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Adair County Memorial Hospital
Greenfield, IA · CMS ID: 161310
This hospital has pricing data for 38 procedures ranging from $19 to $14,569.
Procedures (38)
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$206
Gross Charge
$275
Medicare Rate
$24
Insurance Negotiated Rates
Wellmark Hmo$73
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$236
Gross Charge
$315
Medicare Rate
$31
Insurance Negotiated Rates
Wellmark Hmo$73
Cash Price
(No Insurance)
$1,703
Gross Charge
$2,270
Medicare Rate
$356
Insurance Negotiated Rates
Coventry Advantra Mcr$165
Cash Price
(No Insurance)
$4,028
Gross Charge
$5,370
Medicare Rate
$450
Insurance Negotiated Rates
Coventry Advantra Mcr$179
Cash Price
(No Insurance)
$2,620
Gross Charge
$3,493
Medicare Rate
$471
Insurance Negotiated Rates
Coventry Advantra Mcr$226
Cash Price
(No Insurance)
$105
Gross Charge
$140
Insurance Negotiated Rates
Wellmark Hmo$27
Cash Price
(No Insurance)
$176
Gross Charge
$235
Insurance Negotiated Rates
Wellmark Hmo$54
Cash Price
(No Insurance)
$3,375
Gross Charge
$4,500
Medicare Rate
$280
Insurance Negotiated Rates
Wellmark Hmo$910
Cash Price
(No Insurance)
$2,790
Gross Charge
$3,720
Medicare Rate
$172
Insurance Negotiated Rates
Wellmark Hmo$910
CT Chest Low Dose
71271Cash Price
(No Insurance)
$1,481
Gross Charge
$1,975
Medicare Rate
$128
Insurance Negotiated Rates
Wellmark Hmo$383
Cash Price
(No Insurance)
$3,956
Gross Charge
$5,275
Medicare Rate
$156
Insurance Negotiated Rates
Wellmark Hmo$910
ER Visit Level 3
99283Cash Price
(No Insurance)
$518
Gross Charge
$690
Medicare Rate
$69
Insurance Negotiated Rates
Coventry Advantra Mcr$64
ER Visit Level 4
99284Cash Price
(No Insurance)
$818
Gross Charge
$1,090
Medicare Rate
$117
Insurance Negotiated Rates
UnitedHealthcare$110
ER Visit Level 5
99285Cash Price
(No Insurance)
$1,196
Gross Charge
$1,595
Medicare Rate
$170
Insurance Negotiated Rates
UnitedHealthcare$159
Hemoglobin A1C
83036Cash Price
(No Insurance)
$98
Gross Charge
$130
Insurance Negotiated Rates
Coventry Advantra Mcr$12
Hip Replacement
27130Cash Price
(No Insurance)
$19
Gross Charge
$25
Medicare Rate
$1,129
Insurance Negotiated Rates
Coventry Advantra Mcr$2
Knee Arthroscopy
29881Cash Price
(No Insurance)
$926
Gross Charge
$1,235
Medicare Rate
$495
Insurance Negotiated Rates
Coventry Advantra Mcr$491
Knee X-Ray
73560Cash Price
(No Insurance)
$210
Gross Charge
$280
Medicare Rate
$32
Insurance Negotiated Rates
Wellmark Hmo$73
Cash Price
(No Insurance)
$14,569
Gross Charge
$19,425
Medicare Rate
$615
Insurance Negotiated Rates
Coventry Advantra Mcr$17
Lipid Panel
80061Cash Price
(No Insurance)
$146
Gross Charge
$195
Insurance Negotiated Rates
UnitedHealthcare$12
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$375
Gross Charge
$500
Medicare Rate
$146
Insurance Negotiated Rates
Wellmark Hmo$202
Mammogram Screening
77067Cash Price
(No Insurance)
$330
Gross Charge
$440
Medicare Rate
$118
Insurance Negotiated Rates
Wellmark Hmo$202
MRI Brain
70551Cash Price
(No Insurance)
$2,453
Gross Charge
$3,270
Medicare Rate
$183
Insurance Negotiated Rates
Wellmark Hmo$806
Cash Price
(No Insurance)
$4,013
Gross Charge
$5,350
Medicare Rate
$296
Insurance Negotiated Rates
Coventry Advantra Mcr$37
MRI Cervical Spine
72141Cash Price
(No Insurance)
$2,554
Gross Charge
$3,405
Medicare Rate
$179
Insurance Negotiated Rates
Wellmark Hmo$806
MRI Knee
73721Cash Price
(No Insurance)
$2,426
Gross Charge
$3,235
Medicare Rate
$191
Insurance Negotiated Rates
Wellmark Hmo$806
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$2,625
Gross Charge
$3,500
Medicare Rate
$180
Insurance Negotiated Rates
Wellmark Hmo$806
MRI Shoulder
73221Cash Price
(No Insurance)
$2,381
Gross Charge
$3,175
Medicare Rate
$191
Insurance Negotiated Rates
Wellmark Hmo$806
Office Visit Level 3
99213Cash Price
(No Insurance)
$161
Gross Charge
$215
Medicare Rate
$91
Insurance Negotiated Rates
UnitedHealthcare$60
Office Visit Level 4
99214Cash Price
(No Insurance)
$210
Gross Charge
$280
Medicare Rate
$130
Insurance Negotiated Rates
UnitedHealthcare$89
Shoulder X-Ray
73030Cash Price
(No Insurance)
$229
Gross Charge
$305
Medicare Rate
$33
Insurance Negotiated Rates
UnitedHealthcare$8
TSH (Thyroid)
84443Cash Price
(No Insurance)
$146
Gross Charge
$195
Insurance Negotiated Rates
UnitedHealthcare$12
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$806
Gross Charge
$1,075
Medicare Rate
$107
Insurance Negotiated Rates
Wellmark Hmo$383
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$623
Gross Charge
$830
Medicare Rate
$98
Insurance Negotiated Rates
Wellmark Hmo$383
Cash Price
(No Insurance)
$548
Gross Charge
$730
Medicare Rate
$109
Insurance Negotiated Rates
Wellmark Hmo$248
Cash Price
(No Insurance)
$3,619
Gross Charge
$4,825
Medicare Rate
$301
Insurance Negotiated Rates
Coventry Advantra Mcr$110
Cash Price
(No Insurance)
$3,619
Gross Charge
$4,825
Medicare Rate
$390
Insurance Negotiated Rates
Coventry Advantra Mcr$124