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Service Code CPT 75820 LT
Hospital Charge Code 1170592
Hospital Revenue Code 320
Min. Negotiated Rate $581.00
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: United Healthcare Commercial $747.00
Service Code CPT 75820 RT
Hospital Charge Code 1170594
Hospital Revenue Code 320
Min. Negotiated Rate $414.83
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Aetna of IA Medicare $473.10
Rate for Payer: Amerigroup Medicaid $418.90
Rate for Payer: Amerigroup Medicare $419.15
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $415.00
Rate for Payer: Iowa Total Care Managed Medicaid $414.83
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Medical Associates Managed Medicare $415.00
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: Molina Healthcare Managed Medicaid $421.22
Rate for Payer: Molina Healthcare Managed Medicare $420.98
Rate for Payer: Oscar Health of IA Commercial $622.50
Rate for Payer: Partners Health Alliance Commercial $622.50
Rate for Payer: United Healthcare Commercial $747.00
Rate for Payer: United Healthcare Managed Medicare $489.70
Service Code CPT 75820 RT
Hospital Charge Code 1170594
Hospital Revenue Code 320
Min. Negotiated Rate $581.00
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: United Healthcare Commercial $747.00
Service Code CPT 75820 LT
Hospital Charge Code 1170598
Hospital Revenue Code 320
Min. Negotiated Rate $414.83
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Aetna of IA Medicare $473.10
Rate for Payer: Amerigroup Medicaid $418.90
Rate for Payer: Amerigroup Medicare $419.15
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $415.00
Rate for Payer: Iowa Total Care Managed Medicaid $414.83
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Medical Associates Managed Medicare $415.00
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: Molina Healthcare Managed Medicaid $421.22
Rate for Payer: Molina Healthcare Managed Medicare $420.98
Rate for Payer: Oscar Health of IA Commercial $622.50
Rate for Payer: Partners Health Alliance Commercial $622.50
Rate for Payer: United Healthcare Commercial $747.00
Rate for Payer: United Healthcare Managed Medicare $489.70
Service Code CPT 75820 LT
Hospital Charge Code 1170598
Hospital Revenue Code 320
Min. Negotiated Rate $581.00
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: United Healthcare Commercial $747.00
Service Code CPT 75820 RT
Hospital Charge Code 1170600
Hospital Revenue Code 320
Min. Negotiated Rate $581.00
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: United Healthcare Commercial $747.00
Service Code CPT 75820 RT
Hospital Charge Code 1170600
Hospital Revenue Code 320
Min. Negotiated Rate $414.83
Max. Negotiated Rate $747.00
Rate for Payer: Aetna of IA Commercial $747.00
Rate for Payer: Aetna of IA Medical Rental Products $747.00
Rate for Payer: Aetna of IA Medicare $473.10
Rate for Payer: Amerigroup Medicaid $418.90
Rate for Payer: Amerigroup Medicare $419.15
Rate for Payer: Cash Price $664.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $622.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $415.00
Rate for Payer: Iowa Total Care Managed Medicaid $414.83
Rate for Payer: Medical Associates Commercial $622.50
Rate for Payer: Medical Associates Managed Medicare $415.00
Rate for Payer: Midlands Choice Commercial $581.00
Rate for Payer: Molina Healthcare Managed Medicaid $421.22
Rate for Payer: Molina Healthcare Managed Medicare $420.98
Rate for Payer: Oscar Health of IA Commercial $622.50
Rate for Payer: Partners Health Alliance Commercial $622.50
Rate for Payer: United Healthcare Commercial $747.00
Rate for Payer: United Healthcare Managed Medicare $489.70
Service Code CPT 73100 LT
Hospital Charge Code 1170606
Hospital Revenue Code 320
Min. Negotiated Rate $88.90
Max. Negotiated Rate $114.30
Rate for Payer: Aetna of IA Commercial $114.30
Rate for Payer: Aetna of IA Medical Rental Products $114.30
Rate for Payer: Cash Price $101.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $95.25
Rate for Payer: Medical Associates Commercial $95.25
Rate for Payer: Midlands Choice Commercial $88.90
Rate for Payer: United Healthcare Commercial $114.30
Service Code CPT 73100 LT
Hospital Charge Code 1170606
Hospital Revenue Code 320
Min. Negotiated Rate $63.47
Max. Negotiated Rate $114.30
Rate for Payer: Aetna of IA Commercial $114.30
Rate for Payer: Aetna of IA Medical Rental Products $114.30
Rate for Payer: Aetna of IA Medicare $72.39
Rate for Payer: Amerigroup Medicaid $64.10
Rate for Payer: Amerigroup Medicare $64.14
Rate for Payer: Cash Price $101.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $95.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $63.50
Rate for Payer: Iowa Total Care Managed Medicaid $63.47
Rate for Payer: Medical Associates Commercial $95.25
Rate for Payer: Medical Associates Managed Medicare $63.50
Rate for Payer: Midlands Choice Commercial $88.90
Rate for Payer: Molina Healthcare Managed Medicaid $64.45
Rate for Payer: Molina Healthcare Managed Medicare $64.41
Rate for Payer: Oscar Health of IA Commercial $95.25
Rate for Payer: Partners Health Alliance Commercial $95.25
Rate for Payer: United Healthcare Commercial $114.30
Rate for Payer: United Healthcare Managed Medicare $74.93
Service Code CPT 73100 RT
Hospital Charge Code 1170608
Hospital Revenue Code 320
Min. Negotiated Rate $63.47
Max. Negotiated Rate $114.30
Rate for Payer: Aetna of IA Commercial $114.30
Rate for Payer: Aetna of IA Medical Rental Products $114.30
Rate for Payer: Aetna of IA Medicare $72.39
Rate for Payer: Amerigroup Medicaid $64.10
Rate for Payer: Amerigroup Medicare $64.14
Rate for Payer: Cash Price $101.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $95.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $63.50
Rate for Payer: Iowa Total Care Managed Medicaid $63.47
Rate for Payer: Medical Associates Commercial $95.25
Rate for Payer: Medical Associates Managed Medicare $63.50
Rate for Payer: Midlands Choice Commercial $88.90
Rate for Payer: Molina Healthcare Managed Medicaid $64.45
Rate for Payer: Molina Healthcare Managed Medicare $64.41
Rate for Payer: Oscar Health of IA Commercial $95.25
Rate for Payer: Partners Health Alliance Commercial $95.25
Rate for Payer: United Healthcare Commercial $114.30
Rate for Payer: United Healthcare Managed Medicare $74.93
Service Code CPT 73100 RT
Hospital Charge Code 1170608
Hospital Revenue Code 320
Min. Negotiated Rate $88.90
Max. Negotiated Rate $114.30
Rate for Payer: Aetna of IA Commercial $114.30
Rate for Payer: Aetna of IA Medical Rental Products $114.30
Rate for Payer: Cash Price $101.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $95.25
Rate for Payer: Medical Associates Commercial $95.25
Rate for Payer: Midlands Choice Commercial $88.90
Rate for Payer: United Healthcare Commercial $114.30
Service Code CPT 73110 LT
Hospital Charge Code 1170612
Hospital Revenue Code 320
Min. Negotiated Rate $72.97
Max. Negotiated Rate $131.40
Rate for Payer: Aetna of IA Commercial $131.40
Rate for Payer: Aetna of IA Medical Rental Products $131.40
Rate for Payer: Aetna of IA Medicare $83.22
Rate for Payer: Amerigroup Medicaid $73.69
Rate for Payer: Amerigroup Medicare $73.73
Rate for Payer: Cash Price $116.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $109.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $73.00
Rate for Payer: Iowa Total Care Managed Medicaid $72.97
Rate for Payer: Medical Associates Commercial $109.50
Rate for Payer: Medical Associates Managed Medicare $73.00
Rate for Payer: Midlands Choice Commercial $102.20
Rate for Payer: Molina Healthcare Managed Medicaid $74.10
Rate for Payer: Molina Healthcare Managed Medicare $74.05
Rate for Payer: Oscar Health of IA Commercial $109.50
Rate for Payer: Partners Health Alliance Commercial $109.50
Rate for Payer: United Healthcare Commercial $131.40
Rate for Payer: United Healthcare Managed Medicare $86.14
Service Code CPT 73110 LT
Hospital Charge Code 1170612
Hospital Revenue Code 320
Min. Negotiated Rate $102.20
Max. Negotiated Rate $131.40
Rate for Payer: Aetna of IA Commercial $131.40
Rate for Payer: Aetna of IA Medical Rental Products $131.40
Rate for Payer: Cash Price $116.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $109.50
Rate for Payer: Medical Associates Commercial $109.50
Rate for Payer: Midlands Choice Commercial $102.20
Rate for Payer: United Healthcare Commercial $131.40
Service Code CPT 73110 RT
Hospital Charge Code 1170614
Hospital Revenue Code 320
Min. Negotiated Rate $102.20
Max. Negotiated Rate $131.40
Rate for Payer: Aetna of IA Commercial $131.40
Rate for Payer: Aetna of IA Medical Rental Products $131.40
Rate for Payer: Cash Price $116.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $109.50
Rate for Payer: Medical Associates Commercial $109.50
Rate for Payer: Midlands Choice Commercial $102.20
Rate for Payer: United Healthcare Commercial $131.40
Service Code CPT 73110 RT
Hospital Charge Code 1170614
Hospital Revenue Code 320
Min. Negotiated Rate $72.97
Max. Negotiated Rate $131.40
Rate for Payer: Aetna of IA Commercial $131.40
Rate for Payer: Aetna of IA Medical Rental Products $131.40
Rate for Payer: Aetna of IA Medicare $83.22
Rate for Payer: Amerigroup Medicaid $73.69
Rate for Payer: Amerigroup Medicare $73.73
Rate for Payer: Cash Price $116.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $109.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $73.00
Rate for Payer: Iowa Total Care Managed Medicaid $72.97
Rate for Payer: Medical Associates Commercial $109.50
Rate for Payer: Medical Associates Managed Medicare $73.00
Rate for Payer: Midlands Choice Commercial $102.20
Rate for Payer: Molina Healthcare Managed Medicaid $74.10
Rate for Payer: Molina Healthcare Managed Medicare $74.05
Rate for Payer: Oscar Health of IA Commercial $109.50
Rate for Payer: Partners Health Alliance Commercial $109.50
Rate for Payer: United Healthcare Commercial $131.40
Rate for Payer: United Healthcare Managed Medicare $86.14
Service Code CPT 84630
Hospital Charge Code 8519183
Hospital Revenue Code 301
Min. Negotiated Rate $30.99
Max. Negotiated Rate $55.80
Rate for Payer: Aetna of IA Commercial $55.80
Rate for Payer: Aetna of IA Medical Rental Products $55.80
Rate for Payer: Aetna of IA Medicare $35.34
Rate for Payer: Amerigroup Medicaid $31.29
Rate for Payer: Amerigroup Medicare $31.31
Rate for Payer: Cash Price $49.60
Rate for Payer: Cash Price $49.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $46.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $31.00
Rate for Payer: Iowa Total Care Managed Medicaid $30.99
Rate for Payer: Medical Associates Commercial $46.50
Rate for Payer: Medical Associates Managed Medicare $31.00
Rate for Payer: Midlands Choice Commercial $43.40
Rate for Payer: Molina Healthcare Managed Medicaid $31.46
Rate for Payer: Molina Healthcare Managed Medicare $31.45
Rate for Payer: Oscar Health of IA Commercial $46.50
Rate for Payer: Partners Health Alliance Commercial $46.50
Rate for Payer: United Healthcare Commercial $55.80
Rate for Payer: United Healthcare Managed Medicare $36.58
Rate for Payer: Wellmark IA HMO $37.20
Rate for Payer: Wellmark IA PPO $40.92
Service Code CPT 84630
Hospital Charge Code 8519183
Hospital Revenue Code 301
Min. Negotiated Rate $43.40
Max. Negotiated Rate $55.80
Rate for Payer: Aetna of IA Commercial $55.80
Rate for Payer: Aetna of IA Medical Rental Products $55.80
Rate for Payer: Cash Price $49.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $46.50
Rate for Payer: Medical Associates Commercial $46.50
Rate for Payer: Midlands Choice Commercial $43.40
Rate for Payer: United Healthcare Commercial $55.80
Service Code HCPCS A9270
Hospital Charge Code 22876909
Hospital Revenue Code 259
Min. Negotiated Rate $24.78
Max. Negotiated Rate $31.86
Rate for Payer: Aetna of IA Commercial $31.86
Rate for Payer: Aetna of IA Medical Rental Products $31.86
Rate for Payer: Cash Price $28.32
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $26.55
Rate for Payer: Medical Associates Commercial $26.55
Rate for Payer: Midlands Choice Commercial $24.78
Rate for Payer: United Healthcare Commercial $31.86
Service Code HCPCS A9270
Hospital Charge Code 22876909
Hospital Revenue Code 259
Min. Negotiated Rate $17.69
Max. Negotiated Rate $31.86
Rate for Payer: Aetna of IA Commercial $31.86
Rate for Payer: Aetna of IA Medical Rental Products $31.86
Rate for Payer: Aetna of IA Medicare $20.18
Rate for Payer: Amerigroup Medicaid $17.87
Rate for Payer: Amerigroup Medicare $17.88
Rate for Payer: Cash Price $28.32
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $26.55
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $17.70
Rate for Payer: Iowa Total Care Managed Medicaid $17.69
Rate for Payer: Medical Associates Commercial $26.55
Rate for Payer: Medical Associates Managed Medicare $17.70
Rate for Payer: Midlands Choice Commercial $24.78
Rate for Payer: Molina Healthcare Managed Medicaid $17.97
Rate for Payer: Molina Healthcare Managed Medicare $17.95
Rate for Payer: Oscar Health of IA Commercial $26.55
Rate for Payer: Partners Health Alliance Commercial $26.55
Rate for Payer: United Healthcare Commercial $31.86
Rate for Payer: United Healthcare Managed Medicare $20.89
Service Code HCPCS A9270
Hospital Charge Code 10428828
Hospital Revenue Code 259
Min. Negotiated Rate $0.65
Max. Negotiated Rate $1.18
Rate for Payer: Aetna of IA Commercial $1.18
Rate for Payer: Aetna of IA Medical Rental Products $1.18
Rate for Payer: Aetna of IA Medicare $0.75
Rate for Payer: Amerigroup Medicaid $0.66
Rate for Payer: Amerigroup Medicare $0.66
Rate for Payer: Cash Price $1.05
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $0.98
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $0.66
Rate for Payer: Iowa Total Care Managed Medicaid $0.65
Rate for Payer: Medical Associates Commercial $0.98
Rate for Payer: Medical Associates Managed Medicare $0.66
Rate for Payer: Midlands Choice Commercial $0.92
Rate for Payer: Molina Healthcare Managed Medicaid $0.66
Rate for Payer: Molina Healthcare Managed Medicare $0.66
Rate for Payer: Oscar Health of IA Commercial $0.98
Rate for Payer: Partners Health Alliance Commercial $0.98
Rate for Payer: United Healthcare Commercial $1.18
Rate for Payer: United Healthcare Managed Medicare $0.77
Service Code HCPCS A9270
Hospital Charge Code 10428828
Hospital Revenue Code 259
Min. Negotiated Rate $0.92
Max. Negotiated Rate $1.18
Rate for Payer: Aetna of IA Commercial $1.18
Rate for Payer: Aetna of IA Medical Rental Products $1.18
Rate for Payer: Cash Price $1.05
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $0.98
Rate for Payer: Medical Associates Commercial $0.98
Rate for Payer: Midlands Choice Commercial $0.92
Rate for Payer: United Healthcare Commercial $1.18
Service Code CPT 93242
Hospital Charge Code 8831646
Hospital Revenue Code 730
Min. Negotiated Rate $213.50
Max. Negotiated Rate $274.50
Rate for Payer: Aetna of IA Commercial $274.50
Rate for Payer: Aetna of IA Medical Rental Products $274.50
Rate for Payer: Cash Price $244.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $228.75
Rate for Payer: Medical Associates Commercial $228.75
Rate for Payer: Midlands Choice Commercial $213.50
Rate for Payer: United Healthcare Commercial $274.50
Service Code CPT 93242
Hospital Charge Code 8831646
Hospital Revenue Code 730
Min. Negotiated Rate $152.44
Max. Negotiated Rate $274.50
Rate for Payer: United Healthcare Commercial $274.50
Rate for Payer: Aetna of IA Commercial $274.50
Rate for Payer: Aetna of IA Medical Rental Products $274.50
Rate for Payer: Aetna of IA Medicare $173.85
Rate for Payer: Amerigroup Medicaid $153.93
Rate for Payer: Amerigroup Medicare $154.02
Rate for Payer: Cash Price $244.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $228.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $152.50
Rate for Payer: Iowa Total Care Managed Medicaid $152.44
Rate for Payer: Medical Associates Commercial $228.75
Rate for Payer: Medical Associates Managed Medicare $152.50
Rate for Payer: Midlands Choice Commercial $213.50
Rate for Payer: Molina Healthcare Managed Medicaid $154.79
Rate for Payer: Molina Healthcare Managed Medicare $154.70
Rate for Payer: Oscar Health of IA Commercial $228.75
Rate for Payer: Partners Health Alliance Commercial $228.75
Rate for Payer: United Healthcare Managed Medicare $179.95
Service Code CPT 93246
Hospital Charge Code 8829640
Hospital Revenue Code 730
Min. Negotiated Rate $213.50
Max. Negotiated Rate $274.50
Rate for Payer: Aetna of IA Commercial $274.50
Rate for Payer: Aetna of IA Medical Rental Products $274.50
Rate for Payer: Cash Price $244.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $228.75
Rate for Payer: Medical Associates Commercial $228.75
Rate for Payer: Midlands Choice Commercial $213.50
Rate for Payer: United Healthcare Commercial $274.50
Service Code CPT 93246
Hospital Charge Code 8829640
Hospital Revenue Code 730
Min. Negotiated Rate $152.44
Max. Negotiated Rate $274.50
Rate for Payer: Aetna of IA Commercial $274.50
Rate for Payer: Aetna of IA Medical Rental Products $274.50
Rate for Payer: Aetna of IA Medicare $173.85
Rate for Payer: Amerigroup Medicaid $153.93
Rate for Payer: Amerigroup Medicare $154.02
Rate for Payer: Cash Price $244.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $228.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $152.50
Rate for Payer: Iowa Total Care Managed Medicaid $152.44
Rate for Payer: Medical Associates Commercial $228.75
Rate for Payer: Medical Associates Managed Medicare $152.50
Rate for Payer: Midlands Choice Commercial $213.50
Rate for Payer: Molina Healthcare Managed Medicaid $154.79
Rate for Payer: Molina Healthcare Managed Medicare $154.70
Rate for Payer: Oscar Health of IA Commercial $228.75
Rate for Payer: Partners Health Alliance Commercial $228.75
Rate for Payer: United Healthcare Commercial $274.50
Rate for Payer: United Healthcare Managed Medicare $179.95