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Iowa Specialty Hospital - Belmond
Belmond, IA · CMS ID: 161301
This hospital has pricing data for 39 procedures ranging from $3 to $5,562.
Procedures (39)
Cash Price
(No Insurance)
$18
Gross Charge
$30
Insurance Negotiated Rates
Aetna$4
Cash Price
(No Insurance)
$7
Gross Charge
$11
Insurance Negotiated Rates
Aetna$4
Chest X-Ray 1 View
71045Cash Price
(No Insurance)
$29
Gross Charge
$48
Medicare Rate
$24
Insurance Negotiated Rates
Triwest Va Choice And Pc3-All Plans$8
Chest X-Ray 2 Views
71046Cash Price
(No Insurance)
$35
Gross Charge
$58
Medicare Rate
$31
Insurance Negotiated Rates
Aetna$10
Cash Price
(No Insurance)
$315
Gross Charge
$526
Medicare Rate
$356
Insurance Negotiated Rates
Aetna$153
Cash Price
(No Insurance)
$168
Gross Charge
$281
Medicare Rate
$450
Insurance Negotiated Rates
Aetna$90
Cash Price
(No Insurance)
$1,081
Gross Charge
$1,801
Medicare Rate
$471
Insurance Negotiated Rates
Aetna$208
Cash Price
(No Insurance)
$94
Gross Charge
$157
Insurance Negotiated Rates
Triwest Va Choice And Pc3-All Plans$4
Cash Price
(No Insurance)
$212
Gross Charge
$354
Medicare Rate
$280
Insurance Negotiated Rates
Aetna$80
Cash Price
(No Insurance)
$189
Gross Charge
$315
Medicare Rate
$172
Insurance Negotiated Rates
Triwest Va Choice And Pc3-All Plans$76
CT Chest Low Dose
71271Cash Price
(No Insurance)
$94
Gross Charge
$156
Medicare Rate
$128
Insurance Negotiated Rates
Aetna$47
Cash Price
(No Insurance)
$175
Gross Charge
$291
Medicare Rate
$156
Insurance Negotiated Rates
Aetna$51
ER Visit Level 3
99283Cash Price
(No Insurance)
$118
Gross Charge
$197
Medicare Rate
$69
Insurance Negotiated Rates
Aetna$63
ER Visit Level 4
99284Cash Price
(No Insurance)
$163
Gross Charge
$271
Medicare Rate
$117
Insurance Negotiated Rates
Aetna$110
ER Visit Level 5
99285Cash Price
(No Insurance)
$239
Gross Charge
$399
Medicare Rate
$170
Insurance Negotiated Rates
Aetna$160
Cash Price
(No Insurance)
$67
Gross Charge
$112
Medicare Rate
$48
Insurance Negotiated Rates
Aetna$26
Hemoglobin A1C
83036Cash Price
(No Insurance)
$79
Gross Charge
$132
Insurance Negotiated Rates
Triwest Va Choice And Pc3-All Plans$6
Knee Arthroscopy
29881Cash Price
(No Insurance)
$2,417
Gross Charge
$4,028
Medicare Rate
$495
Insurance Negotiated Rates
Aetna$467
Knee X-Ray
73560Cash Price
(No Insurance)
$27
Gross Charge
$45
Medicare Rate
$32
Insurance Negotiated Rates
Aetna$8
Cash Price
(No Insurance)
$5,562
Gross Charge
$9,270
Medicare Rate
$615
Insurance Negotiated Rates
Tricare-All Plans$561
Mammogram Diagnostic
77066Cash Price
(No Insurance)
$104
Gross Charge
$173
Medicare Rate
$146
Insurance Negotiated Rates
Aetna$44
Mammogram Screening
77067Cash Price
(No Insurance)
$85
Gross Charge
$142
Medicare Rate
$118
Insurance Negotiated Rates
Aetna$34
Cash Price
(No Insurance)
$3
Gross Charge
$5
Insurance Negotiated Rates
Aetna$2
MRI Brain
70551Cash Price
(No Insurance)
$248
Gross Charge
$414
Medicare Rate
$183
Insurance Negotiated Rates
Aetna$65
Cash Price
(No Insurance)
$393
Gross Charge
$655
Medicare Rate
$296
Insurance Negotiated Rates
Aetna$100
MRI Cervical Spine
72141Cash Price
(No Insurance)
$260
Gross Charge
$434
Medicare Rate
$179
Insurance Negotiated Rates
UnitedHealthcare$65
MRI Knee
73721Cash Price
(No Insurance)
$174
Gross Charge
$290
Medicare Rate
$191
Insurance Negotiated Rates
Aetna$60
MRI Lumbar Spine
72148Cash Price
(No Insurance)
$260
Gross Charge
$434
Medicare Rate
$180
Insurance Negotiated Rates
Aetna$65
MRI Shoulder
73221Cash Price
(No Insurance)
$174
Gross Charge
$290
Medicare Rate
$191
Insurance Negotiated Rates
Aetna$60
Office Visit Level 3
99213Cash Price
(No Insurance)
$120
Gross Charge
$200
Medicare Rate
$91
Insurance Negotiated Rates
Aetna$49
Office Visit Level 4
99214Cash Price
(No Insurance)
$151
Gross Charge
$252
Medicare Rate
$130
Insurance Negotiated Rates
Aetna$76
Cash Price
(No Insurance)
$1,095
Gross Charge
$1,825
Insurance Negotiated Rates
AETNA/COVENTRY HMO$1,697
Shoulder X-Ray
73030Cash Price
(No Insurance)
$26
Gross Charge
$44
Medicare Rate
$33
Insurance Negotiated Rates
UnitedHealthcare$9
TSH (Thyroid)
84443Cash Price
(No Insurance)
$15
Gross Charge
$25
Insurance Negotiated Rates
UnitedHealthcare$8
Ultrasound Abdomen
76700Cash Price
(No Insurance)
$150
Gross Charge
$250
Medicare Rate
$107
Insurance Negotiated Rates
Aetna$36
Ultrasound Pelvis
76856Cash Price
(No Insurance)
$109
Gross Charge
$181
Medicare Rate
$98
Insurance Negotiated Rates
UnitedHealthcare$31
Cash Price
(No Insurance)
$109
Gross Charge
$181
Medicare Rate
$109
Insurance Negotiated Rates
Aetna$31
Cash Price
(No Insurance)
$771
Gross Charge
$1,285
Medicare Rate
$301
Insurance Negotiated Rates
Aetna$103
Cash Price
(No Insurance)
$779
Gross Charge
$1,298
Medicare Rate
$390
Insurance Negotiated Rates
Aetna$115