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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
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: Molina Healthcare Managed Medicare $226.21
Rate for Payer: Oscar Health of IA Commercial $334.50
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
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
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: Molina Healthcare Managed Medicare $117.16
Rate for Payer: Oscar Health of IA Commercial $173.25
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
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
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: 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
Rate for Payer: Wellmark IA HMO $20.46
Rate for Payer: Wellmark IA PPO $22.51
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
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: 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
Rate for Payer: Wellmark IA HMO $20.46
Rate for Payer: Wellmark IA PPO $22.51
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
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: 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 $61.38
Rate for Payer: Wellmark IA PPO $67.52
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: 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 $61.38
Rate for Payer: Wellmark IA PPO $67.52
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
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
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: 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 $61.38
Rate for Payer: Wellmark IA PPO $67.52
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: Molina Healthcare Managed Medicare $30.94
Rate for Payer: Oscar Health of IA Commercial $45.75
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
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
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: Molina Healthcare Managed Medicare $30.94
Rate for Payer: Oscar Health of IA Commercial $45.75
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
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
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: Molina Healthcare Managed Medicare $30.94
Rate for Payer: Oscar Health of IA Commercial $45.75
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
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
Service Code CPT 84157
Hospital Charge Code 1634881
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
Service Code CPT 84157
Hospital Charge Code 1634881
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: Molina Healthcare Managed Medicare $30.94
Rate for Payer: Oscar Health of IA Commercial $45.75
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
Service Code MS-DRG 553
Hospital Charge Code 360
Min. Negotiated Rate $11,513.63
Max. Negotiated Rate $11,682.95
Rate for Payer: Amerigroup Medicaid $11,626.51
Rate for Payer: Iowa Total Care Managed Medicaid $11,513.63
Rate for Payer: Molina Healthcare Managed Medicaid $11,682.95
Service Code MS-DRG 554
Hospital Charge Code 361
Min. Negotiated Rate $6,432.88
Max. Negotiated Rate $6,527.49
Rate for Payer: Amerigroup Medicaid $6,495.95
Rate for Payer: Iowa Total Care Managed Medicaid $6,432.88
Rate for Payer: Molina Healthcare Managed Medicaid $6,527.49
Service Code CPT C1713
Hospital Charge Code 8942321
Hospital Revenue Code 278
Min. Negotiated Rate $1,750.00
Max. Negotiated Rate $2,250.00
Rate for Payer: Aetna of IA Commercial $2,250.00
Rate for Payer: Aetna of IA Medical Rental Products $2,250.00
Rate for Payer: Cash Price $2,000.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $1,875.00
Rate for Payer: Medical Associates Commercial $1,875.00
Rate for Payer: Midlands Choice Commercial $1,750.00
Rate for Payer: United Healthcare Commercial $2,250.00