Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
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The hospitals that file a Wellmark rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.
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29 hospital rates
| # | Plans | |||
|---|---|---|---|---|
| 1 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 3 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 4 | Central Iowa Hospital Corporation Des Moines, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 5 | Central Iowa Hospital Corporation West Des Moines, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 6 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 7 | Grinnell Regional Medical Center Grinnell, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 8 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $710.42 | $677.23 – $743.60 |
| 9 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $784.35 | $784.35 – $784.35 |
| 10 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $407.43 | $407.43 – $407.43 |
| 11 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · outpatient | 1 | $289.62 | $289.62 – $289.62 |
| 12 | Meriter Hospital, Inc Madison, WI case rate · outpatient | 1 | $407.43 | $407.43 – $407.43 |
| 13 | Northwest Iowa Hospital Corporation Sioux City, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 14 | Northwest Iowa Hospital Corporation Sioux City, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 15 | St Luke's Methodist Hospital Marion, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 16 | St Luke's Methodist Hospital Marion, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 17 | The Finley Hospital Dubuque, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 18 | The Finley Hospital Dubuque, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 19 | Trinity Medical Center Rock Island, IL case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 20 | Trinity Medical Center Rock Island, IL fee schedule · both | 1 | $407.43 | $407.43 – $407.43 |
| 21 | Trinity Medical Center Bettendorf, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 22 | Trinity Medical Center Bettendorf, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 23 | Trinity Regional Medical Center Fort Dodge, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
| 24 | Trinity Regional Medical Center Fort Dodge, IA fee schedule · both | 3 | $407.43 | $407.43 – $407.43 |
| 25 | Unity Healthcare Muscatine, IA case rate · outpatient | 1 | $415.58 | $415.58 – $415.58 |
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