|
WBC AUTOMATED WITHOUT DIFF
|
Facility
|
OP
|
$34.00
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
2038410
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.30 |
| Max. Negotiated Rate |
$32.02 |
| Rate for Payer: Aetna of IA Commercial |
$30.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$30.60
|
| Rate for Payer: Aetna of IA Medicare |
$19.38
|
| Rate for Payer: Amerigroup Medicaid |
$19.61
|
| Rate for Payer: Amerigroup Medicare |
$15.45
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$25.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$15.30
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$19.42
|
| Rate for Payer: Medical Associates Commercial |
$25.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$15.30
|
| Rate for Payer: Midlands Choice Commercial |
$23.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$19.71
|
| Rate for Payer: Partners Health Alliance Commercial |
$17.60
|
| Rate for Payer: United Healthcare Commercial |
$30.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$20.06
|
| Rate for Payer: Wellmark IA HMO WHPI |
$29.07
|
| Rate for Payer: Wellmark IA PPO |
$32.02
|
|
|
WBC AUTOMATED WITHOUT DIFF
|
Facility
|
IP
|
$34.00
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
2038410
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$30.60 |
| Rate for Payer: Aetna of IA Commercial |
$30.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$30.60
|
| Rate for Payer: Cash Price |
$27.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$25.50
|
| Rate for Payer: Medical Associates Commercial |
$25.50
|
| Rate for Payer: Midlands Choice Commercial |
$23.80
|
| Rate for Payer: United Healthcare Commercial |
$30.60
|
|
|
WBC STOOL LACTOFERRIN
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 89055
|
| Hospital Charge Code |
7807165
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.45 |
| Max. Negotiated Rate |
$54.67 |
| Rate for Payer: Aetna of IA Commercial |
$36.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$36.90
|
| Rate for Payer: Aetna of IA Medicare |
$23.37
|
| Rate for Payer: Amerigroup Medicaid |
$23.65
|
| Rate for Payer: Amerigroup Medicare |
$18.63
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$30.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$18.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$23.42
|
| Rate for Payer: Medical Associates Commercial |
$30.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$18.45
|
| Rate for Payer: Midlands Choice Commercial |
$28.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$23.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$21.22
|
| Rate for Payer: United Healthcare Commercial |
$36.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$24.19
|
| Rate for Payer: Wellmark IA HMO WHPI |
$49.63
|
| Rate for Payer: Wellmark IA PPO |
$54.67
|
|
|
WBC STOOL LACTOFERRIN
|
Facility
|
IP
|
$41.00
|
|
|
Service Code
|
CPT 89055
|
| Hospital Charge Code |
7807165
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.70 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Aetna of IA Commercial |
$36.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$36.90
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$30.75
|
| Rate for Payer: Medical Associates Commercial |
$30.75
|
| Rate for Payer: Midlands Choice Commercial |
$28.70
|
| Rate for Payer: United Healthcare Commercial |
$36.90
|
|
|
West Nile Virus Panel DMCL
|
Facility
|
OP
|
$138.00
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
8037830
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.83 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Aetna of IA Commercial |
$124.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$124.20
|
| Rate for Payer: Aetna of IA Medicare |
$78.66
|
| Rate for Payer: Amerigroup Medicaid |
$79.60
|
| Rate for Payer: Amerigroup Medicare |
$62.72
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$103.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$62.10
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$78.83
|
| Rate for Payer: Medical Associates Commercial |
$103.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$62.10
|
| Rate for Payer: Midlands Choice Commercial |
$96.60
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$79.98
|
| Rate for Payer: Partners Health Alliance Commercial |
$71.42
|
| Rate for Payer: United Healthcare Commercial |
$124.20
|
| Rate for Payer: United Healthcare Managed Medicare |
$81.42
|
| Rate for Payer: Wellmark IA HMO WHPI |
$41.83
|
| Rate for Payer: Wellmark IA PPO |
$46.08
|
|
|
West Nile Virus Panel DMCL
|
Facility
|
IP
|
$138.00
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
8037830
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$124.20 |
| Rate for Payer: Aetna of IA Commercial |
$124.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$124.20
|
| Rate for Payer: Cash Price |
$110.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$103.50
|
| Rate for Payer: Medical Associates Commercial |
$103.50
|
| Rate for Payer: Midlands Choice Commercial |
$96.60
|
| Rate for Payer: United Healthcare Commercial |
$124.20
|
|
|
WET MOUNT VAGINAL
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
7802689
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.45 |
| Max. Negotiated Rate |
$37.49 |
| Rate for Payer: Aetna of IA Commercial |
$36.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$36.90
|
| Rate for Payer: Aetna of IA Medicare |
$23.37
|
| Rate for Payer: Amerigroup Medicaid |
$23.65
|
| Rate for Payer: Amerigroup Medicare |
$18.63
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$30.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$18.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$23.42
|
| Rate for Payer: Medical Associates Commercial |
$30.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$18.45
|
| Rate for Payer: Midlands Choice Commercial |
$28.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$23.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$21.22
|
| Rate for Payer: United Healthcare Commercial |
$36.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$24.19
|
| Rate for Payer: Wellmark IA HMO WHPI |
$34.03
|
| Rate for Payer: Wellmark IA PPO |
$37.49
|
|
|
WET MOUNT VAGINAL
|
Facility
|
IP
|
$41.00
|
|
|
Service Code
|
CPT 87210
|
| Hospital Charge Code |
7802689
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.70 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Aetna of IA Commercial |
$36.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$36.90
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$30.75
|
| Rate for Payer: Medical Associates Commercial |
$30.75
|
| Rate for Payer: Midlands Choice Commercial |
$28.70
|
| Rate for Payer: United Healthcare Commercial |
$36.90
|
|
|
WHIRLPOOL
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 97022 GO
|
| Hospital Charge Code |
1373554
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$73.74 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna of IA Commercial |
$162.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$162.90
|
| Rate for Payer: Aetna of IA Medicare |
$103.17
|
| Rate for Payer: Amerigroup Medicaid |
$104.40
|
| Rate for Payer: Amerigroup Medicare |
$82.26
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$135.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$81.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$103.39
|
| Rate for Payer: Medical Associates Commercial |
$135.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$81.45
|
| Rate for Payer: Midlands Choice Commercial |
$126.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$104.91
|
| Rate for Payer: Partners Health Alliance Commercial |
$93.67
|
| Rate for Payer: United Healthcare Commercial |
$162.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$106.79
|
| Rate for Payer: Wellmark IA HMO WHPI |
$73.74
|
| Rate for Payer: Wellmark IA PPO |
$81.22
|
|
|
WHIRLPOOL
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 97022 GO
|
| Hospital Charge Code |
1373554
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$126.70 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna of IA Commercial |
$162.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$162.90
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$135.75
|
| Rate for Payer: Medical Associates Commercial |
$135.75
|
| Rate for Payer: Midlands Choice Commercial |
$126.70
|
| Rate for Payer: United Healthcare Commercial |
$162.90
|
|
|
WHIRLPOOL APPLICATION
|
Facility
|
IP
|
$181.00
|
|
|
Service Code
|
CPT 97022 GP
|
| Hospital Charge Code |
4812783
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$126.70 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna of IA Commercial |
$162.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$162.90
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$135.75
|
| Rate for Payer: Medical Associates Commercial |
$135.75
|
| Rate for Payer: Midlands Choice Commercial |
$126.70
|
| Rate for Payer: United Healthcare Commercial |
$162.90
|
|
|
WHIRLPOOL APPLICATION
|
Facility
|
OP
|
$181.00
|
|
|
Service Code
|
CPT 97022 GP
|
| Hospital Charge Code |
4812783
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$73.74 |
| Max. Negotiated Rate |
$162.90 |
| Rate for Payer: Aetna of IA Commercial |
$162.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$162.90
|
| Rate for Payer: Aetna of IA Medicare |
$103.17
|
| Rate for Payer: Amerigroup Medicaid |
$104.40
|
| Rate for Payer: Amerigroup Medicare |
$82.26
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Cash Price |
$144.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$135.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$81.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$103.39
|
| Rate for Payer: Medical Associates Commercial |
$135.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$81.45
|
| Rate for Payer: Midlands Choice Commercial |
$126.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$104.91
|
| Rate for Payer: Partners Health Alliance Commercial |
$93.67
|
| Rate for Payer: United Healthcare Commercial |
$162.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$106.79
|
| Rate for Payer: Wellmark IA HMO WHPI |
$73.74
|
| Rate for Payer: Wellmark IA PPO |
$81.22
|
|
|
white petrolatum-mineral oil Oint [VDMC]
|
Facility
|
IP
|
$43.60
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
10410004
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$39.24 |
| Rate for Payer: Aetna of IA Commercial |
$39.24
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$39.24
|
| Rate for Payer: Cash Price |
$34.88
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$32.70
|
| Rate for Payer: Medical Associates Commercial |
$32.70
|
| Rate for Payer: Midlands Choice Commercial |
$30.52
|
| Rate for Payer: United Healthcare Commercial |
$39.24
|
|
|
white petrolatum-mineral oil Oint [VDMC]
|
Facility
|
OP
|
$43.60
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
10410004
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.62 |
| Max. Negotiated Rate |
$39.24 |
| Rate for Payer: Aetna of IA Commercial |
$39.24
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$39.24
|
| Rate for Payer: Aetna of IA Medicare |
$24.85
|
| Rate for Payer: Amerigroup Medicaid |
$25.15
|
| Rate for Payer: Amerigroup Medicare |
$19.82
|
| Rate for Payer: Cash Price |
$34.88
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$32.70
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$19.62
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$24.90
|
| Rate for Payer: Medical Associates Commercial |
$32.70
|
| Rate for Payer: Medical Associates Managed Medicare |
$19.62
|
| Rate for Payer: Midlands Choice Commercial |
$30.52
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$25.27
|
| Rate for Payer: Partners Health Alliance Commercial |
$22.56
|
| Rate for Payer: United Healthcare Commercial |
$39.24
|
| Rate for Payer: United Healthcare Managed Medicare |
$25.72
|
|
|
WIRE KIT WITH BLADE
|
Facility
|
OP
|
$2,025.00
|
|
| Hospital Charge Code |
8046946
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$911.25 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Aetna of IA Commercial |
$1,822.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,822.50
|
| Rate for Payer: Aetna of IA Medicare |
$1,154.25
|
| Rate for Payer: Amerigroup Medicaid |
$1,168.02
|
| Rate for Payer: Amerigroup Medicare |
$920.36
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,518.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$911.25
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,156.68
|
| Rate for Payer: Medical Associates Commercial |
$1,518.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$911.25
|
| Rate for Payer: Midlands Choice Commercial |
$1,417.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$1,173.69
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,047.94
|
| Rate for Payer: United Healthcare Commercial |
$1,822.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$1,194.75
|
|
|
WIRE KIT WITH BLADE
|
Facility
|
IP
|
$2,025.00
|
|
| Hospital Charge Code |
8046946
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,417.50 |
| Max. Negotiated Rate |
$1,822.50 |
| Rate for Payer: Aetna of IA Commercial |
$1,822.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,822.50
|
| Rate for Payer: Cash Price |
$1,620.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,518.75
|
| Rate for Payer: Medical Associates Commercial |
$1,518.75
|
| Rate for Payer: Midlands Choice Commercial |
$1,417.50
|
| Rate for Payer: United Healthcare Commercial |
$1,822.50
|
|
|
WIRE KIT WITH BLADE-1
|
Facility
|
OP
|
$405.00
|
|
| Hospital Charge Code |
8047062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.25 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna of IA Commercial |
$364.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$364.50
|
| Rate for Payer: Aetna of IA Medicare |
$230.85
|
| Rate for Payer: Amerigroup Medicaid |
$233.60
|
| Rate for Payer: Amerigroup Medicare |
$184.07
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$303.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$182.25
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$231.34
|
| Rate for Payer: Medical Associates Commercial |
$303.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$182.25
|
| Rate for Payer: Midlands Choice Commercial |
$283.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$234.74
|
| Rate for Payer: Partners Health Alliance Commercial |
$209.59
|
| Rate for Payer: United Healthcare Commercial |
$364.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$238.95
|
|
|
WIRE KIT WITH BLADE-1
|
Facility
|
IP
|
$405.00
|
|
| Hospital Charge Code |
8047062
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$283.50 |
| Max. Negotiated Rate |
$364.50 |
| Rate for Payer: Aetna of IA Commercial |
$364.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$364.50
|
| Rate for Payer: Cash Price |
$324.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$303.75
|
| Rate for Payer: Medical Associates Commercial |
$303.75
|
| Rate for Payer: Midlands Choice Commercial |
$283.50
|
| Rate for Payer: United Healthcare Commercial |
$364.50
|
|
|
WIRES KIRSCHNER 0.6MM
|
Facility
|
IP
|
$140.00
|
|
| Hospital Charge Code |
8046721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna of IA Commercial |
$126.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$126.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$105.00
|
| Rate for Payer: Medical Associates Commercial |
$105.00
|
| Rate for Payer: Midlands Choice Commercial |
$98.00
|
| Rate for Payer: United Healthcare Commercial |
$126.00
|
|
|
WIRES KIRSCHNER 0.6MM
|
Facility
|
OP
|
$140.00
|
|
| Hospital Charge Code |
8046721
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna of IA Commercial |
$126.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$126.00
|
| Rate for Payer: Aetna of IA Medicare |
$79.80
|
| Rate for Payer: Amerigroup Medicaid |
$80.75
|
| Rate for Payer: Amerigroup Medicare |
$63.63
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$105.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$63.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$79.97
|
| Rate for Payer: Medical Associates Commercial |
$105.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$63.00
|
| Rate for Payer: Midlands Choice Commercial |
$98.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$81.14
|
| Rate for Payer: Partners Health Alliance Commercial |
$72.45
|
| Rate for Payer: United Healthcare Commercial |
$126.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$82.60
|
|
|
WIRES KIRSCHNER 0.8MM
|
Facility
|
IP
|
$140.00
|
|
| Hospital Charge Code |
8046897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$98.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna of IA Commercial |
$126.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$126.00
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$105.00
|
| Rate for Payer: Medical Associates Commercial |
$105.00
|
| Rate for Payer: Midlands Choice Commercial |
$98.00
|
| Rate for Payer: United Healthcare Commercial |
$126.00
|
|
|
WIRES KIRSCHNER 0.8MM
|
Facility
|
OP
|
$140.00
|
|
| Hospital Charge Code |
8046897
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.00 |
| Max. Negotiated Rate |
$126.00 |
| Rate for Payer: Aetna of IA Commercial |
$126.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$126.00
|
| Rate for Payer: Aetna of IA Medicare |
$79.80
|
| Rate for Payer: Amerigroup Medicaid |
$80.75
|
| Rate for Payer: Amerigroup Medicare |
$63.63
|
| Rate for Payer: Cash Price |
$112.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$105.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$63.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$79.97
|
| Rate for Payer: Medical Associates Commercial |
$105.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$63.00
|
| Rate for Payer: Midlands Choice Commercial |
$98.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$81.14
|
| Rate for Payer: Partners Health Alliance Commercial |
$72.45
|
| Rate for Payer: United Healthcare Commercial |
$126.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$82.60
|
|
|
WIRES KIRSCHNER 1.0MM
|
Facility
|
IP
|
$161.00
|
|
| Hospital Charge Code |
8046903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$112.70 |
| Max. Negotiated Rate |
$144.90 |
| Rate for Payer: Aetna of IA Commercial |
$144.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$144.90
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$120.75
|
| Rate for Payer: Medical Associates Commercial |
$120.75
|
| Rate for Payer: Midlands Choice Commercial |
$112.70
|
| Rate for Payer: United Healthcare Commercial |
$144.90
|
|
|
WIRES KIRSCHNER 1.0MM
|
Facility
|
OP
|
$161.00
|
|
| Hospital Charge Code |
8046903
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$72.45 |
| Max. Negotiated Rate |
$144.90 |
| Rate for Payer: Aetna of IA Commercial |
$144.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$144.90
|
| Rate for Payer: Aetna of IA Medicare |
$91.77
|
| Rate for Payer: Amerigroup Medicaid |
$92.86
|
| Rate for Payer: Amerigroup Medicare |
$73.17
|
| Rate for Payer: Cash Price |
$128.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$120.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$72.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$91.96
|
| Rate for Payer: Medical Associates Commercial |
$120.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$72.45
|
| Rate for Payer: Midlands Choice Commercial |
$112.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$93.32
|
| Rate for Payer: Partners Health Alliance Commercial |
$83.32
|
| Rate for Payer: United Healthcare Commercial |
$144.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$94.99
|
|
|
WIRES KIRSCHNER 1.0MM X 150MM
|
Facility
|
OP
|
$191.00
|
|
| Hospital Charge Code |
8047027
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$85.95 |
| Max. Negotiated Rate |
$171.90 |
| Rate for Payer: Aetna of IA Commercial |
$171.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$171.90
|
| Rate for Payer: Aetna of IA Medicare |
$108.87
|
| Rate for Payer: Amerigroup Medicaid |
$110.17
|
| Rate for Payer: Amerigroup Medicare |
$86.81
|
| Rate for Payer: Cash Price |
$152.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$143.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$85.95
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$109.10
|
| Rate for Payer: Medical Associates Commercial |
$143.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$85.95
|
| Rate for Payer: Midlands Choice Commercial |
$133.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$110.70
|
| Rate for Payer: Partners Health Alliance Commercial |
$98.84
|
| Rate for Payer: United Healthcare Commercial |
$171.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$112.69
|
|
