CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone Newton Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $538
  • Cash Discount Price: $3,953
  • vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone Newton Medical Center is $538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,953. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 2.21x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$3,953

Average discount available for prompt cash payment at this facility.

Insurance Median
$538

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $3,953 (1622%)
Insurance Median: $538 (221%)
Cash: $3,953 (1622% of Medicare)
Ins. Median: $538 (221% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 221% of the Medicare baseline (a markup of 121%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $226 - $5,627 93%
Medicare (plans) $226 - $235 93%
Blue Cross Blue Shield $228 - $538 94%
UnitedHealthcare $230 - $3,423 94%
Blue Benefit Administrators Of Massachusetts $244 - $538 100%
Blue Care Network $244 - $538 100%
Blue Distinction Transplant $244 - $538 100%
Blue Shield - Ca $244 - $538 100%
Blue Shield - Id (Regence) $244 - $538 100%
Blue Shield - Ny Highmark Northeastern $244 - $538 100%
Blue Shield - Ny Highmark Western $244 - $538 100%
Blue Shield - Pa (Highmark) $244 - $538 100%
Blue Shield - Wa (Regence) $244 - $538 100%
Iowa Total Care $275 113%
Medicaid / KanCare $278 - $279 114%
Amish Hospital Aid $307 126%
Oscar $327 134%
Centivo $333 137%
Ambetter / Centene $387 159%
Claimdoc $463 190%
Nova $463 190%
Geha $2,282 - $3,423 936%
Newton Correctional Facility $2,602 - $3,903 1067%
Health Choices $3,022 - $4,534 1240%
Medical Associates $3,022 - $4,534 1240%
Health Partners $3,531 - $5,296 1448%
Auxiant $3,683 - $5,525 1511%
Cigna $3,683 - $5,525 1511%
Health Alliance $3,683 - $5,525 1511%
Medica $3,683 - $5,525 1511%
Midlands $3,683 - $5,525 1511%
Midlands Choice $3,683 - $5,525 1511%
1199 National Benefit Fund $3,751 - $5,627 1539%
Allied Benefit Systems $3,751 - $5,627 1539%
Asr Health Benefits $3,751 - $5,627 1539%
Christian Brother Services $3,751 - $5,627 1539%
Coventry $3,751 - $5,627 1539%
First Health $3,751 - $5,627 1539%
Lucent Health $3,751 - $5,627 1539%
Luminare Health $3,751 - $5,627 1539%
Medical Mutual $3,751 - $5,627 1539%
Meritain $3,751 - $5,627 1539%
Trustmark Small Business Benefits $3,751 - $5,627 1539%
Webtpa $3,751 - $5,627 1539%
Crime Victim Assistance $4,003 - $6,005 1642%
Iowa Dept Of Public Health $4,003 - $6,005 1642%

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