|
BILL CROSSMATCH EA
|
Facility
|
OP
|
$99.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
8015153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.48 |
| Max. Negotiated Rate |
$107.07 |
| Rate for Payer: Aetna of IA Commercial |
$89.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$89.10
|
| Rate for Payer: Aetna of IA Medicare |
$56.43
|
| Rate for Payer: Amerigroup Medicaid |
$49.97
|
| Rate for Payer: Amerigroup Medicare |
$50.00
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$74.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$49.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$49.48
|
| Rate for Payer: Medical Associates Commercial |
$74.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$49.50
|
| Rate for Payer: Midlands Choice Commercial |
$69.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$50.24
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$50.21
|
| Rate for Payer: Oscar Health of IA Commercial |
$74.25
|
| Rate for Payer: Partners Health Alliance Commercial |
$74.25
|
| Rate for Payer: United Healthcare Commercial |
$89.10
|
| Rate for Payer: United Healthcare Managed Medicare |
$58.41
|
| Rate for Payer: Wellmark IA HMO |
$97.34
|
| Rate for Payer: Wellmark IA PPO |
$107.07
|
|
|
BILL CROSSMATCH EA
|
Facility
|
IP
|
$99.00
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
8015153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$69.30 |
| Max. Negotiated Rate |
$89.10 |
| Rate for Payer: Aetna of IA Commercial |
$89.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$89.10
|
| Rate for Payer: Cash Price |
$79.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$74.25
|
| Rate for Payer: Medical Associates Commercial |
$74.25
|
| Rate for Payer: Midlands Choice Commercial |
$69.30
|
| Rate for Payer: United Healthcare Commercial |
$89.10
|
|
|
Bill Cytology Fluid 88104
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
7452782
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$51.98 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna of IA Commercial |
$93.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$93.60
|
| Rate for Payer: Aetna of IA Medicare |
$59.28
|
| Rate for Payer: Amerigroup Medicaid |
$52.49
|
| Rate for Payer: Amerigroup Medicare |
$52.52
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$78.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$52.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$51.98
|
| Rate for Payer: Medical Associates Commercial |
$78.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$52.00
|
| Rate for Payer: Midlands Choice Commercial |
$72.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$52.78
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$52.75
|
| Rate for Payer: Oscar Health of IA Commercial |
$78.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$78.00
|
| Rate for Payer: United Healthcare Commercial |
$93.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$61.36
|
| Rate for Payer: Wellmark IA HMO |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
|
Bill Cytology Fluid 88104
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
7452782
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.80 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna of IA Commercial |
$93.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$93.60
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$78.00
|
| Rate for Payer: Medical Associates Commercial |
$78.00
|
| Rate for Payer: Midlands Choice Commercial |
$72.80
|
| Rate for Payer: United Healthcare Commercial |
$93.60
|
|
|
Bill Cyto Needle Aspirate Report 88173
|
Facility
|
IP
|
$167.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
8099056
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$116.90 |
| Max. Negotiated Rate |
$150.30 |
| Rate for Payer: Aetna of IA Commercial |
$150.30
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$150.30
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$125.25
|
| Rate for Payer: Medical Associates Commercial |
$125.25
|
| Rate for Payer: Midlands Choice Commercial |
$116.90
|
| Rate for Payer: United Healthcare Commercial |
$150.30
|
|
|
Bill Cyto Needle Aspirate Report 88173
|
Facility
|
OP
|
$167.00
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
8099056
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$83.47 |
| Max. Negotiated Rate |
$150.30 |
| Rate for Payer: Aetna of IA Commercial |
$150.30
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$150.30
|
| Rate for Payer: Aetna of IA Medicare |
$95.19
|
| Rate for Payer: Amerigroup Medicaid |
$84.28
|
| Rate for Payer: Amerigroup Medicare |
$84.34
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Cash Price |
$133.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$125.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$83.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$83.47
|
| Rate for Payer: Medical Associates Commercial |
$125.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$83.50
|
| Rate for Payer: Midlands Choice Commercial |
$116.90
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$84.75
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$84.70
|
| Rate for Payer: Oscar Health of IA Commercial |
$125.25
|
| Rate for Payer: Partners Health Alliance Commercial |
$125.25
|
| Rate for Payer: United Healthcare Commercial |
$150.30
|
| Rate for Payer: United Healthcare Managed Medicare |
$98.53
|
| Rate for Payer: Wellmark IA HMO |
$112.84
|
| Rate for Payer: Wellmark IA PPO |
$124.12
|
|
|
Bill Cyto Smears Screening w/Interp 88160
|
Facility
|
OP
|
$85.00
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
8099074
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$42.48 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna of IA Commercial |
$76.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$76.50
|
| Rate for Payer: Aetna of IA Medicare |
$48.45
|
| Rate for Payer: Amerigroup Medicaid |
$42.90
|
| Rate for Payer: Amerigroup Medicare |
$42.92
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$63.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$42.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$42.48
|
| Rate for Payer: Medical Associates Commercial |
$63.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$42.50
|
| Rate for Payer: Midlands Choice Commercial |
$59.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$43.14
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$43.11
|
| Rate for Payer: Oscar Health of IA Commercial |
$63.75
|
| Rate for Payer: Partners Health Alliance Commercial |
$63.75
|
| Rate for Payer: United Healthcare Commercial |
$76.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$50.15
|
| Rate for Payer: Wellmark IA HMO |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
|
Bill Cyto Smears Screening w/Interp 88160
|
Facility
|
IP
|
$85.00
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
8099074
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$59.50 |
| Max. Negotiated Rate |
$76.50 |
| Rate for Payer: Aetna of IA Commercial |
$76.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$76.50
|
| Rate for Payer: Cash Price |
$68.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$63.75
|
| Rate for Payer: Medical Associates Commercial |
$63.75
|
| Rate for Payer: Midlands Choice Commercial |
$59.50
|
| Rate for Payer: United Healthcare Commercial |
$76.50
|
|
|
Bill Cyto Thin Prep 88112
|
Facility
|
OP
|
$105.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
8099073
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$52.48 |
| Max. Negotiated Rate |
$124.12 |
| Rate for Payer: Aetna of IA Commercial |
$94.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$94.50
|
| Rate for Payer: Aetna of IA Medicare |
$59.85
|
| Rate for Payer: Amerigroup Medicaid |
$52.99
|
| Rate for Payer: Amerigroup Medicare |
$53.02
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$78.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$52.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$52.48
|
| Rate for Payer: Medical Associates Commercial |
$78.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$52.50
|
| Rate for Payer: Midlands Choice Commercial |
$73.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$53.29
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$53.26
|
| Rate for Payer: Oscar Health of IA Commercial |
$78.75
|
| Rate for Payer: Partners Health Alliance Commercial |
$78.75
|
| Rate for Payer: United Healthcare Commercial |
$94.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$61.95
|
| Rate for Payer: Wellmark IA HMO |
$112.84
|
| Rate for Payer: Wellmark IA PPO |
$124.12
|
|
|
Bill Cyto Thin Prep 88112
|
Facility
|
IP
|
$105.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
8099073
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$73.50 |
| Max. Negotiated Rate |
$94.50 |
| Rate for Payer: Aetna of IA Commercial |
$94.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$94.50
|
| Rate for Payer: Cash Price |
$84.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$78.75
|
| Rate for Payer: Medical Associates Commercial |
$78.75
|
| Rate for Payer: Midlands Choice Commercial |
$73.50
|
| Rate for Payer: United Healthcare Commercial |
$94.50
|
|
|
BILL DIRECT ANTIGLOBULIN
|
Facility
|
IP
|
$58.00
|
|
|
Service Code
|
CPT 86880
|
| Hospital Charge Code |
7864921
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$52.20 |
| Rate for Payer: Aetna of IA Commercial |
$52.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$52.20
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$43.50
|
| Rate for Payer: Medical Associates Commercial |
$43.50
|
| Rate for Payer: Midlands Choice Commercial |
$40.60
|
| Rate for Payer: United Healthcare Commercial |
$52.20
|
|
|
BILL DIRECT ANTIGLOBULIN
|
Facility
|
OP
|
$58.00
|
|
|
Service Code
|
CPT 86880
|
| Hospital Charge Code |
7864921
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.99 |
| Max. Negotiated Rate |
$107.07 |
| Rate for Payer: Aetna of IA Commercial |
$52.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$52.20
|
| Rate for Payer: Aetna of IA Medicare |
$33.06
|
| Rate for Payer: Amerigroup Medicaid |
$29.27
|
| Rate for Payer: Amerigroup Medicare |
$29.29
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Cash Price |
$46.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$43.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$29.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$28.99
|
| Rate for Payer: Medical Associates Commercial |
$43.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$29.00
|
| Rate for Payer: Midlands Choice Commercial |
$40.60
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$29.44
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$29.42
|
| Rate for Payer: Oscar Health of IA Commercial |
$43.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$43.50
|
| Rate for Payer: United Healthcare Commercial |
$52.20
|
| Rate for Payer: United Healthcare Managed Medicare |
$34.22
|
| Rate for Payer: Wellmark IA HMO |
$97.34
|
| Rate for Payer: Wellmark IA PPO |
$107.07
|
|
|
Bill Dna Probe 88271
|
Facility
|
OP
|
$220.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
8099070
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna of IA Commercial |
$198.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$198.00
|
| Rate for Payer: Aetna of IA Medicare |
$125.40
|
| Rate for Payer: Amerigroup Medicaid |
$111.03
|
| Rate for Payer: Amerigroup Medicare |
$111.10
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$165.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$110.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$109.96
|
| Rate for Payer: Medical Associates Commercial |
$165.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$110.00
|
| Rate for Payer: Midlands Choice Commercial |
$154.00
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$111.65
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$111.58
|
| Rate for Payer: Oscar Health of IA Commercial |
$165.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$165.00
|
| Rate for Payer: United Healthcare Commercial |
$198.00
|
| Rate for Payer: United Healthcare Managed Medicare |
$129.80
|
| Rate for Payer: Wellmark IA HMO |
$143.22
|
| Rate for Payer: Wellmark IA PPO |
$157.54
|
|
|
Bill Dna Probe 88271
|
Facility
|
IP
|
$220.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
8099070
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Aetna of IA Commercial |
$198.00
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$198.00
|
| Rate for Payer: Cash Price |
$176.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$165.00
|
| Rate for Payer: Medical Associates Commercial |
$165.00
|
| Rate for Payer: Midlands Choice Commercial |
$154.00
|
| Rate for Payer: United Healthcare Commercial |
$198.00
|
|
|
Bill Each Additonal Ab Per Slide 88341
|
Facility
|
IP
|
$212.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
7452803
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$148.40 |
| Max. Negotiated Rate |
$190.80 |
| Rate for Payer: Aetna of IA Commercial |
$190.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$190.80
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$159.00
|
| Rate for Payer: Medical Associates Commercial |
$159.00
|
| Rate for Payer: Midlands Choice Commercial |
$148.40
|
| Rate for Payer: United Healthcare Commercial |
$190.80
|
|
|
Bill Each Additonal Ab Per Slide 88341
|
Facility
|
OP
|
$212.00
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
7452803
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$105.96 |
| Max. Negotiated Rate |
$190.80 |
| Rate for Payer: Aetna of IA Commercial |
$190.80
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$190.80
|
| Rate for Payer: Aetna of IA Medicare |
$120.84
|
| Rate for Payer: Amerigroup Medicaid |
$107.00
|
| Rate for Payer: Amerigroup Medicare |
$107.06
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Cash Price |
$169.60
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$159.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$106.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$105.96
|
| Rate for Payer: Medical Associates Commercial |
$159.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$106.00
|
| Rate for Payer: Midlands Choice Commercial |
$148.40
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$107.59
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$107.53
|
| Rate for Payer: Oscar Health of IA Commercial |
$159.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$159.00
|
| Rate for Payer: United Healthcare Commercial |
$190.80
|
| Rate for Payer: United Healthcare Managed Medicare |
$125.08
|
| Rate for Payer: Wellmark IA HMO |
$145.08
|
| Rate for Payer: Wellmark IA PPO |
$159.59
|
|
|
BILL ENZYME TREATMENT EA
|
Facility
|
IP
|
$101.00
|
|
|
Service Code
|
CPT 86971
|
| Hospital Charge Code |
8015154
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.70 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna of IA Commercial |
$90.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$90.90
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$75.75
|
| Rate for Payer: Medical Associates Commercial |
$75.75
|
| Rate for Payer: Midlands Choice Commercial |
$70.70
|
| Rate for Payer: United Healthcare Commercial |
$90.90
|
|
|
BILL ENZYME TREATMENT EA
|
Facility
|
OP
|
$101.00
|
|
|
Service Code
|
CPT 86971
|
| Hospital Charge Code |
8015154
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.48 |
| Max. Negotiated Rate |
$90.90 |
| Rate for Payer: Aetna of IA Commercial |
$90.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$90.90
|
| Rate for Payer: Aetna of IA Medicare |
$57.57
|
| Rate for Payer: Amerigroup Medicaid |
$50.97
|
| Rate for Payer: Amerigroup Medicare |
$51.00
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Cash Price |
$80.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$75.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$50.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$50.48
|
| Rate for Payer: Medical Associates Commercial |
$75.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$50.50
|
| Rate for Payer: Midlands Choice Commercial |
$70.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$51.26
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$51.23
|
| Rate for Payer: Oscar Health of IA Commercial |
$75.75
|
| Rate for Payer: Partners Health Alliance Commercial |
$75.75
|
| Rate for Payer: United Healthcare Commercial |
$90.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$59.59
|
| Rate for Payer: Wellmark IA HMO |
$55.18
|
| Rate for Payer: Wellmark IA PPO |
$60.70
|
|
|
Bill Fine Needle Aspirate 88172
|
Facility
|
IP
|
$74.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
8099075
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$66.60 |
| Rate for Payer: Aetna of IA Commercial |
$66.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$66.60
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$55.50
|
| Rate for Payer: Medical Associates Commercial |
$55.50
|
| Rate for Payer: Midlands Choice Commercial |
$51.80
|
| Rate for Payer: United Healthcare Commercial |
$66.60
|
|
|
Bill Fine Needle Aspirate 88172
|
Facility
|
OP
|
$74.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
8099075
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$36.99 |
| Max. Negotiated Rate |
$159.59 |
| Rate for Payer: Aetna of IA Commercial |
$66.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$66.60
|
| Rate for Payer: Aetna of IA Medicare |
$42.18
|
| Rate for Payer: Amerigroup Medicaid |
$37.35
|
| Rate for Payer: Amerigroup Medicare |
$37.37
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Cash Price |
$59.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$55.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$37.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$36.99
|
| Rate for Payer: Medical Associates Commercial |
$55.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$37.00
|
| Rate for Payer: Midlands Choice Commercial |
$51.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$37.56
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$37.53
|
| Rate for Payer: Oscar Health of IA Commercial |
$55.50
|
| Rate for Payer: Partners Health Alliance Commercial |
$55.50
|
| Rate for Payer: United Healthcare Commercial |
$66.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$43.66
|
| Rate for Payer: Wellmark IA HMO |
$145.08
|
| Rate for Payer: Wellmark IA PPO |
$159.59
|
|
|
Bill Flow Cytometry 9-15 Markers 88188
|
Facility
|
OP
|
$136.00
|
|
|
Service Code
|
CPT 88188
|
| Hospital Charge Code |
8099059
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$61.38 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna of IA Commercial |
$122.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$122.40
|
| Rate for Payer: Aetna of IA Medicare |
$77.52
|
| Rate for Payer: Amerigroup Medicaid |
$68.64
|
| Rate for Payer: Amerigroup Medicare |
$68.68
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$102.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$68.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$67.97
|
| Rate for Payer: Medical Associates Commercial |
$102.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$68.00
|
| Rate for Payer: Midlands Choice Commercial |
$95.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$69.02
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$68.98
|
| Rate for Payer: Oscar Health of IA Commercial |
$102.00
|
| Rate for Payer: Partners Health Alliance Commercial |
$102.00
|
| Rate for Payer: United Healthcare Commercial |
$122.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$80.24
|
| Rate for Payer: Wellmark IA HMO |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
|
Bill Flow Cytometry 9-15 Markers 88188
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 88188
|
| Hospital Charge Code |
8099059
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$95.20 |
| Max. Negotiated Rate |
$122.40 |
| Rate for Payer: Aetna of IA Commercial |
$122.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$122.40
|
| Rate for Payer: Cash Price |
$108.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$102.00
|
| Rate for Payer: Medical Associates Commercial |
$102.00
|
| Rate for Payer: Midlands Choice Commercial |
$95.20
|
| Rate for Payer: United Healthcare Commercial |
$122.40
|
|
|
Bill Flow Cytometry Marker 1st 88184
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
8099057
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$150.50 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna of IA Commercial |
$193.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$193.50
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$161.25
|
| Rate for Payer: Medical Associates Commercial |
$161.25
|
| Rate for Payer: Midlands Choice Commercial |
$150.50
|
| Rate for Payer: United Healthcare Commercial |
$193.50
|
|
|
Bill Flow Cytometry Marker 1st 88184
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
8099057
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$107.46 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Aetna of IA Commercial |
$193.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$193.50
|
| Rate for Payer: Aetna of IA Medicare |
$122.55
|
| Rate for Payer: Amerigroup Medicaid |
$108.51
|
| Rate for Payer: Amerigroup Medicare |
$108.58
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Cash Price |
$172.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$161.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$107.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$107.46
|
| Rate for Payer: Medical Associates Commercial |
$161.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$107.50
|
| Rate for Payer: Midlands Choice Commercial |
$150.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$109.11
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$109.05
|
| Rate for Payer: Oscar Health of IA Commercial |
$161.25
|
| Rate for Payer: Partners Health Alliance Commercial |
$161.25
|
| Rate for Payer: United Healthcare Commercial |
$193.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$126.85
|
| Rate for Payer: Wellmark IA HMO |
$145.08
|
| Rate for Payer: Wellmark IA PPO |
$159.59
|
|
|
Bill Flow Cytometry Marker 1st 88189
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 88189
|
| Hospital Charge Code |
8099060
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$57.48 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna of IA Commercial |
$103.50
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$103.50
|
| Rate for Payer: Aetna of IA Medicare |
$65.55
|
| Rate for Payer: Amerigroup Medicaid |
$58.04
|
| Rate for Payer: Amerigroup Medicare |
$58.08
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$86.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$57.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$57.48
|
| Rate for Payer: Medical Associates Commercial |
$86.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$57.50
|
| Rate for Payer: Midlands Choice Commercial |
$80.50
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$58.36
|
| Rate for Payer: Molina Healthcare Managed Medicare |
$58.33
|
| Rate for Payer: Oscar Health of IA Commercial |
$86.25
|
| Rate for Payer: Partners Health Alliance Commercial |
$86.25
|
| Rate for Payer: United Healthcare Commercial |
$103.50
|
| Rate for Payer: United Healthcare Managed Medicare |
$67.85
|
| Rate for Payer: Wellmark IA HMO |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
