|
BIOPSY OF BREAST OPEN
|
Facility
|
IP
|
$1,624.00
|
|
|
Service Code
|
CPT 19101
|
| Hospital Charge Code |
7983046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,136.80 |
| Max. Negotiated Rate |
$1,461.60 |
| Rate for Payer: Aetna of IA Commercial |
$1,461.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,461.60
|
| Rate for Payer: Cash Price |
$1,299.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,218.00
|
| Rate for Payer: Medical Associates Commercial |
$1,218.00
|
| Rate for Payer: Midlands Choice Commercial |
$1,136.80
|
| Rate for Payer: United Healthcare Commercial |
$1,461.60
|
|
|
BIOPSY OF RECTUM
|
Facility
|
IP
|
$1,894.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
7983047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,325.80 |
| Max. Negotiated Rate |
$1,704.60 |
| Rate for Payer: Aetna of IA Commercial |
$1,704.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,704.60
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,420.50
|
| Rate for Payer: Medical Associates Commercial |
$1,420.50
|
| Rate for Payer: Midlands Choice Commercial |
$1,325.80
|
| Rate for Payer: United Healthcare Commercial |
$1,704.60
|
|
|
BIOPSY OF RECTUM
|
Facility
|
OP
|
$1,894.00
|
|
|
Service Code
|
CPT 45100
|
| Hospital Charge Code |
7983047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$852.30 |
| Max. Negotiated Rate |
$4,161.95 |
| Rate for Payer: Aetna of IA Commercial |
$1,704.60
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$1,704.60
|
| Rate for Payer: Aetna of IA Medicare |
$1,079.58
|
| Rate for Payer: Amerigroup Medicaid |
$1,092.46
|
| Rate for Payer: Amerigroup Medicare |
$860.82
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Cash Price |
$1,515.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$1,420.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$852.30
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,081.85
|
| Rate for Payer: Medical Associates Commercial |
$1,420.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$852.30
|
| Rate for Payer: Midlands Choice Commercial |
$1,325.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$1,097.76
|
| Rate for Payer: Partners Health Alliance Commercial |
$980.14
|
| Rate for Payer: United Healthcare Commercial |
$1,704.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$1,117.46
|
| Rate for Payer: Wellmark IA HMO WHPI |
$3,778.26
|
| Rate for Payer: Wellmark IA PPO |
$4,161.95
|
|
|
BIOPSY OF UTERUS LINING
|
Facility
|
OP
|
$401.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
4863432
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$180.45 |
| Max. Negotiated Rate |
$990.31 |
| Rate for Payer: Aetna of IA Commercial |
$360.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$360.90
|
| Rate for Payer: Aetna of IA Medicare |
$228.57
|
| Rate for Payer: Amerigroup Medicaid |
$231.30
|
| Rate for Payer: Amerigroup Medicare |
$182.25
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$300.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$180.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$229.05
|
| Rate for Payer: Medical Associates Commercial |
$300.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$180.45
|
| Rate for Payer: Midlands Choice Commercial |
$280.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$232.42
|
| Rate for Payer: Partners Health Alliance Commercial |
$207.52
|
| Rate for Payer: United Healthcare Commercial |
$360.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$236.59
|
| Rate for Payer: Wellmark IA HMO WHPI |
$899.01
|
| Rate for Payer: Wellmark IA PPO |
$990.31
|
|
|
BIOPSY OF UTERUS LINING
|
Facility
|
IP
|
$401.00
|
|
|
Service Code
|
CPT 58100
|
| Hospital Charge Code |
4863432
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$280.70 |
| Max. Negotiated Rate |
$360.90 |
| Rate for Payer: Aetna of IA Commercial |
$360.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$360.90
|
| Rate for Payer: Cash Price |
$320.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$300.75
|
| Rate for Payer: Medical Associates Commercial |
$300.75
|
| Rate for Payer: Midlands Choice Commercial |
$280.70
|
| Rate for Payer: United Healthcare Commercial |
$360.90
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Facility
|
OP
|
$653.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
7983043
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$293.85 |
| Max. Negotiated Rate |
$990.31 |
| Rate for Payer: Aetna of IA Commercial |
$587.70
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$587.70
|
| Rate for Payer: Aetna of IA Medicare |
$372.21
|
| Rate for Payer: Amerigroup Medicaid |
$376.65
|
| Rate for Payer: Amerigroup Medicare |
$296.79
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$489.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$293.85
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$372.99
|
| Rate for Payer: Medical Associates Commercial |
$489.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$293.85
|
| Rate for Payer: Midlands Choice Commercial |
$457.10
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$378.48
|
| Rate for Payer: Partners Health Alliance Commercial |
$337.93
|
| Rate for Payer: United Healthcare Commercial |
$587.70
|
| Rate for Payer: United Healthcare Managed Medicare |
$385.27
|
| Rate for Payer: Wellmark IA HMO WHPI |
$899.01
|
| Rate for Payer: Wellmark IA PPO |
$990.31
|
|
|
BIOPSY OF VULVA/PERINEUM
|
Facility
|
IP
|
$653.00
|
|
|
Service Code
|
CPT 56605
|
| Hospital Charge Code |
7983043
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$457.10 |
| Max. Negotiated Rate |
$587.70 |
| Rate for Payer: Aetna of IA Commercial |
$587.70
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$587.70
|
| Rate for Payer: Cash Price |
$522.40
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$489.75
|
| Rate for Payer: Medical Associates Commercial |
$489.75
|
| Rate for Payer: Midlands Choice Commercial |
$457.10
|
| Rate for Payer: United Healthcare Commercial |
$587.70
|
|
|
BIOPSY OR EXCISION OF LYMP NODES OPEN ING NODES
|
Professional
|
Both
|
$1,529.00
|
|
|
Service Code
|
CPT 38531
|
| Hospital Charge Code |
8825535
|
|
Hospital Revenue Code
|
975
|
| Min. Negotiated Rate |
$403.68 |
| Max. Negotiated Rate |
$1,146.75 |
| Rate for Payer: Amerigroup Medicaid |
$407.63
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Cash Price |
$1,223.20
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$403.68
|
| Rate for Payer: Medical Associates Commercial |
$1,146.75
|
| Rate for Payer: Midlands Choice Commercial |
$1,070.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$405.65
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,146.75
|
| Rate for Payer: United Healthcare Commercial |
$660.94
|
| Rate for Payer: Wellmark IA HMO WHPI |
$861.90
|
| Rate for Payer: Wellmark IA PPO |
$1,014.00
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$2,839.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
7983045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,277.55 |
| Max. Negotiated Rate |
$5,032.76 |
| Rate for Payer: Aetna of IA Commercial |
$2,555.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2,555.10
|
| Rate for Payer: Aetna of IA Medicare |
$1,618.23
|
| Rate for Payer: Amerigroup Medicaid |
$1,637.54
|
| Rate for Payer: Amerigroup Medicare |
$1,290.33
|
| Rate for Payer: Cash Price |
$2,271.20
|
| Rate for Payer: Cash Price |
$2,271.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,129.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$1,277.55
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,621.64
|
| Rate for Payer: Medical Associates Commercial |
$2,129.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,277.55
|
| Rate for Payer: Midlands Choice Commercial |
$1,987.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$1,645.48
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,469.18
|
| Rate for Payer: United Healthcare Commercial |
$2,555.10
|
| Rate for Payer: United Healthcare Managed Medicare |
$1,675.01
|
| Rate for Payer: Wellmark IA HMO WHPI |
$4,568.80
|
| Rate for Payer: Wellmark IA PPO |
$5,032.76
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$2,839.00
|
|
|
Service Code
|
CPT 38510
|
| Hospital Charge Code |
7983045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,987.30 |
| Max. Negotiated Rate |
$2,555.10 |
| Rate for Payer: Aetna of IA Commercial |
$2,555.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2,555.10
|
| Rate for Payer: Cash Price |
$2,271.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,129.25
|
| Rate for Payer: Medical Associates Commercial |
$2,129.25
|
| Rate for Payer: Midlands Choice Commercial |
$1,987.30
|
| Rate for Payer: United Healthcare Commercial |
$2,555.10
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
OP
|
$2,839.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
7983044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,277.55 |
| Max. Negotiated Rate |
$5,032.76 |
| Rate for Payer: Aetna of IA Commercial |
$2,555.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2,555.10
|
| Rate for Payer: Aetna of IA Medicare |
$1,618.23
|
| Rate for Payer: Amerigroup Medicaid |
$1,637.54
|
| Rate for Payer: Amerigroup Medicare |
$1,290.33
|
| Rate for Payer: Cash Price |
$2,271.20
|
| Rate for Payer: Cash Price |
$2,271.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,129.25
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$1,277.55
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$1,621.64
|
| Rate for Payer: Medical Associates Commercial |
$2,129.25
|
| Rate for Payer: Medical Associates Managed Medicare |
$1,277.55
|
| Rate for Payer: Midlands Choice Commercial |
$1,987.30
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$1,645.48
|
| Rate for Payer: Partners Health Alliance Commercial |
$1,469.18
|
| Rate for Payer: United Healthcare Commercial |
$2,555.10
|
| Rate for Payer: United Healthcare Managed Medicare |
$1,675.01
|
| Rate for Payer: Wellmark IA HMO WHPI |
$4,568.80
|
| Rate for Payer: Wellmark IA PPO |
$5,032.76
|
|
|
BIOPSY/REMOVAL LYMPH NODES
|
Facility
|
IP
|
$2,839.00
|
|
|
Service Code
|
CPT 38500
|
| Hospital Charge Code |
7983044
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,987.30 |
| Max. Negotiated Rate |
$2,555.10 |
| Rate for Payer: Aetna of IA Commercial |
$2,555.10
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$2,555.10
|
| Rate for Payer: Cash Price |
$2,271.20
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$2,129.25
|
| Rate for Payer: Medical Associates Commercial |
$2,129.25
|
| Rate for Payer: Midlands Choice Commercial |
$1,987.30
|
| Rate for Payer: United Healthcare Commercial |
$2,555.10
|
|
|
BIOPSY SKIN ADD-ON
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
7983041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$182.70 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
|
|
BIOPSY SKIN ADD-ON
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 11101
|
| Hospital Charge Code |
7983041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$117.45 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Aetna of IA Commercial |
$234.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$234.90
|
| Rate for Payer: Aetna of IA Medicare |
$148.77
|
| Rate for Payer: Amerigroup Medicaid |
$150.54
|
| Rate for Payer: Amerigroup Medicare |
$118.62
|
| Rate for Payer: Cash Price |
$208.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$195.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$117.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$149.08
|
| Rate for Payer: Medical Associates Commercial |
$195.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$117.45
|
| Rate for Payer: Midlands Choice Commercial |
$182.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$151.28
|
| Rate for Payer: Partners Health Alliance Commercial |
$135.07
|
| Rate for Payer: United Healthcare Commercial |
$234.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$153.99
|
|
|
BIOPSY SKIN LESION
|
Facility
|
IP
|
$326.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
4862813
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$228.20 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Aetna of IA Commercial |
$293.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$293.40
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$244.50
|
| Rate for Payer: Medical Associates Commercial |
$244.50
|
| Rate for Payer: Midlands Choice Commercial |
$228.20
|
| Rate for Payer: United Healthcare Commercial |
$293.40
|
|
|
BIOPSY SKIN LESION
|
Facility
|
OP
|
$326.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
4862813
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$146.70 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Aetna of IA Commercial |
$293.40
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$293.40
|
| Rate for Payer: Aetna of IA Medicare |
$185.82
|
| Rate for Payer: Amerigroup Medicaid |
$188.04
|
| Rate for Payer: Amerigroup Medicare |
$148.17
|
| Rate for Payer: Cash Price |
$260.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$244.50
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$146.70
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$186.21
|
| Rate for Payer: Medical Associates Commercial |
$244.50
|
| Rate for Payer: Medical Associates Managed Medicare |
$146.70
|
| Rate for Payer: Midlands Choice Commercial |
$228.20
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$188.95
|
| Rate for Payer: Partners Health Alliance Commercial |
$168.70
|
| Rate for Payer: United Healthcare Commercial |
$293.40
|
| Rate for Payer: United Healthcare Managed Medicare |
$192.34
|
|
|
BIOPSY SKIN LESION
|
Professional
|
Both
|
$342.00
|
|
|
Service Code
|
CPT 11100
|
| Hospital Charge Code |
7982852
|
|
Hospital Revenue Code
|
981
|
| Min. Negotiated Rate |
$177.00 |
| Max. Negotiated Rate |
$256.50 |
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Cash Price |
$273.60
|
| Rate for Payer: Medical Associates Commercial |
$256.50
|
| Rate for Payer: Midlands Choice Commercial |
$239.40
|
| Rate for Payer: Partners Health Alliance Commercial |
$256.50
|
| Rate for Payer: Wellmark IA HMO WHPI |
$177.00
|
| Rate for Payer: Wellmark IA PPO |
$215.00
|
|
|
BIO PUSHLOCK 3.5X19.5
|
Facility
|
IP
|
$684.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
8026045
|
|
Hospital Revenue Code
|
278
|
| 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
|
|
|
BIO PUSHLOCK 3.5X19.5
|
Facility
|
OP
|
$684.00
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
8026045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$307.80 |
| 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: Aetna of IA Medicare |
$389.88
|
| Rate for Payer: Amerigroup Medicaid |
$394.53
|
| Rate for Payer: Amerigroup Medicare |
$310.88
|
| 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 |
$307.80
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$390.70
|
| Rate for Payer: Medical Associates Commercial |
$513.00
|
| Rate for Payer: Medical Associates Managed Medicare |
$307.80
|
| Rate for Payer: Midlands Choice Commercial |
$478.80
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$396.45
|
| Rate for Payer: Partners Health Alliance Commercial |
$353.97
|
| Rate for Payer: United Healthcare Commercial |
$615.60
|
| Rate for Payer: United Healthcare Managed Medicare |
$403.56
|
|
|
BIPAP/CPAP INITIAL 21%
|
Facility
|
IP
|
$521.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
4770826
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$364.70 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna of IA Commercial |
$468.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$468.90
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$390.75
|
| Rate for Payer: Medical Associates Commercial |
$390.75
|
| Rate for Payer: Midlands Choice Commercial |
$364.70
|
| Rate for Payer: United Healthcare Commercial |
$468.90
|
|
|
BIPAP/CPAP INITIAL 21%
|
Facility
|
OP
|
$521.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
4770829
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$234.45 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna of IA Commercial |
$468.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$468.90
|
| Rate for Payer: Aetna of IA Medicare |
$296.97
|
| Rate for Payer: Amerigroup Medicaid |
$300.51
|
| Rate for Payer: Amerigroup Medicare |
$236.79
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$390.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$234.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$297.60
|
| Rate for Payer: Medical Associates Commercial |
$390.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$234.45
|
| Rate for Payer: Midlands Choice Commercial |
$364.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$301.97
|
| Rate for Payer: Partners Health Alliance Commercial |
$269.62
|
| Rate for Payer: United Healthcare Commercial |
$468.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$307.39
|
| Rate for Payer: Wellmark IA HMO WHPI |
$346.70
|
| Rate for Payer: Wellmark IA PPO |
$381.91
|
|
|
BIPAP/CPAP INITIAL 21%
|
Facility
|
OP
|
$521.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
4770826
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$234.45 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna of IA Commercial |
$468.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$468.90
|
| Rate for Payer: Aetna of IA Medicare |
$296.97
|
| Rate for Payer: Amerigroup Medicaid |
$300.51
|
| Rate for Payer: Amerigroup Medicare |
$236.79
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$390.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$234.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$297.60
|
| Rate for Payer: Medical Associates Commercial |
$390.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$234.45
|
| Rate for Payer: Midlands Choice Commercial |
$364.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$301.97
|
| Rate for Payer: Partners Health Alliance Commercial |
$269.62
|
| Rate for Payer: United Healthcare Commercial |
$468.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$307.39
|
| Rate for Payer: Wellmark IA HMO WHPI |
$346.70
|
| Rate for Payer: Wellmark IA PPO |
$381.91
|
|
|
BIPAP/CPAP INITIAL 21%
|
Facility
|
IP
|
$521.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
4770829
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$364.70 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna of IA Commercial |
$468.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$468.90
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$390.75
|
| Rate for Payer: Medical Associates Commercial |
$390.75
|
| Rate for Payer: Midlands Choice Commercial |
$364.70
|
| Rate for Payer: United Healthcare Commercial |
$468.90
|
|
|
BIPAP/CPAP SUBSEQUENT 21%
|
Facility
|
OP
|
$521.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
4770825
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$234.45 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna of IA Commercial |
$468.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$468.90
|
| Rate for Payer: Aetna of IA Medicare |
$296.97
|
| Rate for Payer: Amerigroup Medicaid |
$300.51
|
| Rate for Payer: Amerigroup Medicare |
$236.79
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$390.75
|
| Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS |
$234.45
|
| Rate for Payer: Iowa Total Care Managed Medicaid |
$297.60
|
| Rate for Payer: Medical Associates Commercial |
$390.75
|
| Rate for Payer: Medical Associates Managed Medicare |
$234.45
|
| Rate for Payer: Midlands Choice Commercial |
$364.70
|
| Rate for Payer: Molina Healthcare Managed Medicaid |
$301.97
|
| Rate for Payer: Partners Health Alliance Commercial |
$269.62
|
| Rate for Payer: United Healthcare Commercial |
$468.90
|
| Rate for Payer: United Healthcare Managed Medicare |
$307.39
|
| Rate for Payer: Wellmark IA HMO WHPI |
$346.70
|
| Rate for Payer: Wellmark IA PPO |
$381.91
|
|
|
BIPAP/CPAP SUBSEQUENT 21%
|
Facility
|
IP
|
$521.00
|
|
|
Service Code
|
CPT 94660
|
| Hospital Charge Code |
4770825
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$364.70 |
| Max. Negotiated Rate |
$468.90 |
| Rate for Payer: Aetna of IA Commercial |
$468.90
|
| Rate for Payer: Aetna of IA Medical Rental Products |
$468.90
|
| Rate for Payer: Cash Price |
$416.80
|
| Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial |
$390.75
|
| Rate for Payer: Medical Associates Commercial |
$390.75
|
| Rate for Payer: Midlands Choice Commercial |
$364.70
|
| Rate for Payer: United Healthcare Commercial |
$468.90
|
|
