CMS Price Transparency Data
Hospital file updated: 2026-03-31
Injection procedure for pain management
Facility: Mercyone Newton Medical Center
Billing Code: G0260 (HCPCS)
Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.High Markup · Shop Alternatives
$652Fair BaseRate (2.15× Market)
Position vs. 1.00× Fair Price+115% Above Fair Price
1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.
This hospital's typical commercial price is $1,404 compared to the $652 fair price benchmark.
Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Clinical Quality & ER SpeedChecks whether higher hospital prices actually buy better clinical quality — combining CMS Star Ratings, hospital safety scores, and emergency room wait times.High-Markup · Check Safety
CMS Star Rating4/5 StarsOfficial CMS Overall Hospital Quality Star Rating (1 to 5 stars) summarizing mortality, safety of care, readmissions, and patient experience.
Safety Score78/100Composite patient safety score (0–100) derived from CMS hospital-acquired infection rates (CLABSI, CAUTI, MRSA, C. diff), surgical complications, and HCAHPS surveys.
Typical ER WaitNo ER DataMedian minutes patients spent in the emergency department before leaving from the visit, as reported to CMS Timely and Effective Care.
4-Star CMS clinical quality rating paired with 2.15× fair market pricing.
The BaseRate · fair price high confidence
A fair price for this
$652
about 0.9× the $721 Medicare rate · typically $413–$872
modeled estimate · not a bill or quote
Medicare pays $721 Fair price $652 Cash price $1,404 Hospital's list price $1,444
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
UnitedHealthcareBlue Cross Blue ShieldAetnaCigna HumanaKaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $682 - $1,251 | 95% |
| Blue Cross Blue Shieldmajor | $675 | 94% |
| Aetnamajor | $668 - $1,624 | 93% |
| Cignamajor | $1,063 - $1,594 | 147% |
| Ambetter (Centene) | $116 | 16% |
| GEHA | $834 - $1,251 | 116% |
| HealthPartners | $1,019 - $1,529 | 141% |
| Medica | $1,063 - $1,594 | 147% |
| Medical Mutual | $1,082 - $1,624 | 150% |
| Oscar Health | $98 | 14% |
| + 20 smaller / regional plans | $92 - $1,733 |
Government programs also on file: Medicare, Medicaid.
Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.
Self-Pay How to get the cash price
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Other Procedures at Mercyone Newton Medical Center
Compare: Injection procedure for pain management at other IA hospitals
- Jones Regional Medical Center · Anamosa $229
- Henry County Health Center · Mount Pleasant $391
- University of Iowa Health Care Medical Center Down · Iowa City $410
- Davis County Hospital · Bloomfield $415
- CHI Health - Mercy Corning · Corning $456
- CHI Health Missouri Valley · Missouri Valley $456
- George C Grape Community Hospital · Hamburg $554
- Gundersen Palmer Lutheran Hospital and Clinics · West Union $614
Insurance negotiated median for the same procedure, sorted lowest first.
Inline Bill X-Ray & 501(r) Calculator
501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 36.3%
Audit a Bill or Quote at Mercyone Newton Medical Center (Zero PHI Required)
CMS CCN: 160032
HCPCS G0260
Fair BaseRate™ $652
Medicare Rate $721
Self-Pay Cash $1,404
Insurer Median $750
Pre-filled with Mercyone Newton Medical Center’s charged/list benchmark
Screened against 2026 HHS Federal Poverty Guidelines
2026 FPL: $15,650 + $5,500 per additional person
Step 1 · 501(r) Charity Care Check
501(r) AGB Cap: $524 (274% FPL)
Statutory 501(r) AGB Cap Limits Bill to $524
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $524).
Step 2 · Cash vs. Insurance Arbitrage
Save $40 Paying Cash
Self-Pay Cash Rate ($1,404) Beats Your Bill
Mercyone Newton Medical Center's published 45 CFR § 180 self-pay cash rate is $1,404 (vs. $750 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Step 3 · Fair BaseRate Target
+$792 Above Fair BaseRate
Negotiate Toward $652 Fair BaseRate ($721 Medicare)
Your bill ($1,444) is $792 above the denoised Fair BaseRate ($652) and 2.0× the $721 Medicare rate.
1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, HCPCS code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.
CMS Care Compare Public Quality Record
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Overall4/5 Stars (4/5)
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
45 CFR § 180 Primary-Source Lineage & Federal Verification
Verified
CMS CCN 160032
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
MRF Portal Indexed (421470935_mercy-medical-center-newton_standardcharges.zip!421470935_Mercy-Medical-Center-Newton_standardcharges.csv)
Verify on CMS Medicare.gov (CCN 160032) ↗
CMS HCRIS Cost Reports ↗
Published MRF File421470935_mercy-medical-center-newton_standardcharges.zip!421470935_Mercy-Medical-Center-Newton_standardcharges.csv
Publication / Vintage2026-03-31 · 30.80 MB
Validated Rate Rows4,359,660 (CMS v3.0.0)
File Integrity Digest54d3cacc94fef950293b…
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.