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Service Code CPT 93971
Hospital Charge Code 1998324
Hospital Revenue Code 921
Min. Negotiated Rate $191.58
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Aetna of IA Medicare $331.74
Rate for Payer: Amerigroup Medicaid $293.74
Rate for Payer: Amerigroup Medicare $293.91
Rate for Payer: Cash Price $465.60
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $291.00
Rate for Payer: Iowa Total Care Managed Medicaid $290.88
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Medical Associates Managed Medicare $291.00
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: Molina Healthcare Managed Medicaid $295.36
Rate for Payer: Molina Healthcare Managed Medicare $295.19
Rate for Payer: Oscar Health of IA Commercial $436.50
Rate for Payer: Partners Health Alliance Commercial $436.50
Rate for Payer: United Healthcare Commercial $523.80
Rate for Payer: United Healthcare Managed Medicare $343.38
Rate for Payer: Wellmark IA HMO $191.58
Rate for Payer: Wellmark IA PPO $210.74
Service Code CPT 93971 LT
Hospital Charge Code 1169771
Hospital Revenue Code 921
Min. Negotiated Rate $407.40
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: United Healthcare Commercial $523.80
Service Code CPT 93971
Hospital Charge Code 1998323
Hospital Revenue Code 921
Min. Negotiated Rate $407.40
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: United Healthcare Commercial $523.80
Service Code CPT 93971 RT
Hospital Charge Code 1169773
Hospital Revenue Code 921
Min. Negotiated Rate $290.88
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Aetna of IA Medicare $331.74
Rate for Payer: Amerigroup Medicaid $293.74
Rate for Payer: Amerigroup Medicare $293.91
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $291.00
Rate for Payer: Iowa Total Care Managed Medicaid $290.88
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Medical Associates Managed Medicare $291.00
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: Molina Healthcare Managed Medicaid $295.36
Rate for Payer: Molina Healthcare Managed Medicare $295.19
Rate for Payer: Oscar Health of IA Commercial $436.50
Rate for Payer: Partners Health Alliance Commercial $436.50
Rate for Payer: United Healthcare Commercial $523.80
Rate for Payer: United Healthcare Managed Medicare $343.38
Service Code CPT 93971 RT
Hospital Charge Code 1169773
Hospital Revenue Code 921
Min. Negotiated Rate $407.40
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: United Healthcare Commercial $523.80
Service Code CPT 93971
Hospital Charge Code 1998323
Hospital Revenue Code 921
Min. Negotiated Rate $191.58
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Aetna of IA Medicare $331.74
Rate for Payer: Amerigroup Medicaid $293.74
Rate for Payer: Amerigroup Medicare $293.91
Rate for Payer: Cash Price $465.60
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $291.00
Rate for Payer: Iowa Total Care Managed Medicaid $290.88
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Medical Associates Managed Medicare $291.00
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: Molina Healthcare Managed Medicaid $295.36
Rate for Payer: Molina Healthcare Managed Medicare $295.19
Rate for Payer: Oscar Health of IA Commercial $436.50
Rate for Payer: Partners Health Alliance Commercial $436.50
Rate for Payer: United Healthcare Commercial $523.80
Rate for Payer: United Healthcare Managed Medicare $343.38
Rate for Payer: Wellmark IA HMO $191.58
Rate for Payer: Wellmark IA PPO $210.74
Service Code CPT 93971 LT
Hospital Charge Code 8654295
Hospital Revenue Code 921
Min. Negotiated Rate $290.88
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Aetna of IA Medicare $331.74
Rate for Payer: Amerigroup Medicaid $293.74
Rate for Payer: Amerigroup Medicare $293.91
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $291.00
Rate for Payer: Iowa Total Care Managed Medicaid $290.88
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Medical Associates Managed Medicare $291.00
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: Molina Healthcare Managed Medicaid $295.36
Rate for Payer: Molina Healthcare Managed Medicare $295.19
Rate for Payer: Oscar Health of IA Commercial $436.50
Rate for Payer: Partners Health Alliance Commercial $436.50
Rate for Payer: United Healthcare Commercial $523.80
Rate for Payer: United Healthcare Managed Medicare $343.38
Service Code CPT 93971 LT
Hospital Charge Code 8654295
Hospital Revenue Code 921
Min. Negotiated Rate $407.40
Max. Negotiated Rate $523.80
Rate for Payer: Aetna of IA Commercial $523.80
Rate for Payer: Aetna of IA Medical Rental Products $523.80
Rate for Payer: Cash Price $465.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $436.50
Rate for Payer: Medical Associates Commercial $436.50
Rate for Payer: Midlands Choice Commercial $407.40
Rate for Payer: United Healthcare Commercial $523.80
Service Code CPT 76881 LT
Hospital Charge Code 1169784
Hospital Revenue Code 402
Min. Negotiated Rate $275.80
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: United Healthcare Commercial $354.60
Service Code CPT 76881 LT
Hospital Charge Code 1169784
Hospital Revenue Code 402
Min. Negotiated Rate $196.92
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Aetna of IA Medicare $224.58
Rate for Payer: Amerigroup Medicaid $198.85
Rate for Payer: Amerigroup Medicare $198.97
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $197.00
Rate for Payer: Iowa Total Care Managed Medicaid $196.92
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Medical Associates Managed Medicare $197.00
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: Molina Healthcare Managed Medicaid $199.96
Rate for Payer: Molina Healthcare Managed Medicare $199.84
Rate for Payer: Oscar Health of IA Commercial $295.50
Rate for Payer: Partners Health Alliance Commercial $295.50
Rate for Payer: United Healthcare Commercial $354.60
Rate for Payer: United Healthcare Managed Medicare $232.46
Service Code CPT 76881 RT
Hospital Charge Code 1169787
Hospital Revenue Code 402
Min. Negotiated Rate $275.80
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: United Healthcare Commercial $354.60
Service Code CPT 76881 RT
Hospital Charge Code 1169787
Hospital Revenue Code 402
Min. Negotiated Rate $196.92
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Aetna of IA Medicare $224.58
Rate for Payer: Amerigroup Medicaid $198.85
Rate for Payer: Amerigroup Medicare $198.97
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $197.00
Rate for Payer: Iowa Total Care Managed Medicaid $196.92
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Medical Associates Managed Medicare $197.00
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: Molina Healthcare Managed Medicaid $199.96
Rate for Payer: Molina Healthcare Managed Medicare $199.84
Rate for Payer: Oscar Health of IA Commercial $295.50
Rate for Payer: Partners Health Alliance Commercial $295.50
Rate for Payer: United Healthcare Commercial $354.60
Rate for Payer: United Healthcare Managed Medicare $232.46
Service Code CPT 76856
Hospital Charge Code 1169844
Hospital Revenue Code 402
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
Service Code CPT 76856
Hospital Charge Code 1169844
Hospital Revenue Code 402
Min. Negotiated Rate $229.41
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: Aetna of IA Medicare $261.63
Rate for Payer: Amerigroup Medicaid $231.66
Rate for Payer: Amerigroup Medicare $231.80
Rate for Payer: Cash Price $367.20
Rate for Payer: Cash Price $367.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $344.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $229.50
Rate for Payer: Iowa Total Care Managed Medicaid $229.41
Rate for Payer: Medical Associates Commercial $344.25
Rate for Payer: Medical Associates Managed Medicare $229.50
Rate for Payer: Midlands Choice Commercial $321.30
Rate for Payer: Molina Healthcare Managed Medicaid $232.94
Rate for Payer: Molina Healthcare Managed Medicare $232.80
Rate for Payer: Oscar Health of IA Commercial $344.25
Rate for Payer: Partners Health Alliance Commercial $344.25
Rate for Payer: United Healthcare Commercial $413.10
Rate for Payer: United Healthcare Managed Medicare $270.81
Rate for Payer: Wellmark IA HMO $302.56
Rate for Payer: Wellmark IA PPO $332.82
Service Code CPT 76856
Hospital Charge Code 7840664
Hospital Revenue Code 402
Min. Negotiated Rate $229.41
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: Aetna of IA Medicare $261.63
Rate for Payer: Amerigroup Medicaid $231.66
Rate for Payer: Amerigroup Medicare $231.80
Rate for Payer: Cash Price $367.20
Rate for Payer: Cash Price $367.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $344.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $229.50
Rate for Payer: Iowa Total Care Managed Medicaid $229.41
Rate for Payer: Medical Associates Commercial $344.25
Rate for Payer: Medical Associates Managed Medicare $229.50
Rate for Payer: Midlands Choice Commercial $321.30
Rate for Payer: Molina Healthcare Managed Medicaid $232.94
Rate for Payer: Molina Healthcare Managed Medicare $232.80
Rate for Payer: Oscar Health of IA Commercial $344.25
Rate for Payer: Partners Health Alliance Commercial $344.25
Rate for Payer: United Healthcare Commercial $413.10
Rate for Payer: United Healthcare Managed Medicare $270.81
Rate for Payer: Wellmark IA HMO $302.56
Rate for Payer: Wellmark IA PPO $332.82
Service Code CPT 76856
Hospital Charge Code 7840664
Hospital Revenue Code 402
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
Service Code CPT 76857
Hospital Charge Code 1169846
Hospital Revenue Code 402
Min. Negotiated Rate $207.90
Max. Negotiated Rate $267.30
Rate for Payer: Aetna of IA Commercial $267.30
Rate for Payer: Aetna of IA Medical Rental Products $267.30
Rate for Payer: Cash Price $237.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $222.75
Rate for Payer: Medical Associates Commercial $222.75
Rate for Payer: Midlands Choice Commercial $207.90
Rate for Payer: United Healthcare Commercial $267.30
Service Code CPT 76857
Hospital Charge Code 1169846
Hospital Revenue Code 402
Min. Negotiated Rate $148.44
Max. Negotiated Rate $267.30
Rate for Payer: Aetna of IA Commercial $267.30
Rate for Payer: Aetna of IA Medical Rental Products $267.30
Rate for Payer: Aetna of IA Medicare $169.29
Rate for Payer: Amerigroup Medicaid $149.90
Rate for Payer: Amerigroup Medicare $149.98
Rate for Payer: Cash Price $237.60
Rate for Payer: Cash Price $237.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $222.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $148.50
Rate for Payer: Iowa Total Care Managed Medicaid $148.44
Rate for Payer: Medical Associates Commercial $222.75
Rate for Payer: Medical Associates Managed Medicare $148.50
Rate for Payer: Midlands Choice Commercial $207.90
Rate for Payer: Molina Healthcare Managed Medicaid $150.73
Rate for Payer: Molina Healthcare Managed Medicare $150.64
Rate for Payer: Oscar Health of IA Commercial $222.75
Rate for Payer: Partners Health Alliance Commercial $222.75
Rate for Payer: United Healthcare Commercial $267.30
Rate for Payer: United Healthcare Managed Medicare $175.23
Rate for Payer: Wellmark IA HMO $191.58
Rate for Payer: Wellmark IA PPO $210.74
Service Code CPT 76830
Hospital Charge Code 7960823
Hospital Revenue Code 402
Min. Negotiated Rate $244.30
Max. Negotiated Rate $314.10
Rate for Payer: Aetna of IA Commercial $314.10
Rate for Payer: Aetna of IA Medical Rental Products $314.10
Rate for Payer: Cash Price $279.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $261.75
Rate for Payer: Medical Associates Commercial $261.75
Rate for Payer: Midlands Choice Commercial $244.30
Rate for Payer: United Healthcare Commercial $314.10
Service Code CPT 76830
Hospital Charge Code 7960823
Hospital Revenue Code 402
Min. Negotiated Rate $174.43
Max. Negotiated Rate $314.10
Rate for Payer: Aetna of IA Commercial $314.10
Rate for Payer: Aetna of IA Medical Rental Products $314.10
Rate for Payer: Aetna of IA Medicare $198.93
Rate for Payer: Amerigroup Medicaid $176.14
Rate for Payer: Amerigroup Medicare $176.24
Rate for Payer: Cash Price $279.20
Rate for Payer: Cash Price $279.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $261.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $174.50
Rate for Payer: Iowa Total Care Managed Medicaid $174.43
Rate for Payer: Medical Associates Commercial $261.75
Rate for Payer: Medical Associates Managed Medicare $174.50
Rate for Payer: Midlands Choice Commercial $244.30
Rate for Payer: Molina Healthcare Managed Medicaid $177.12
Rate for Payer: Molina Healthcare Managed Medicare $177.01
Rate for Payer: Oscar Health of IA Commercial $261.75
Rate for Payer: Partners Health Alliance Commercial $261.75
Rate for Payer: United Healthcare Commercial $314.10
Rate for Payer: United Healthcare Managed Medicare $205.91
Rate for Payer: Wellmark IA HMO $191.58
Rate for Payer: Wellmark IA PPO $210.74
Service Code CPT 76816
Hospital Charge Code 1169854
Hospital Revenue Code 402
Min. Negotiated Rate $147.94
Max. Negotiated Rate $266.40
Rate for Payer: Aetna of IA Commercial $266.40
Rate for Payer: Aetna of IA Medical Rental Products $266.40
Rate for Payer: Aetna of IA Medicare $168.72
Rate for Payer: Amerigroup Medicaid $149.39
Rate for Payer: Amerigroup Medicare $149.48
Rate for Payer: Cash Price $236.80
Rate for Payer: Cash Price $236.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $222.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $148.00
Rate for Payer: Iowa Total Care Managed Medicaid $147.94
Rate for Payer: Medical Associates Commercial $222.00
Rate for Payer: Medical Associates Managed Medicare $148.00
Rate for Payer: Midlands Choice Commercial $207.20
Rate for Payer: Molina Healthcare Managed Medicaid $150.22
Rate for Payer: Molina Healthcare Managed Medicare $150.13
Rate for Payer: Oscar Health of IA Commercial $222.00
Rate for Payer: Partners Health Alliance Commercial $222.00
Rate for Payer: United Healthcare Commercial $266.40
Rate for Payer: United Healthcare Managed Medicare $174.64
Rate for Payer: Wellmark IA HMO $169.88
Rate for Payer: Wellmark IA PPO $186.87
Service Code CPT 76816
Hospital Charge Code 1169854
Hospital Revenue Code 402
Min. Negotiated Rate $207.20
Max. Negotiated Rate $266.40
Rate for Payer: Aetna of IA Commercial $266.40
Rate for Payer: Aetna of IA Medical Rental Products $266.40
Rate for Payer: Cash Price $236.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $222.00
Rate for Payer: Medical Associates Commercial $222.00
Rate for Payer: Midlands Choice Commercial $207.20
Rate for Payer: United Healthcare Commercial $266.40
Service Code CPT 76815
Hospital Charge Code 1169856
Hospital Revenue Code 402
Min. Negotiated Rate $169.88
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Aetna of IA Medicare $224.58
Rate for Payer: Amerigroup Medicaid $198.85
Rate for Payer: Amerigroup Medicare $198.97
Rate for Payer: Cash Price $315.20
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $197.00
Rate for Payer: Iowa Total Care Managed Medicaid $196.92
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Medical Associates Managed Medicare $197.00
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: Molina Healthcare Managed Medicaid $199.96
Rate for Payer: Molina Healthcare Managed Medicare $199.84
Rate for Payer: Oscar Health of IA Commercial $295.50
Rate for Payer: Partners Health Alliance Commercial $295.50
Rate for Payer: United Healthcare Commercial $354.60
Rate for Payer: United Healthcare Managed Medicare $232.46
Rate for Payer: Wellmark IA HMO $169.88
Rate for Payer: Wellmark IA PPO $186.87
Service Code CPT 76815
Hospital Charge Code 1169856
Hospital Revenue Code 402
Min. Negotiated Rate $275.80
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: United Healthcare Commercial $354.60
Service Code CPT 76817
Hospital Charge Code 1169861
Hospital Revenue Code 402
Min. Negotiated Rate $275.80
Max. Negotiated Rate $354.60
Rate for Payer: Aetna of IA Commercial $354.60
Rate for Payer: Aetna of IA Medical Rental Products $354.60
Rate for Payer: Cash Price $315.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $295.50
Rate for Payer: Medical Associates Commercial $295.50
Rate for Payer: Midlands Choice Commercial $275.80
Rate for Payer: United Healthcare Commercial $354.60