CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercyone Newton Medical Center

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $5,940
  • Cash Discount Price: $24,358
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Mercyone Newton Medical Center is $5,940. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24,358. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.05x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$24,358

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,940

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Cash / Self-Pay: $24,358 (429%)
Insurance Median: $5,940 (105%)
Cash: $24,358 (429% of Medicare)
Ins. Median: $5,940 (105% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $5,243 92%
Medicare (plans) $5,243 - $5,457 92%
Blue Cross Blue Shield $5,296 93%
UnitedHealthcare $5,348 94%
Iowa Total Care $5,911 104%
Medicaid / KanCare $5,969 - $5,992 105%
Oscar $7,026 124%
Amish Hospital Aid $7,116 125%
Centivo $8,442 149%
Ambetter / Centene $8,988 158%
Claimdoc $10,754 189%
Nova $10,754 189%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals