Van Diest Medical Center

All Charges

Charge

Type

Setting

Price

CHEST PHYSIOTHERAPY, SUBSQ

Facility

$109.00

Service Code	CPT 94668
Hospital Charge Code	4770828
Hospital Revenue Code	410
Min. Negotiated Rate	$76.30
Max. Negotiated Rate	$98.10
Rate for Payer: Aetna of IA Commercial	$98.10
Rate for Payer: Aetna of IA Medical Rental Products	$98.10
Rate for Payer: Cash Price	$87.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$81.75
Rate for Payer: Medical Associates Commercial	$81.75
Rate for Payer: Midlands Choice Commercial	$76.30
Rate for Payer: United Healthcare Commercial	$98.10

CHEST PHYSIOTHERAPY, SUBSQ

Facility

$109.00

Service Code	CPT 94668
Hospital Charge Code	4770828
Hospital Revenue Code	410
Min. Negotiated Rate	$49.05
Max. Negotiated Rate	$203.84
Rate for Payer: Aetna of IA Commercial	$98.10
Rate for Payer: Aetna of IA Medical Rental Products	$98.10
Rate for Payer: Aetna of IA Medicare	$62.13
Rate for Payer: Amerigroup Medicaid	$62.87
Rate for Payer: Amerigroup Medicare	$49.54
Rate for Payer: Cash Price	$87.20
Rate for Payer: Cash Price	$87.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$81.75
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$49.05
Rate for Payer: Iowa Total Care Managed Medicaid	$62.26
Rate for Payer: Medical Associates Commercial	$81.75
Rate for Payer: Medical Associates Managed Medicare	$49.05
Rate for Payer: Midlands Choice Commercial	$76.30
Rate for Payer: Molina Healthcare Managed Medicaid	$63.18
Rate for Payer: Partners Health Alliance Commercial	$56.41
Rate for Payer: United Healthcare Commercial	$98.10
Rate for Payer: United Healthcare Managed Medicare	$64.31
Rate for Payer: Wellmark IA HMO WHPI	$185.05
Rate for Payer: Wellmark IA PPO	$203.84

CHEST PHYSIOTHERPY INTIAL

Facility

$154.00

Service Code	CPT 94667
Hospital Charge Code	4770827
Hospital Revenue Code	410
Min. Negotiated Rate	$107.80
Max. Negotiated Rate	$138.60
Rate for Payer: Aetna of IA Commercial	$138.60
Rate for Payer: Aetna of IA Medical Rental Products	$138.60
Rate for Payer: Cash Price	$123.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$115.50
Rate for Payer: Medical Associates Commercial	$115.50
Rate for Payer: Midlands Choice Commercial	$107.80
Rate for Payer: United Healthcare Commercial	$138.60

CHEST PHYSIOTHERPY INTIAL

Facility

$154.00

Service Code	CPT 94667
Hospital Charge Code	4770827
Hospital Revenue Code	410
Min. Negotiated Rate	$69.30
Max. Negotiated Rate	$203.84
Rate for Payer: Aetna of IA Commercial	$138.60
Rate for Payer: Aetna of IA Medical Rental Products	$138.60
Rate for Payer: Aetna of IA Medicare	$87.78
Rate for Payer: Amerigroup Medicaid	$88.83
Rate for Payer: Amerigroup Medicare	$69.99
Rate for Payer: Cash Price	$123.20
Rate for Payer: Cash Price	$123.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$115.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$69.30
Rate for Payer: Iowa Total Care Managed Medicaid	$87.96
Rate for Payer: Medical Associates Commercial	$115.50
Rate for Payer: Medical Associates Managed Medicare	$69.30
Rate for Payer: Midlands Choice Commercial	$107.80
Rate for Payer: Molina Healthcare Managed Medicaid	$89.26
Rate for Payer: Partners Health Alliance Commercial	$79.70
Rate for Payer: United Healthcare Commercial	$138.60
Rate for Payer: United Healthcare Managed Medicare	$90.86
Rate for Payer: Wellmark IA HMO WHPI	$185.05
Rate for Payer: Wellmark IA PPO	$203.84

CHEST TUBE INSERTION ER CHARGE

Professional

Both

$595.00

Hospital Charge Code	8069016
Hospital Revenue Code	981
Min. Negotiated Rate	$416.50
Max. Negotiated Rate	$446.25
Rate for Payer: Cash Price	$476.00
Rate for Payer: Medical Associates Commercial	$446.25
Rate for Payer: Midlands Choice Commercial	$416.50
Rate for Payer: Partners Health Alliance Commercial	$446.25

CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES

Facility

$420,424.05

Service Code	MSDRG 018
Min. Negotiated Rate	$414,330.76
Max. Negotiated Rate	$420,424.05
Rate for Payer: Amerigroup Medicaid	$418,392.83
Rate for Payer: Iowa Total Care Managed Medicaid	$414,330.76
Rate for Payer: Molina Healthcare Managed Medicaid	$420,424.05

chlordiazePOXIDE 25 mg Cap [VDMC]

Facility

$3.52

Service Code	HCPCS A9270
Hospital Charge Code	10377368
Hospital Revenue Code	259
Min. Negotiated Rate	$1.58
Max. Negotiated Rate	$3.17
Rate for Payer: Aetna of IA Commercial	$3.17
Rate for Payer: Aetna of IA Medical Rental Products	$3.17
Rate for Payer: Aetna of IA Medicare	$2.01
Rate for Payer: Amerigroup Medicaid	$2.03
Rate for Payer: Amerigroup Medicare	$1.60
Rate for Payer: Cash Price	$2.82
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2.64
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$1.58
Rate for Payer: Iowa Total Care Managed Medicaid	$2.01
Rate for Payer: Medical Associates Commercial	$2.64
Rate for Payer: Medical Associates Managed Medicare	$1.58
Rate for Payer: Midlands Choice Commercial	$2.46
Rate for Payer: Molina Healthcare Managed Medicaid	$2.04
Rate for Payer: Partners Health Alliance Commercial	$1.82
Rate for Payer: United Healthcare Commercial	$3.17
Rate for Payer: United Healthcare Managed Medicare	$2.08

chlordiazePOXIDE 25 mg Cap [VDMC]

Facility

$3.52

Service Code	HCPCS A9270
Hospital Charge Code	10377368
Hospital Revenue Code	259
Min. Negotiated Rate	$2.46
Max. Negotiated Rate	$3.17
Rate for Payer: Aetna of IA Commercial	$3.17
Rate for Payer: Aetna of IA Medical Rental Products	$3.17
Rate for Payer: Cash Price	$2.82
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2.64
Rate for Payer: Medical Associates Commercial	$2.64
Rate for Payer: Midlands Choice Commercial	$2.46
Rate for Payer: United Healthcare Commercial	$3.17

chlordiazePOXIDE 5 mg Cap [VDMC]

Facility

$3.63

Service Code	HCPCS A9270
Hospital Charge Code	10377299
Hospital Revenue Code	259
Min. Negotiated Rate	$1.63
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna of IA Commercial	$3.27
Rate for Payer: Aetna of IA Medical Rental Products	$3.27
Rate for Payer: Aetna of IA Medicare	$2.07
Rate for Payer: Amerigroup Medicaid	$2.09
Rate for Payer: Amerigroup Medicare	$1.65
Rate for Payer: Cash Price	$2.90
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2.72
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$1.63
Rate for Payer: Iowa Total Care Managed Medicaid	$2.07
Rate for Payer: Medical Associates Commercial	$2.72
Rate for Payer: Medical Associates Managed Medicare	$1.63
Rate for Payer: Midlands Choice Commercial	$2.54
Rate for Payer: Molina Healthcare Managed Medicaid	$2.10
Rate for Payer: Partners Health Alliance Commercial	$1.88
Rate for Payer: United Healthcare Commercial	$3.27
Rate for Payer: United Healthcare Managed Medicare	$2.14

chlordiazePOXIDE 5 mg Cap [VDMC]

Facility

$3.63

Service Code	HCPCS A9270
Hospital Charge Code	10377299
Hospital Revenue Code	259
Min. Negotiated Rate	$2.54
Max. Negotiated Rate	$3.27
Rate for Payer: Aetna of IA Commercial	$3.27
Rate for Payer: Aetna of IA Medical Rental Products	$3.27
Rate for Payer: Cash Price	$2.90
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2.72
Rate for Payer: Medical Associates Commercial	$2.72
Rate for Payer: Midlands Choice Commercial	$2.54
Rate for Payer: United Healthcare Commercial	$3.27

chlorhexidine gluconate 0.12% Liq 15 mL [VDMC]

Facility

$6.70

Service Code	HCPCS A9270
Hospital Charge Code	10433870
Hospital Revenue Code	259
Min. Negotiated Rate	$4.69
Max. Negotiated Rate	$6.03
Rate for Payer: Aetna of IA Commercial	$6.03
Rate for Payer: Aetna of IA Medical Rental Products	$6.03
Rate for Payer: Cash Price	$5.36
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$5.03
Rate for Payer: Medical Associates Commercial	$5.03
Rate for Payer: Midlands Choice Commercial	$4.69
Rate for Payer: United Healthcare Commercial	$6.03

chlorhexidine gluconate 0.12% Liq 15 mL [VDMC]

Facility

$6.70

Service Code	HCPCS A9270
Hospital Charge Code	10433870
Hospital Revenue Code	259
Min. Negotiated Rate	$3.02
Max. Negotiated Rate	$6.03
Rate for Payer: Aetna of IA Commercial	$6.03
Rate for Payer: Aetna of IA Medical Rental Products	$6.03
Rate for Payer: Aetna of IA Medicare	$3.82
Rate for Payer: Amerigroup Medicaid	$3.87
Rate for Payer: Amerigroup Medicare	$3.05
Rate for Payer: Cash Price	$5.36
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$5.03
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$3.02
Rate for Payer: Iowa Total Care Managed Medicaid	$3.83
Rate for Payer: Medical Associates Commercial	$5.03
Rate for Payer: Medical Associates Managed Medicare	$3.02
Rate for Payer: Midlands Choice Commercial	$4.69
Rate for Payer: Molina Healthcare Managed Medicaid	$3.88
Rate for Payer: Partners Health Alliance Commercial	$3.47
Rate for Payer: United Healthcare Commercial	$6.03
Rate for Payer: United Healthcare Managed Medicare	$3.95

chlorhexidine gluconate Top 0.12% Liq 473 mL [VDMC]

Facility

$23.44

Service Code	HCPCS A9270
Hospital Charge Code	11558983
Hospital Revenue Code	259
Min. Negotiated Rate	$10.55
Max. Negotiated Rate	$21.09
Rate for Payer: Aetna of IA Commercial	$21.09
Rate for Payer: Aetna of IA Medical Rental Products	$21.09
Rate for Payer: Aetna of IA Medicare	$13.36
Rate for Payer: Amerigroup Medicaid	$13.52
Rate for Payer: Amerigroup Medicare	$10.65
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.58
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$10.55
Rate for Payer: Iowa Total Care Managed Medicaid	$13.39
Rate for Payer: Medical Associates Commercial	$17.58
Rate for Payer: Medical Associates Managed Medicare	$10.55
Rate for Payer: Midlands Choice Commercial	$16.41
Rate for Payer: Molina Healthcare Managed Medicaid	$13.58
Rate for Payer: Partners Health Alliance Commercial	$12.13
Rate for Payer: United Healthcare Commercial	$21.09
Rate for Payer: United Healthcare Managed Medicare	$13.83

chlorhexidine gluconate Top 0.12% Liq 473 mL [VDMC]

Facility

$23.44

Service Code	HCPCS A9270
Hospital Charge Code	11558983
Hospital Revenue Code	259
Min. Negotiated Rate	$16.41
Max. Negotiated Rate	$21.09
Rate for Payer: Aetna of IA Commercial	$21.09
Rate for Payer: Aetna of IA Medical Rental Products	$21.09
Rate for Payer: Cash Price	$18.75
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$17.58
Rate for Payer: Medical Associates Commercial	$17.58
Rate for Payer: Midlands Choice Commercial	$16.41
Rate for Payer: United Healthcare Commercial	$21.09

CHLORIDE LEVEL

Facility

$44.00

Service Code	CPT 82435
Hospital Charge Code	633621
Hospital Revenue Code	301
Min. Negotiated Rate	$19.80
Max. Negotiated Rate	$39.60
Rate for Payer: Aetna of IA Commercial	$39.60
Rate for Payer: Aetna of IA Medical Rental Products	$39.60
Rate for Payer: Aetna of IA Medicare	$25.08
Rate for Payer: Amerigroup Medicaid	$25.38
Rate for Payer: Amerigroup Medicare	$20.00
Rate for Payer: Cash Price	$35.20
Rate for Payer: Cash Price	$35.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$33.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$19.80
Rate for Payer: Iowa Total Care Managed Medicaid	$25.13
Rate for Payer: Medical Associates Commercial	$33.00
Rate for Payer: Medical Associates Managed Medicare	$19.80
Rate for Payer: Midlands Choice Commercial	$30.80
Rate for Payer: Molina Healthcare Managed Medicaid	$25.50
Rate for Payer: Partners Health Alliance Commercial	$22.77
Rate for Payer: United Healthcare Commercial	$39.60
Rate for Payer: United Healthcare Managed Medicare	$25.96
Rate for Payer: Wellmark IA HMO WHPI	$30.49
Rate for Payer: Wellmark IA PPO	$33.58

CHLORIDE LEVEL

Facility

$44.00

Service Code	CPT 82435
Hospital Charge Code	633621
Hospital Revenue Code	301
Min. Negotiated Rate	$30.80
Max. Negotiated Rate	$39.60
Rate for Payer: Aetna of IA Commercial	$39.60
Rate for Payer: Aetna of IA Medical Rental Products	$39.60
Rate for Payer: Cash Price	$35.20
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$33.00
Rate for Payer: Medical Associates Commercial	$33.00
Rate for Payer: Midlands Choice Commercial	$30.80
Rate for Payer: United Healthcare Commercial	$39.60

chloroprocaine 3% PF 600mg/20ml SDV [VDMC]

Facility

$101.52

Service Code	HCPCS J2401
Hospital Charge Code	20830338
Hospital Revenue Code	259
Min. Negotiated Rate	$71.06
Max. Negotiated Rate	$91.36
Rate for Payer: Aetna of IA Commercial	$91.36
Rate for Payer: Aetna of IA Medical Rental Products	$91.36
Rate for Payer: Cash Price	$81.21
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$76.14
Rate for Payer: Medical Associates Commercial	$76.14
Rate for Payer: Midlands Choice Commercial	$71.06
Rate for Payer: United Healthcare Commercial	$91.36

chloroprocaine 3% PF 600mg/20ml SDV [VDMC]

Facility

$101.52

Service Code	HCPCS J2401
Hospital Charge Code	20830338
Hospital Revenue Code	259
Min. Negotiated Rate	$45.68
Max. Negotiated Rate	$91.36
Rate for Payer: Aetna of IA Commercial	$91.36
Rate for Payer: Aetna of IA Medical Rental Products	$91.36
Rate for Payer: Aetna of IA Medicare	$57.86
Rate for Payer: Amerigroup Medicaid	$58.55
Rate for Payer: Amerigroup Medicare	$46.14
Rate for Payer: Cash Price	$81.21
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$76.14
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$45.68
Rate for Payer: Iowa Total Care Managed Medicaid	$57.99
Rate for Payer: Medical Associates Commercial	$76.14
Rate for Payer: Medical Associates Managed Medicare	$45.68
Rate for Payer: Midlands Choice Commercial	$71.06
Rate for Payer: Molina Healthcare Managed Medicaid	$58.84
Rate for Payer: Partners Health Alliance Commercial	$52.53
Rate for Payer: United Healthcare Commercial	$91.36
Rate for Payer: United Healthcare Managed Medicare	$59.89

chlorpheniramine 4 mg Tab [VDMC]

Facility

$1.03

Service Code	HCPCS A9270
Hospital Charge Code	10377433
Hospital Revenue Code	259
Min. Negotiated Rate	$0.46
Max. Negotiated Rate	$0.93
Rate for Payer: Aetna of IA Commercial	$0.93
Rate for Payer: Aetna of IA Medical Rental Products	$0.93
Rate for Payer: Aetna of IA Medicare	$0.59
Rate for Payer: Amerigroup Medicaid	$0.59
Rate for Payer: Amerigroup Medicare	$0.47
Rate for Payer: Cash Price	$0.82
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.77
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.46
Rate for Payer: Iowa Total Care Managed Medicaid	$0.59
Rate for Payer: Medical Associates Commercial	$0.77
Rate for Payer: Medical Associates Managed Medicare	$0.46
Rate for Payer: Midlands Choice Commercial	$0.72
Rate for Payer: Molina Healthcare Managed Medicaid	$0.60
Rate for Payer: Partners Health Alliance Commercial	$0.53
Rate for Payer: United Healthcare Commercial	$0.93
Rate for Payer: United Healthcare Managed Medicare	$0.61

chlorpheniramine 4 mg Tab [VDMC]

Facility

$1.03

Service Code	HCPCS A9270
Hospital Charge Code	10377433
Hospital Revenue Code	259
Min. Negotiated Rate	$0.72
Max. Negotiated Rate	$0.93
Rate for Payer: Aetna of IA Commercial	$0.93
Rate for Payer: Aetna of IA Medical Rental Products	$0.93
Rate for Payer: Cash Price	$0.82
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.77
Rate for Payer: Medical Associates Commercial	$0.77
Rate for Payer: Midlands Choice Commercial	$0.72
Rate for Payer: United Healthcare Commercial	$0.93

chlorproMAZINE 25 mg/mL 1ml SDV Inj Amp [VDMC]

Facility

$87.01

Service Code	HCPCS J3230
Hospital Charge Code	10377571
Hospital Revenue Code	259
Min. Negotiated Rate	$39.15
Max. Negotiated Rate	$78.31
Rate for Payer: Aetna of IA Commercial	$78.31
Rate for Payer: Aetna of IA Medical Rental Products	$78.31
Rate for Payer: Aetna of IA Medicare	$49.59
Rate for Payer: Amerigroup Medicaid	$50.19
Rate for Payer: Amerigroup Medicare	$39.54
Rate for Payer: Cash Price	$69.61
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$65.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$39.15
Rate for Payer: Iowa Total Care Managed Medicaid	$49.70
Rate for Payer: Medical Associates Commercial	$65.25
Rate for Payer: Medical Associates Managed Medicare	$39.15
Rate for Payer: Midlands Choice Commercial	$60.90
Rate for Payer: Molina Healthcare Managed Medicaid	$50.43
Rate for Payer: Partners Health Alliance Commercial	$45.03
Rate for Payer: United Healthcare Commercial	$78.31
Rate for Payer: United Healthcare Managed Medicare	$51.33

chlorproMAZINE 25 mg/mL 1ml SDV Inj Amp [VDMC]

Facility

$87.01

Service Code	HCPCS J3230
Hospital Charge Code	10377571
Hospital Revenue Code	259
Min. Negotiated Rate	$60.90
Max. Negotiated Rate	$78.31
Rate for Payer: Aetna of IA Commercial	$78.31
Rate for Payer: Aetna of IA Medical Rental Products	$78.31
Rate for Payer: Cash Price	$69.61
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$65.25
Rate for Payer: Medical Associates Commercial	$65.25
Rate for Payer: Midlands Choice Commercial	$60.90
Rate for Payer: United Healthcare Commercial	$78.31

chlorthalidone 25 mg Tab [VDMC]

Facility

$3.21

Service Code	HCPCS A9270
Hospital Charge Code	10377640
Hospital Revenue Code	259
Min. Negotiated Rate	$1.44
Max. Negotiated Rate	$2.89
Rate for Payer: Aetna of IA Commercial	$2.89
Rate for Payer: Aetna of IA Medical Rental Products	$2.89
Rate for Payer: Aetna of IA Medicare	$1.83
Rate for Payer: Amerigroup Medicaid	$1.85
Rate for Payer: Amerigroup Medicare	$1.46
Rate for Payer: Cash Price	$2.57
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2.40
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$1.44
Rate for Payer: Iowa Total Care Managed Medicaid	$1.83
Rate for Payer: Medical Associates Commercial	$2.40
Rate for Payer: Medical Associates Managed Medicare	$1.44
Rate for Payer: Midlands Choice Commercial	$2.24
Rate for Payer: Molina Healthcare Managed Medicaid	$1.86
Rate for Payer: Partners Health Alliance Commercial	$1.66
Rate for Payer: United Healthcare Commercial	$2.89
Rate for Payer: United Healthcare Managed Medicare	$1.89

chlorthalidone 25 mg Tab [VDMC]

Facility

$3.21

Service Code	HCPCS A9270
Hospital Charge Code	10377640
Hospital Revenue Code	259
Min. Negotiated Rate	$2.24
Max. Negotiated Rate	$2.89
Rate for Payer: Aetna of IA Commercial	$2.89
Rate for Payer: Aetna of IA Medical Rental Products	$2.89
Rate for Payer: Cash Price	$2.57
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$2.40
Rate for Payer: Medical Associates Commercial	$2.40
Rate for Payer: Midlands Choice Commercial	$2.24
Rate for Payer: United Healthcare Commercial	$2.89

cholecalciferol 125 mcg (5000 intl units) Cap [VDMC]

Facility

$1.07

Service Code	HCPCS A9270
Hospital Charge Code	10431573
Hospital Revenue Code	259
Min. Negotiated Rate	$0.48
Max. Negotiated Rate	$0.96
Rate for Payer: Aetna of IA Commercial	$0.96
Rate for Payer: Aetna of IA Medical Rental Products	$0.96
Rate for Payer: Aetna of IA Medicare	$0.61
Rate for Payer: Amerigroup Medicaid	$0.62
Rate for Payer: Amerigroup Medicare	$0.48
Rate for Payer: Cash Price	$0.85
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial	$0.80
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS	$0.48
Rate for Payer: Iowa Total Care Managed Medicaid	$0.61
Rate for Payer: Medical Associates Commercial	$0.80
Rate for Payer: Medical Associates Managed Medicare	$0.48
Rate for Payer: Midlands Choice Commercial	$0.75
Rate for Payer: Molina Healthcare Managed Medicaid	$0.62
Rate for Payer: Partners Health Alliance Commercial	$0.55
Rate for Payer: United Healthcare Commercial	$0.96
Rate for Payer: United Healthcare Managed Medicare	$0.63

Know your out-of-pocket cost for care.

All Charges