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
INSJ/RPLC CAR MODULJ PLS GN
Sioux City, IA
See all hospitals reporting CPT 0409T →Price type
Northwest Iowa Hospital Corporation’s median price of $23.0k is 2% above the median hospital's median price ($22.5k), higher than 56% of the 1,319 hospitals reporting CPT 0409T. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 12 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | ||||
|---|---|---|---|---|
| 1 | Cigna commercial fee schedule · both | $427.34 | $427.34 | $427.34 – $427.34 |
| 2 | UnitedHealthcare hmo fee schedule · both | $1,067 | $1,067 | $1,067 – $1,067 |
| 3 | UnitedHealthcare ppo fee schedule · both | $1,067 | $1,067 | $1,067 – $1,067 |
| 4 | Aetna medicare advantage case rate · outpatient | $22,313 | $22,313 | $22,313 – $22,313 |
| 5 | Molina medicare advantage case rate · outpatient | $22,313 | $22,313 | $22,313 – $22,313 |
| 6 | Wellmark medicare advantage case rate · outpatient | $22,313 | $22,313 | $22,313 – $22,313 |
| 7 | Humana medicare advantage case rate · outpatient | $22,969 | $22,969 | $22,969 – $22,969 |
| 8 | UnitedHealthcare medicare advantage case rate · outpatient | $22,969 | $22,969 | $22,969 – $22,969 |
| 9 | Aetna hmo fee schedule · outpatient | $47,828 | $47,828 | $47,828 – $47,828 |
| 10 | Aetna ppo fee schedule · outpatient | $54,876 | $54,876 | $54,876 – $54,876 |
| 11 | UnitedHealthcare hmo fee schedule · outpatient | $59,911 | $59,911 | $59,911 – $59,911 |
| 12 | UnitedHealthcare ppo fee schedule · outpatient | $59,911 | $59,911 | $59,911 – $59,911 |
Last updated: Jan 28, 2026
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