for Payer: Amerigroup Medicaid $181.69
Rate for Payer: Amerigroup Medicare $181.80
Rate for Payer: Cash Price $288.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $270.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $180.00
Rate for Payer: Iowa Total Care Managed Medicaid $179.93
Rate for Payer: Medical Associates Commercial $270.00
Rate for Payer: Medical Associates Managed Medicare $180.00
Rate for Payer: Midlands Choice Commercial $252.00
Rate for Payer: Molina Healthcare Managed Medicaid $182.70
Rate for Payer: Molina Healthcare Managed Medicare $182.59
Rate for Payer: Oscar Health of IA Commercial $270.00
Rate for Payer: Partners Health Alliance Commercial $270.00
Rate for Payer: United Healthcare Commercial $324.00
Rate for Payer: United Healthcare Managed Medicare $212.40