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Service Code CPT 87635 CS
Hospital Charge Code 8783451
Hospital Revenue Code 306
Min. Negotiated Rate $168.93
Max. Negotiated Rate $304.20
Rate for Payer: Aetna of IA Commercial $304.20
Rate for Payer: Aetna of IA Medical Rental Products $304.20
Rate for Payer: Aetna of IA Medicare $192.66
Rate for Payer: Amerigroup Medicaid $170.59
Rate for Payer: Amerigroup Medicare $170.69
Rate for Payer: Cash Price $270.40
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $253.50
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $169.00
Rate for Payer: Iowa Total Care Managed Medicaid $168.93
Rate for Payer: Medical Associates Commercial $253.50
Rate for Payer: Medical Associates Managed Medicare $169.00
Rate for Payer: Midlands Choice Commercial $236.60
Rate for Payer: Molina Healthcare Managed Medicaid $171.54
Rate for Payer: Molina Healthcare Managed Medicare $171.43
Rate for Payer: Oscar Health of IA Commercial $253.50
Rate for Payer: Partners Health Alliance Commercial $253.50
Rate for Payer: United Healthcare Commercial $304.20
Rate for Payer: United Healthcare Managed Medicare $199.42
Service Code CPT 28299
Hospital Revenue Code 360
Min. Negotiated Rate $8,852.98
Max. Negotiated Rate $9,738.28
Rate for Payer: Wellmark IA HMO $8,852.98
Rate for Payer: Wellmark IA PPO $9,738.28
Service Code CPT 28285
Hospital Revenue Code 360
Min. Negotiated Rate $4,235.22
Max. Negotiated Rate $4,658.74
Rate for Payer: Wellmark IA HMO $4,235.22
Rate for Payer: Wellmark IA PPO $4,658.74
Service Code CPT C1713
Hospital Charge Code 8895433
Hospital Revenue Code 278
Min. Negotiated Rate $220.50
Max. Negotiated Rate $283.50
Rate for Payer: Aetna of IA Commercial $283.50
Rate for Payer: Aetna of IA Medical Rental Products $283.50
Rate for Payer: Cash Price $252.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $236.25
Rate for Payer: Medical Associates Commercial $236.25
Rate for Payer: Midlands Choice Commercial $220.50
Rate for Payer: United Healthcare Commercial $283.50
Service Code CPT C1713
Hospital Charge Code 8895433
Hospital Revenue Code 278
Min. Negotiated Rate $157.44
Max. Negotiated Rate $283.50
Rate for Payer: Aetna of IA Commercial $283.50
Rate for Payer: Aetna of IA Medical Rental Products $283.50
Rate for Payer: Aetna of IA Medicare $179.55
Rate for Payer: Amerigroup Medicaid $158.98
Rate for Payer: Amerigroup Medicare $159.08
Rate for Payer: Cash Price $252.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $236.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $157.50
Rate for Payer: Iowa Total Care Managed Medicaid $157.44
Rate for Payer: Medical Associates Commercial $236.25
Rate for Payer: Medical Associates Managed Medicare $157.50
Rate for Payer: Midlands Choice Commercial $220.50
Rate for Payer: Molina Healthcare Managed Medicaid $159.86
Rate for Payer: Molina Healthcare Managed Medicare $159.77
Rate for Payer: Oscar Health of IA Commercial $236.25
Rate for Payer: Partners Health Alliance Commercial $236.25
Rate for Payer: United Healthcare Commercial $283.50
Rate for Payer: United Healthcare Managed Medicare $185.85
Service Code CPT C1713
Hospital Charge Code 8908717
Hospital Revenue Code 278
Min. Negotiated Rate $220.50
Max. Negotiated Rate $283.50
Rate for Payer: Aetna of IA Commercial $283.50
Rate for Payer: Aetna of IA Medical Rental Products $283.50
Rate for Payer: Cash Price $252.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $236.25
Rate for Payer: Medical Associates Commercial $236.25
Rate for Payer: Midlands Choice Commercial $220.50
Rate for Payer: United Healthcare Commercial $283.50
Service Code CPT C1713
Hospital Charge Code 8908717
Hospital Revenue Code 278
Min. Negotiated Rate $157.44
Max. Negotiated Rate $283.50
Rate for Payer: Aetna of IA Commercial $283.50
Rate for Payer: Aetna of IA Medical Rental Products $283.50
Rate for Payer: Aetna of IA Medicare $179.55
Rate for Payer: Amerigroup Medicaid $158.98
Rate for Payer: Amerigroup Medicare $159.08
Rate for Payer: Cash Price $252.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $236.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $157.50
Rate for Payer: Iowa Total Care Managed Medicaid $157.44
Rate for Payer: Medical Associates Commercial $236.25
Rate for Payer: Medical Associates Managed Medicare $157.50
Rate for Payer: Midlands Choice Commercial $220.50
Rate for Payer: Molina Healthcare Managed Medicaid $159.86
Rate for Payer: Molina Healthcare Managed Medicare $159.77
Rate for Payer: Oscar Health of IA Commercial $236.25
Rate for Payer: Partners Health Alliance Commercial $236.25
Rate for Payer: United Healthcare Commercial $283.50
Rate for Payer: United Healthcare Managed Medicare $185.85
Service Code CPT C1713
Hospital Charge Code 8908713
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT C1713
Hospital Charge Code 8908713
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8911062
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT C1713
Hospital Charge Code 8911062
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8924287
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8924287
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT C1713
Hospital Charge Code 8931416
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8931416
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT C1713
Hospital Charge Code 8895429
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT C1713
Hospital Charge Code 8895429
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8908715
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8908715
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT C1713
Hospital Charge Code 8895431
Hospital Revenue Code 278
Min. Negotiated Rate $126.00
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: United Healthcare Commercial $162.00
Service Code CPT C1713
Hospital Charge Code 8895431
Hospital Revenue Code 278
Min. Negotiated Rate $89.96
Max. Negotiated Rate $162.00
Rate for Payer: Aetna of IA Commercial $162.00
Rate for Payer: Aetna of IA Medical Rental Products $162.00
Rate for Payer: Aetna of IA Medicare $102.60
Rate for Payer: Amerigroup Medicaid $90.85
Rate for Payer: Amerigroup Medicare $90.90
Rate for Payer: Cash Price $144.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $135.00
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $90.00
Rate for Payer: Iowa Total Care Managed Medicaid $89.96
Rate for Payer: Medical Associates Commercial $135.00
Rate for Payer: Medical Associates Managed Medicare $90.00
Rate for Payer: Midlands Choice Commercial $126.00
Rate for Payer: Molina Healthcare Managed Medicaid $91.35
Rate for Payer: Molina Healthcare Managed Medicare $91.30
Rate for Payer: Oscar Health of IA Commercial $135.00
Rate for Payer: Partners Health Alliance Commercial $135.00
Rate for Payer: United Healthcare Commercial $162.00
Rate for Payer: United Healthcare Managed Medicare $106.20
Service Code CPT 82533
Hospital Charge Code 8037517
Hospital Revenue Code 301
Min. Negotiated Rate $47.12
Max. Negotiated Rate $121.50
Rate for Payer: Aetna of IA Commercial $121.50
Rate for Payer: Aetna of IA Medical Rental Products $121.50
Rate for Payer: Aetna of IA Medicare $76.95
Rate for Payer: Amerigroup Medicaid $68.13
Rate for Payer: Amerigroup Medicare $68.18
Rate for Payer: Cash Price $108.00
Rate for Payer: Cash Price $108.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $101.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $67.50
Rate for Payer: Iowa Total Care Managed Medicaid $67.47
Rate for Payer: Medical Associates Commercial $101.25
Rate for Payer: Medical Associates Managed Medicare $67.50
Rate for Payer: Midlands Choice Commercial $94.50
Rate for Payer: Molina Healthcare Managed Medicaid $68.51
Rate for Payer: Molina Healthcare Managed Medicare $68.47
Rate for Payer: Oscar Health of IA Commercial $101.25
Rate for Payer: Partners Health Alliance Commercial $101.25
Rate for Payer: United Healthcare Commercial $121.50
Rate for Payer: United Healthcare Managed Medicare $79.65
Rate for Payer: Wellmark IA HMO $47.12
Rate for Payer: Wellmark IA PPO $51.83
Service Code CPT 82533
Hospital Charge Code 8037517
Hospital Revenue Code 301
Min. Negotiated Rate $94.50
Max. Negotiated Rate $121.50
Rate for Payer: Aetna of IA Commercial $121.50
Rate for Payer: Aetna of IA Medical Rental Products $121.50
Rate for Payer: Cash Price $108.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $101.25
Rate for Payer: Medical Associates Commercial $101.25
Rate for Payer: Midlands Choice Commercial $94.50
Rate for Payer: United Healthcare Commercial $121.50
Service Code CPT 82533
Hospital Charge Code 8093929
Hospital Revenue Code 301
Min. Negotiated Rate $47.12
Max. Negotiated Rate $121.50
Rate for Payer: Aetna of IA Commercial $121.50
Rate for Payer: Aetna of IA Medical Rental Products $121.50
Rate for Payer: Aetna of IA Medicare $76.95
Rate for Payer: Amerigroup Medicaid $68.13
Rate for Payer: Amerigroup Medicare $68.18
Rate for Payer: Cash Price $108.00
Rate for Payer: Cash Price $108.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $101.25
Rate for Payer: Humana of IA Commercial PPO (non PPOx)/Medicare Advantage HMO/Medicare Advantage PPO/PFFS $67.50
Rate for Payer: Iowa Total Care Managed Medicaid $67.47
Rate for Payer: Medical Associates Commercial $101.25
Rate for Payer: Medical Associates Managed Medicare $67.50
Rate for Payer: Midlands Choice Commercial $94.50
Rate for Payer: Molina Healthcare Managed Medicaid $68.51
Rate for Payer: Molina Healthcare Managed Medicare $68.47
Rate for Payer: Oscar Health of IA Commercial $101.25
Rate for Payer: Partners Health Alliance Commercial $101.25
Rate for Payer: United Healthcare Commercial $121.50
Rate for Payer: United Healthcare Managed Medicare $79.65
Rate for Payer: Wellmark IA HMO $47.12
Rate for Payer: Wellmark IA PPO $51.83
Service Code CPT 82533
Hospital Charge Code 8093929
Hospital Revenue Code 301
Min. Negotiated Rate $94.50
Max. Negotiated Rate $121.50
Rate for Payer: Aetna of IA Commercial $121.50
Rate for Payer: Aetna of IA Medical Rental Products $121.50
Rate for Payer: Cash Price $108.00
Rate for Payer: Health Alliance-Midwest, Inc. of IA Commercial $101.25
Rate for Payer: Medical Associates Commercial $101.25
Rate for Payer: Midlands Choice Commercial $94.50
Rate for Payer: United Healthcare Commercial $121.50