Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

carfilzomib 60 mg Pow SDV [VDMC]

Facility

$7,174.38

Service Code	HCPCS J9047
Hospital Charge Code	22278386
Hospital Revenue Code	259
Min. Negotiated Rate	$3,228.47
Max. Negotiated Rate	$6,456.94
Rate for Payer: Aetna of IA Commercial	$6,456.94
Rate for Payer: Aetna of IA Medical Rental Products	$6,456.94
Rate for Payer: Aetna of IA Medicare	$4,089.40
Rate for Payer: Amerigroup Medicaid	$4,138.18
Rate for Payer: Amerigroup Medicare	$3,260.76
Rate for Payer: Cash Price	$5,739.50
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$5,380.78
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$3,228.47
Rate for Payer: Iowa Total Care Managed Medicaid	$4,098.01
Rate for Payer: Medical Associates Commercial	$5,380.78
Rate for Payer: Medical Associates Managed Medicare	$3,228.47
Rate for Payer: Midlands Choice Commercial	$5,022.07
Rate for Payer: Molina Healthcare Managed Medicaid	$4,158.27
Rate for Payer: Partners Health Alliance Commercial	$3,712.74
Rate for Payer: United Healthcare Commercial	$6,456.94
Rate for Payer: United Healthcare Managed Medicare	$4,232.88

carfilzomib 60 mg Pow SDV [VDMC]

Facility

$7,174.38

Service Code	HCPCS J9047
Hospital Charge Code	22278386
Hospital Revenue Code	259
Min. Negotiated Rate	$5,022.07
Max. Negotiated Rate	$6,456.94
Rate for Payer: Aetna of IA Commercial	$6,456.94
Rate for Payer: Aetna of IA Medical Rental Products	$6,456.94
Rate for Payer: Cash Price	$5,739.50
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$5,380.78
Rate for Payer: Medical Associates Commercial	$5,380.78
Rate for Payer: Midlands Choice Commercial	$5,022.07
Rate for Payer: United Healthcare Commercial	$6,456.94

CAROTID ARTERY STENT PROCEDURES WITH CC

Facility

$22,089.42

Service Code	MSDRG 035
Min. Negotiated Rate	$21,769.27
Max. Negotiated Rate	$22,089.42
Rate for Payer: Amerigroup Medicaid	$21,982.69
Rate for Payer: Iowa Total Care Managed Medicaid	$21,769.27
Rate for Payer: Molina Healthcare Managed Medicaid	$22,089.42

CAROTID ARTERY STENT PROCEDURES WITH MCC

Facility

$27,610.08

Service Code	MSDRG 034
Min. Negotiated Rate	$27,209.92
Max. Negotiated Rate	$27,610.08
Rate for Payer: Amerigroup Medicaid	$27,476.69
Rate for Payer: Iowa Total Care Managed Medicaid	$27,209.92
Rate for Payer: Molina Healthcare Managed Medicaid	$27,610.08

CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC

Facility

$18,865.74

Service Code	MSDRG 036
Min. Negotiated Rate	$18,592.32
Max. Negotiated Rate	$18,865.74
Rate for Payer: Amerigroup Medicaid	$18,774.60
Rate for Payer: Iowa Total Care Managed Medicaid	$18,592.32
Rate for Payer: Molina Healthcare Managed Medicaid	$18,865.74

carvedilol 12.5 mg Tab [VDMC]

Facility

$1.08

Service Code	HCPCS A9270
Hospital Charge Code	10374624
Hospital Revenue Code	259
Min. Negotiated Rate	$0.76
Max. Negotiated Rate	$0.97
Rate for Payer: Aetna of IA Commercial	$0.97
Rate for Payer: Aetna of IA Medical Rental Products	$0.97
Rate for Payer: Cash Price	$0.87
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.81
Rate for Payer: Medical Associates Commercial	$0.81
Rate for Payer: Midlands Choice Commercial	$0.76
Rate for Payer: United Healthcare Commercial	$0.97

carvedilol 12.5 mg Tab [VDMC]

Facility

$1.08

Service Code	HCPCS A9270
Hospital Charge Code	10374624
Hospital Revenue Code	259
Min. Negotiated Rate	$0.49
Max. Negotiated Rate	$0.97
Rate for Payer: Aetna of IA Commercial	$0.97
Rate for Payer: Aetna of IA Medical Rental Products	$0.97
Rate for Payer: Aetna of IA Medicare	$0.62
Rate for Payer: Amerigroup Medicaid	$0.62
Rate for Payer: Amerigroup Medicare	$0.49
Rate for Payer: Cash Price	$0.87
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.81
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.49
Rate for Payer: Iowa Total Care Managed Medicaid	$0.62
Rate for Payer: Medical Associates Commercial	$0.81
Rate for Payer: Medical Associates Managed Medicare	$0.49
Rate for Payer: Midlands Choice Commercial	$0.76
Rate for Payer: Molina Healthcare Managed Medicaid	$0.63
Rate for Payer: Partners Health Alliance Commercial	$0.56
Rate for Payer: United Healthcare Commercial	$0.97
Rate for Payer: United Healthcare Managed Medicare	$0.64

carvedilol 25 mg Tab UD [VDMC]

Facility

$1.27

Service Code	HCPCS A9270
Hospital Charge Code	23268132
Hospital Revenue Code	259
Min. Negotiated Rate	$0.57
Max. Negotiated Rate	$1.14
Rate for Payer: Aetna of IA Commercial	$1.14
Rate for Payer: Aetna of IA Medical Rental Products	$1.14
Rate for Payer: Aetna of IA Medicare	$0.72
Rate for Payer: Amerigroup Medicaid	$0.73
Rate for Payer: Amerigroup Medicare	$0.58
Rate for Payer: Cash Price	$1.02
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.95
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.57
Rate for Payer: Iowa Total Care Managed Medicaid	$0.73
Rate for Payer: Medical Associates Commercial	$0.95
Rate for Payer: Medical Associates Managed Medicare	$0.57
Rate for Payer: Midlands Choice Commercial	$0.89
Rate for Payer: Molina Healthcare Managed Medicaid	$0.74
Rate for Payer: Partners Health Alliance Commercial	$0.66
Rate for Payer: United Healthcare Commercial	$1.14
Rate for Payer: United Healthcare Managed Medicare	$0.75

carvedilol 25 mg Tab UD [VDMC]

Facility

$1.27

Service Code	HCPCS A9270
Hospital Charge Code	23268132
Hospital Revenue Code	259
Min. Negotiated Rate	$0.89
Max. Negotiated Rate	$1.14
Rate for Payer: Aetna of IA Commercial	$1.14
Rate for Payer: Aetna of IA Medical Rental Products	$1.14
Rate for Payer: Cash Price	$1.02
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.95
Rate for Payer: Medical Associates Commercial	$0.95
Rate for Payer: Midlands Choice Commercial	$0.89
Rate for Payer: United Healthcare Commercial	$1.14

carvedilol 6.25 mg Tab [VDMC]

Facility

$1.33

Service Code	HCPCS A9270
Hospital Charge Code	10374764
Hospital Revenue Code	259
Min. Negotiated Rate	$0.93
Max. Negotiated Rate	$1.19
Rate for Payer: Aetna of IA Commercial	$1.19
Rate for Payer: Aetna of IA Medical Rental Products	$1.19
Rate for Payer: Cash Price	$1.06
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1.00
Rate for Payer: Medical Associates Commercial	$1.00
Rate for Payer: Midlands Choice Commercial	$0.93
Rate for Payer: United Healthcare Commercial	$1.19

carvedilol 6.25 mg Tab [VDMC]

Facility

$1.33

Service Code	HCPCS A9270
Hospital Charge Code	10374764
Hospital Revenue Code	259
Min. Negotiated Rate	$0.60
Max. Negotiated Rate	$1.19
Rate for Payer: Aetna of IA Commercial	$1.19
Rate for Payer: Aetna of IA Medical Rental Products	$1.19
Rate for Payer: Aetna of IA Medicare	$0.76
Rate for Payer: Amerigroup Medicaid	$0.77
Rate for Payer: Amerigroup Medicare	$0.60
Rate for Payer: Cash Price	$1.06
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.60
Rate for Payer: Iowa Total Care Managed Medicaid	$0.76
Rate for Payer: Medical Associates Commercial	$1.00
Rate for Payer: Medical Associates Managed Medicare	$0.60
Rate for Payer: Midlands Choice Commercial	$0.93
Rate for Payer: Molina Healthcare Managed Medicaid	$0.77
Rate for Payer: Partners Health Alliance Commercial	$0.69
Rate for Payer: United Healthcare Commercial	$1.19
Rate for Payer: United Healthcare Managed Medicare	$0.78

caspofungin 50 mg Pow [VDMC]

Facility

$273.88

Service Code	HCPCS J0637
Hospital Charge Code	29250121
Hospital Revenue Code	259
Min. Negotiated Rate	$191.72
Max. Negotiated Rate	$246.49
Rate for Payer: Aetna of IA Commercial	$246.49
Rate for Payer: Aetna of IA Medical Rental Products	$246.49
Rate for Payer: Cash Price	$219.10
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$205.41
Rate for Payer: Medical Associates Commercial	$205.41
Rate for Payer: Midlands Choice Commercial	$191.72
Rate for Payer: United Healthcare Commercial	$246.49

caspofungin 50 mg Pow [VDMC]

Facility

$273.88

Service Code	HCPCS J0637
Hospital Charge Code	29250121
Hospital Revenue Code	259
Min. Negotiated Rate	$123.25
Max. Negotiated Rate	$246.49
Rate for Payer: Aetna of IA Commercial	$246.49
Rate for Payer: Aetna of IA Medical Rental Products	$246.49
Rate for Payer: Aetna of IA Medicare	$156.11
Rate for Payer: Amerigroup Medicaid	$157.97
Rate for Payer: Amerigroup Medicare	$124.48
Rate for Payer: Cash Price	$219.10
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$205.41
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$123.25
Rate for Payer: Iowa Total Care Managed Medicaid	$156.44
Rate for Payer: Medical Associates Commercial	$205.41
Rate for Payer: Medical Associates Managed Medicare	$123.25
Rate for Payer: Midlands Choice Commercial	$191.72
Rate for Payer: Molina Healthcare Managed Medicaid	$158.74
Rate for Payer: Partners Health Alliance Commercial	$141.73
Rate for Payer: United Healthcare Commercial	$246.49
Rate for Payer: United Healthcare Managed Medicare	$161.59

CASTING/STRAPPING PROCEDURE

Facility

$247.00

Service Code	CPT 29799
Hospital Charge Code	7982910
Hospital Revenue Code	450
Min. Negotiated Rate	$102.81
Max. Negotiated Rate	$222.30
Rate for Payer: Aetna of IA Commercial	$222.30
Rate for Payer: Aetna of IA Medical Rental Products	$222.30
Rate for Payer: Aetna of IA Medicare	$140.79
Rate for Payer: Amerigroup Medicaid	$142.47
Rate for Payer: Amerigroup Medicare	$112.26
Rate for Payer: Cash Price	$197.60
Rate for Payer: Cash Price	$197.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$185.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$111.15
Rate for Payer: Iowa Total Care Managed Medicaid	$141.09
Rate for Payer: Medical Associates Commercial	$185.25
Rate for Payer: Medical Associates Managed Medicare	$111.15
Rate for Payer: Midlands Choice Commercial	$172.90
Rate for Payer: Molina Healthcare Managed Medicaid	$143.16
Rate for Payer: Partners Health Alliance Commercial	$127.82
Rate for Payer: United Healthcare Commercial	$222.30
Rate for Payer: United Healthcare Managed Medicare	$145.73
Rate for Payer: Wellmark IA HMO WHPI	$102.81
Rate for Payer: Wellmark IA PPO	$113.25

CASTING/STRAPPING PROCEDURE

Facility

$247.00

Service Code	CPT 29799
Hospital Charge Code	7982910
Hospital Revenue Code	450
Min. Negotiated Rate	$172.90
Max. Negotiated Rate	$222.30
Rate for Payer: Aetna of IA Commercial	$222.30
Rate for Payer: Aetna of IA Medical Rental Products	$222.30
Rate for Payer: Cash Price	$197.60
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$185.25
Rate for Payer: Medical Associates Commercial	$185.25
Rate for Payer: Midlands Choice Commercial	$172.90
Rate for Payer: United Healthcare Commercial	$222.30

CBC NO DIFF

Facility

$66.00

Service Code	CPT 85027
Hospital Charge Code	4004795
Hospital Revenue Code	305
Min. Negotiated Rate	$29.07
Max. Negotiated Rate	$59.40
Rate for Payer: Aetna of IA Commercial	$59.40
Rate for Payer: Aetna of IA Medical Rental Products	$59.40
Rate for Payer: Aetna of IA Medicare	$37.62
Rate for Payer: Amerigroup Medicaid	$38.07
Rate for Payer: Amerigroup Medicare	$30.00
Rate for Payer: Cash Price	$52.80
Rate for Payer: Cash Price	$52.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$49.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$29.70
Rate for Payer: Iowa Total Care Managed Medicaid	$37.70
Rate for Payer: Medical Associates Commercial	$49.50
Rate for Payer: Medical Associates Managed Medicare	$29.70
Rate for Payer: Midlands Choice Commercial	$46.20
Rate for Payer: Molina Healthcare Managed Medicaid	$38.25
Rate for Payer: Partners Health Alliance Commercial	$34.16
Rate for Payer: United Healthcare Commercial	$59.40
Rate for Payer: United Healthcare Managed Medicare	$38.94
Rate for Payer: Wellmark IA HMO WHPI	$29.07
Rate for Payer: Wellmark IA PPO	$32.02

CBC NO DIFF

Facility

$66.00

Service Code	CPT 85027
Hospital Charge Code	4004795
Hospital Revenue Code	305
Min. Negotiated Rate	$46.20
Max. Negotiated Rate	$59.40
Rate for Payer: Aetna of IA Commercial	$59.40
Rate for Payer: Aetna of IA Medical Rental Products	$59.40
Rate for Payer: Cash Price	$52.80
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$49.50
Rate for Payer: Medical Associates Commercial	$49.50
Rate for Payer: Midlands Choice Commercial	$46.20
Rate for Payer: United Healthcare Commercial	$59.40

CBC WITH DIFF

Facility

$80.00

Service Code	CPT 85025
Hospital Charge Code	4004796
Hospital Revenue Code	305
Min. Negotiated Rate	$56.00
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of IA Commercial	$72.00
Rate for Payer: Aetna of IA Medical Rental Products	$72.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$60.00
Rate for Payer: Medical Associates Commercial	$60.00
Rate for Payer: Midlands Choice Commercial	$56.00
Rate for Payer: United Healthcare Commercial	$72.00

CBC WITH DIFF

Facility

$80.00

Service Code	CPT 85025
Hospital Charge Code	4004796
Hospital Revenue Code	305
Min. Negotiated Rate	$29.07
Max. Negotiated Rate	$72.00
Rate for Payer: Aetna of IA Commercial	$72.00
Rate for Payer: Aetna of IA Medical Rental Products	$72.00
Rate for Payer: Aetna of IA Medicare	$45.60
Rate for Payer: Amerigroup Medicaid	$46.14
Rate for Payer: Amerigroup Medicare	$36.36
Rate for Payer: Cash Price	$64.00
Rate for Payer: Cash Price	$64.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$60.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$36.00
Rate for Payer: Iowa Total Care Managed Medicaid	$45.70
Rate for Payer: Medical Associates Commercial	$60.00
Rate for Payer: Medical Associates Managed Medicare	$36.00
Rate for Payer: Midlands Choice Commercial	$56.00
Rate for Payer: Molina Healthcare Managed Medicaid	$46.37
Rate for Payer: Partners Health Alliance Commercial	$41.40
Rate for Payer: United Healthcare Commercial	$72.00
Rate for Payer: United Healthcare Managed Medicare	$47.20
Rate for Payer: Wellmark IA HMO WHPI	$29.07
Rate for Payer: Wellmark IA PPO	$32.02

C. Diff Toxin and Ag

Facility

$58.00

Service Code	CPT 87324
Hospital Charge Code	8507515
Hospital Revenue Code	306
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

C. Diff Toxin and Ag

Facility

$58.00

Service Code	CPT 87324
Hospital Charge Code	8507515
Hospital Revenue Code	306
Min. Negotiated Rate	$26.10
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: Aetna of IA Medicare	$33.06
Rate for Payer: Amerigroup Medicaid	$33.45
Rate for Payer: Amerigroup Medicare	$26.36
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	$26.10
Rate for Payer: Iowa Total Care Managed Medicaid	$33.13
Rate for Payer: Medical Associates Commercial	$43.50
Rate for Payer: Medical Associates Managed Medicare	$26.10
Rate for Payer: Midlands Choice Commercial	$40.60
Rate for Payer: Molina Healthcare Managed Medicaid	$33.62
Rate for Payer: Partners Health Alliance Commercial	$30.02
Rate for Payer: United Healthcare Commercial	$52.20
Rate for Payer: United Healthcare Managed Medicare	$34.22
Rate for Payer: Wellmark IA HMO WHPI	$34.03
Rate for Payer: Wellmark IA PPO	$37.49

cefadroxil 500 mg Cap [VDMC]

Facility

$1.79

Service Code	HCPCS A9270
Hospital Charge Code	10374904
Hospital Revenue Code	259
Min. Negotiated Rate	$1.25
Max. Negotiated Rate	$1.61
Rate for Payer: Aetna of IA Commercial	$1.61
Rate for Payer: Aetna of IA Medical Rental Products	$1.61
Rate for Payer: Cash Price	$1.43
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1.34
Rate for Payer: Medical Associates Commercial	$1.34
Rate for Payer: Midlands Choice Commercial	$1.25
Rate for Payer: United Healthcare Commercial	$1.61

cefadroxil 500 mg Cap [VDMC]

Facility

$1.79

Service Code	HCPCS A9270
Hospital Charge Code	10374904
Hospital Revenue Code	259
Min. Negotiated Rate	$0.80
Max. Negotiated Rate	$1.61
Rate for Payer: Aetna of IA Commercial	$1.61
Rate for Payer: Aetna of IA Medical Rental Products	$1.61
Rate for Payer: Aetna of IA Medicare	$1.02
Rate for Payer: Amerigroup Medicaid	$1.03
Rate for Payer: Amerigroup Medicare	$0.81
Rate for Payer: Cash Price	$1.43
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$1.34
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.80
Rate for Payer: Iowa Total Care Managed Medicaid	$1.02
Rate for Payer: Medical Associates Commercial	$1.34
Rate for Payer: Medical Associates Managed Medicare	$0.80
Rate for Payer: Midlands Choice Commercial	$1.25
Rate for Payer: Molina Healthcare Managed Medicaid	$1.04
Rate for Payer: Partners Health Alliance Commercial	$0.92
Rate for Payer: United Healthcare Commercial	$1.61
Rate for Payer: United Healthcare Managed Medicare	$1.05

ceFAZolin 1 g/50 mL IV Premix [VDMC]

Facility

$94.79

Service Code	HCPCS J0690
Hospital Charge Code	10375042
Hospital Revenue Code	259
Min. Negotiated Rate	$42.65
Max. Negotiated Rate	$221.80
Rate for Payer: Aetna of IA Commercial	$85.31
Rate for Payer: Aetna of IA Medical Rental Products	$85.31
Rate for Payer: Aetna of IA Medicare	$54.03
Rate for Payer: Amerigroup Medicaid	$54.67
Rate for Payer: Amerigroup Medicare	$43.08
Rate for Payer: Cash Price	$75.83
Rate for Payer: Cash Price	$75.83
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$71.09
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$42.65
Rate for Payer: Iowa Total Care Managed Medicaid	$54.14
Rate for Payer: Medical Associates Commercial	$71.09
Rate for Payer: Medical Associates Managed Medicare	$42.65
Rate for Payer: Midlands Choice Commercial	$66.35
Rate for Payer: Molina Healthcare Managed Medicaid	$54.94
Rate for Payer: Partners Health Alliance Commercial	$49.05
Rate for Payer: United Healthcare Commercial	$85.31
Rate for Payer: United Healthcare Managed Medicare	$55.92
Rate for Payer: Wellmark IA HMO WHPI	$201.36
Rate for Payer: Wellmark IA PPO	$221.80

ceFAZolin 1 g/50 mL IV Premix [VDMC]

Facility

$94.79

Service Code	HCPCS J0690
Hospital Charge Code	10375042
Hospital Revenue Code	259
Min. Negotiated Rate	$66.35
Max. Negotiated Rate	$85.31
Rate for Payer: Aetna of IA Commercial	$85.31
Rate for Payer: Aetna of IA Medical Rental Products	$85.31
Rate for Payer: Cash Price	$75.83
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$71.09
Rate for Payer: Medical Associates Commercial	$71.09
Rate for Payer: Midlands Choice Commercial	$66.35
Rate for Payer: United Healthcare Commercial	$85.31

Know your out-of-pocket cost for care.

All Charges