|
BLOOD TRANSFUSION-OB
|
Facility
OP
|
$684.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
7763434
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$341.86 |
| Max. Negotiated Rate |
$1,444.48 |
| Rate for Payer: Aetna of IA Commercial |
$615.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$615.60
|
| Rate for Payer: Aetna of IA Medicare |
$389.88
|
| Rate for Payer: Amerigroup Medicaid |
$345.21
|
| Rate for Payer: Amerigroup Medicare |
$345.42
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$513.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$342.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$341.86
|
| Rate for Payer: Medical Associates Commercial |
$513.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$342.00
|
| Rate for Payer: Midlands Choice Commercial |
$478.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$347.13
|
| Rate for Payer: Partners Health Alliance Commercial |
$513.00
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$403.56
|
| Rate for Payer: Wellmark IA HMO |
$1,313.16
|
| Rate for Payer: Wellmark IA PPO |
$1,444.48
|
|
|
BLOOD TRANSFUSION, SCHEDULED
|
Facility
IP
|
$684.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
8012930
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$478.80 |
| Max. Negotiated Rate |
$615.60 |
| Rate for Payer: Aetna of IA Commercial |
$615.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$615.60
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$513.00
|
| Rate for Payer: Medical Associates Commercial |
$513.00
|
| Rate for Payer: Midlands Choice Commercial |
$478.80
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
|
|
BLOOD TRANSFUSION, SCHEDULED
|
Facility
OP
|
$684.00
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
8012930
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$341.86 |
| Max. Negotiated Rate |
$1,444.48 |
| Rate for Payer: Aetna of IA Commercial |
$615.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$615.60
|
| Rate for Payer: Aetna of IA Medicare |
$389.88
|
| Rate for Payer: Amerigroup Medicaid |
$345.21
|
| Rate for Payer: Amerigroup Medicare |
$345.42
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Cash Price |
$547.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$513.00
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$342.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$341.86
|
| Rate for Payer: Medical Associates Commercial |
$513.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$342.00
|
| Rate for Payer: Midlands Choice Commercial |
$478.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$347.13
|
| Rate for Payer: Partners Health Alliance Commercial |
$513.00
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$403.56
|
| Rate for Payer: Wellmark IA HMO |
$1,313.16
|
| Rate for Payer: Wellmark IA PPO |
$1,444.48
|
|
|
BLS EMERGENCY
|
Facility
OP
|
$598.00
|
|
|
Service Code
|
CPT A0429 QN
|
| Hospital Charge Code |
5230785
|
|
Hospital Revenue Code
|
540
|
| Min. Negotiated Rate |
$298.88 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Aetna of IA Commercial |
$538.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$538.20
|
| Rate for Payer: Aetna of IA Medicare |
$340.86
|
| Rate for Payer: Amerigroup Medicaid |
$301.81
|
| Rate for Payer: Amerigroup Medicare |
$301.99
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$448.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$299.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$298.88
|
| Rate for Payer: Medical Associates Commercial |
$448.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$299.00
|
| Rate for Payer: Midlands Choice Commercial |
$418.60
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$303.48
|
| Rate for Payer: Partners Health Alliance Commercial |
$448.50
|
| Rate for Payer: United Healthcare Commercial |
$538.20
|
| Rate for Payer: United Healthcare Managed Medicare |
$508.30
|
|
|
BLS EMERGENCY
|
Facility
IP
|
$598.00
|
|
|
Service Code
|
CPT A0429 QN
|
| Hospital Charge Code |
5230785
|
|
Hospital Revenue Code
|
540
|
| Min. Negotiated Rate |
$418.60 |
| Max. Negotiated Rate |
$538.20 |
| Rate for Payer: Aetna of IA Commercial |
$538.20
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$538.20
|
| Rate for Payer: Cash Price |
$478.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$448.50
|
| Rate for Payer: Medical Associates Commercial |
$448.50
|
| Rate for Payer: Midlands Choice Commercial |
$418.60
|
| Rate for Payer: United Healthcare Commercial |
$538.20
|
|
|
BLS NON EMERGENCY
|
Facility
IP
|
$446.00
|
|
|
Service Code
|
CPT A0428
|
| Hospital Charge Code |
8059609
|
|
Hospital Revenue Code
|
540
|
| Min. Negotiated Rate |
$312.20 |
| Max. Negotiated Rate |
$401.40 |
| Rate for Payer: Aetna of IA Commercial |
$401.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$401.40
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$334.50
|
| Rate for Payer: Medical Associates Commercial |
$334.50
|
| Rate for Payer: Midlands Choice Commercial |
$312.20
|
| Rate for Payer: United Healthcare Commercial |
$401.40
|
|
|
BLS NON EMERGENCY
|
Facility
OP
|
$446.00
|
|
|
Service Code
|
CPT A0428
|
| Hospital Charge Code |
8059609
|
|
Hospital Revenue Code
|
540
|
| Min. Negotiated Rate |
$222.91 |
| Max. Negotiated Rate |
$401.40 |
| Rate for Payer: Aetna of IA Commercial |
$401.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$401.40
|
| Rate for Payer: Aetna of IA Medicare |
$254.22
|
| Rate for Payer: Amerigroup Medicaid |
$225.10
|
| Rate for Payer: Amerigroup Medicare |
$225.23
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$334.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$223.00
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$222.91
|
| Rate for Payer: Medical Associates Commercial |
$334.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$223.00
|
| Rate for Payer: Midlands Choice Commercial |
$312.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$226.34
|
| Rate for Payer: Partners Health Alliance Commercial |
$334.50
|
| Rate for Payer: United Healthcare Commercial |
$401.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$379.10
|
|
|
B NATURIURETIC PEPTIDE
|
Facility
IP
|
$231.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
1383771
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$161.70 |
| Max. Negotiated Rate |
$207.90 |
| Rate for Payer: Aetna of IA Commercial |
$207.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$207.90
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$173.25
|
| Rate for Payer: Medical Associates Commercial |
$173.25
|
| Rate for Payer: Midlands Choice Commercial |
$161.70
|
| Rate for Payer: United Healthcare Commercial |
$207.90
|
|
|
B NATURIURETIC PEPTIDE
|
Facility
OP
|
$231.00
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
1383771
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$102.92 |
| Max. Negotiated Rate |
$207.90 |
| Rate for Payer: Aetna of IA Commercial |
$207.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$207.90
|
| Rate for Payer: Aetna of IA Medicare |
$131.67
|
| Rate for Payer: Amerigroup Medicaid |
$116.59
|
| Rate for Payer: Amerigroup Medicare |
$116.66
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Cash Price |
$184.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$173.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$115.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$115.45
|
| Rate for Payer: Medical Associates Commercial |
$173.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$115.50
|
| Rate for Payer: Midlands Choice Commercial |
$161.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$117.23
|
| Rate for Payer: Partners Health Alliance Commercial |
$173.25
|
| Rate for Payer: United Healthcare Commercial |
$207.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$136.29
|
| Rate for Payer: Wellmark IA HMO |
$102.92
|
| Rate for Payer: Wellmark IA PPO |
$113.21
|
|
|
BODY FLUID ALBUMIN
|
Facility
OP
|
$146.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
8093928
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| 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: 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: Partners Health Alliance Commercial |
$109.50
|
| Rate for Payer: United Healthcare Commercial |
$131.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$86.14
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
BODY FLUID ALBUMIN
|
Facility
IP
|
$146.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
7934761
|
|
Hospital Revenue Code
|
301
|
| 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
|
|
|
BODY FLUID ALBUMIN
|
Facility
IP
|
$146.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
8093928
|
|
Hospital Revenue Code
|
301
|
| 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
|
|
|
BODY FLUID ALBUMIN
|
Facility
OP
|
$146.00
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
7934761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.46 |
| 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: 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: Partners Health Alliance Commercial |
$109.50
|
| Rate for Payer: United Healthcare Commercial |
$131.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$86.14
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
BODY FLUID CELL COUNT
|
Facility
IP
|
$74.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
4006785
|
|
Hospital Revenue Code
|
309
|
| 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
|
|
|
BODY FLUID CELL COUNT
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
4006785
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$36.99 |
| Max. Negotiated Rate |
$67.52 |
| 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: 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 |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
|
BODY FLUID CELL COUNT
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
4006786
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$36.99 |
| Max. Negotiated Rate |
$67.52 |
| 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: 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 |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
|
BODY FLUID CELL COUNT
|
Facility
IP
|
$74.00
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
4006786
|
|
Hospital Revenue Code
|
309
|
| 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
|
|
|
BODY FLUID CRYSTALS
|
Facility
OP
|
$74.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
4022819
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$36.99 |
| Max. Negotiated Rate |
$67.52 |
| 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: 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 |
$61.38
|
| Rate for Payer: Wellmark IA PPO |
$67.52
|
|
|
BODY FLUID CRYSTALS
|
Facility
IP
|
$74.00
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
4022819
|
|
Hospital Revenue Code
|
309
|
| 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
|
|
|
BODY FLUID GLUCOSE
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
1628897
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
BODY FLUID GLUCOSE
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
4022832
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
BODY FLUID GLUCOSE
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
4022832
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
BODY FLUID GLUCOSE
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
1628897
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
|
BODY FLUID PROTEIN
|
Facility
IP
|
$61.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
4022830
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$42.70 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
|
|
BODY FLUID PROTEIN
|
Facility
OP
|
$61.00
|
|
|
Service Code
|
CPT 84157
|
| Hospital Charge Code |
4022830
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna of IA Commercial |
$54.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$54.90
|
| Rate for Payer: Aetna of IA Medicare |
$34.77
|
| Rate for Payer: Amerigroup Medicaid |
$30.79
|
| Rate for Payer: Amerigroup Medicare |
$30.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$45.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$30.50
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$30.49
|
| Rate for Payer: Medical Associates Commercial |
$45.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$30.50
|
| Rate for Payer: Midlands Choice Commercial |
$42.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$30.96
|
| Rate for Payer: Partners Health Alliance Commercial |
$45.75
|
| Rate for Payer: United Healthcare Commercial |
$54.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$35.99
|
| Rate for Payer: Wellmark IA HMO |
$20.46
|
| Rate for Payer: Wellmark IA PPO |
$22.51
|
|
