CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercyone Newton Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $49
  • Cash Discount Price: $207
  • vs. Medicare Baseline: 0.36x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercyone Newton Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.36x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$207

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $207 (153%)
Insurance Median: $49 (36%)
Cash: $207 (153% of Medicare)
Ins. Median: $49 (36% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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
Champva $14 - $89 10%
Humana $14 - $129 10%
Tricare $14 - $89 10%
Triwest Health Alliance $14 - $89 10%
Us Family Health Plan $14 - $89 10%
Veterans Eval Services $14 - $89 10%
Medicaid / KanCare $16 - $80 12%
Amish Hospital Aid $17 - $107 13%
Amps $17 - $108 13%
Avera $20 - $122 15%
Health Partners $21 - $201 15%
Medical Associates $21 - $134 15%
Ambetter / Centene $22 - $137 16%
Bcn Domestic $22 - $137 16%
Blue Benefit Administrators Of Massachusetts $22 - $137 16%
Blue Care Network $22 - $137 16%
Blue Cross Blue Shield $22 - $137 16%
Blue Distinction Transplant $22 - $137 16%
Blue Shield - Ca $22 - $137 16%
Blue Shield - Id (Regence) $22 - $137 16%
Blue Shield - Ny Highmark Northeastern $22 - $137 16%
Blue Shield - Ny Highmark Western $22 - $137 16%
Blue Shield - Pa (Highmark) $22 - $137 16%
Blue Shield - Wa (Regence) $22 - $137 16%
Health Choices $22 - $165 16%
Kaiser Domestic $22 - $137 16%
Newton Correctional Facility $22 - $136 16%
Pre-Employment $22 - $137 16%
Sanford Health Plan $22 - $135 16%
Wc Domestic $22 - $137 16%
Lucent Health $23 - $145 17%
Stephenson Cty Health $23 - $142 17%
Ucare $23 - $143 17%
Health Smart $24 - $149 18%
Oscar $24 - $148 18%
Centivo $25 - $157 18%
Genex Wc $25 - $157 18%
Usa Managed Care $25 - $156 18%
Wc Align Network $26 - $167 19%
Claimdoc $27 - $168 20%
Geha $27 - $168 20%
The Alliance $27 - $169 20%
UnitedHealthcare $27 - $168 20%
Wc Praxis Health Network $28 - $178 21%
Aetna $29 - $209 21%
Global Excel $29 - $182 21%
Meritain $29 - $179 21%
Wc Reny Company $29 - $182 21%
Wc Velocity $29 - $182 21%
Auto Velocity $30 - $188 22%
Velocity $30 - $189 22%
Wc O'Hara Corp $30 - $188 22%
Preferred One $31 - $195 23%
Allied Benefit Systems $33 - $165 24%
Andrie Inc $33 - $209 24%
Auxiant $33 - $165 24%
Cigna $33 - $165 24%
East Greenbush Central School District $33 - $209 24%
First Choice Health $33 - $165 24%
Group Administrators $33 - $165 24%
Healthsmart Workers Comp $33 - $209 24%
Iowa Dept Of Public Health $33 - $89 24%
Jag Source $33 - $209 24%
Midlands $33 - $165 24%
Midlands Choice $33 - $165 24%
Multiplan $33 - $209 24%
Nebraska Total Care $33 - $75 24%
New York State Insurance Fund $33 - $209 24%
Njm Insurance Group $33 - $209 24%
Quiktrip $33 - $209 24%
Rx Heatlhcomp $33 - $209 24%
Rx Restat $33 - $209 24%
Rx Saif Opdp Wc $33 - $209 24%
Rx Worker'S Comp $33 - $209 24%
Wc Accident Fund $33 - $209 24%
Wc Ace $33 - $209 24%
Wc Acs Federal Employees $33 - $209 24%
Wc Acuity $33 - $209 24%
Wc Advantage $33 - $209 24%
Wc Aegis $33 - $209 24%
Wc Aig $33 - $209 24%
Wc Aims $33 - $209 24%
Wc Alaska National Ins $33 - $209 24%
Wc Allied $33 - $209 24%
Wc Am Trust N America $33 - $209 24%
Wc American Claims Mgmt $33 - $209 24%
Wc Amerisure $33 - $209 24%
Wc Amtrust $33 - $209 24%
Wc Asu Risk Mgt $33 - $209 24%
Wc Benetech $33 - $209 24%
Wc Berkley Admin $33 - $209 24%
Wc Broadspire $33 - $209 24%
Wc Broward County $33 - $209 24%
Wc Bunch & Associates $33 - $209 24%
Wc California State Comp Ins $33 - $209 24%
Wc California State Ins Fund $33 - $209 24%
Wc Capitol Area Health Consortium $33 - $209 24%
Wc Ccmsi $33 - $209 24%
Wc Chartis $33 - $209 24%
Wc Chubb $33 - $209 24%
Wc Cirma $33 - $209 24%
Wc City Of Albany $33 - $209 24%
Wc City Of Sioux City $33 - $209 24%
Wc Claims Mgmt Inc $33 - $209 24%
Wc Cna $33 - $209 24%
Wc Comp One Admin C/O Manageability $33 - $209 24%
Wc Compone Admin $33 - $209 24%
Wc Ct Healthcare Trust $33 - $209 24%
Wc Donegal Insurance Group $33 - $209 24%
Wc Emc Insurance Company $33 - $209 24%
Wc Employee Mutual $33 - $209 24%
Wc Enablecomp $33 - $209 24%
Wc Encore Health Network $33 - $209 24%
Wc Erie $33 - $209 24%
Wc Esis $33 - $209 24%
Wc Evolutions $33 - $209 24%
Wc Fcci $33 - $209 24%
Wc Fed Ex $33 - $209 24%
Wc Federal Black Lung $33 - $209 24%
Wc Federated $33 - $209 24%
Wc Finley Occupational Health $33 - $209 24%
Wc First Agency/Occunet $33 - $209 24%
Wc Ford Motor $33 - $209 24%
Wc Fresno Unified Emp $33 - $209 24%
Wc Gallagher Bassett $33 - $209 24%
Wc General Motors $33 - $209 24%
Wc Generic $33 - $209 24%
Wc Genex Care For Ohio $33 - $209 24%
Wc Great West Casualty $33 - $209 24%
Wc Guarantee Insurance $33 - $209 24%
Wc Guard Insurance Company $33 - $209 24%
Wc Hab $33 - $209 24%
Wc Hartford $33 - $209 24%
Wc Hastings $33 - $209 24%
Wc Health Management $33 - $209 24%
Wc Heritage Summit $33 - $209 24%
Wc Hireright $33 - $209 24%
Wc Horizon $33 - $209 24%
Wc Icw Group $33 - $209 24%
Wc Idaho State Ins Fund $33 - $209 24%
Wc Intercare Insurance $33 - $209 24%
Wc Intermountain $33 - $209 24%
Wc Johns Eastern $33 - $209 24%
Wc Kemberton $33 - $209 24%
Wc Key Ins & Benefit Solutions $33 - $209 24%
Wc Liberty Mutual $33 - $209 24%
Wc Mac Risk Management $33 - $209 24%
Wc Massachusetts $33 - $209 24%
Wc Mdia $33 - $209 24%
Wc Meadowbrook Claim $33 - $209 24%
Wc Medical Administrators $33 - $209 24%
Wc Meijers $33 - $209 24%
Wc Memic $33 - $209 24%
Wc Mercy Workcare $33 - $209 24%
Wc Michigan $33 - $209 24%
Wc Michigan Millers Mutual $33 - $209 24%
Wc Mitchell Frankenmuth $33 - $209 24%
Wc Mra $33 - $209 24%
Wc Nationwide $33 - $209 24%
Wc Nca Comp $33 - $209 24%
Wc New York $33 - $209 24%
Wc New York Special Funds $33 - $209 24%
Wc North American Rishces $33 - $209 24%
Wc Northeast Health $33 - $209 24%
Wc Notre Dame $33 - $209 24%
Wc Novanet $33 - $209 24%
Wc Occ Health Allen $33 - $209 24%
Wc Ohio Bureau $33 - $209 24%
Wc One Call Medical $33 - $209 24%
Wc Paradigm $33 - $209 24%
Wc Peerless $33 - $209 24%
Wc Pma $33 - $209 24%
Wc Price Chopper $33 - $209 24%
Wc Procura Management $33 - $209 24%
Wc Qualcare $33 - $209 24%
Wc Quiktrip $33 - $209 24%
Wc Rev Claims $33 - $209 24%
Wc Risico $33 - $209 24%
Wc Rural Mutual $33 - $209 24%
Wc Saif Oregon $33 - $209 24%
Wc Secura $33 - $209 24%
Wc Sedgwick $33 - $209 24%
Wc Sentry $33 - $209 24%
Wc Sheakley Unicomp $33 - $209 24%
Wc Smile Lodge $33 - $209 24%
Wc Society $33 - $209 24%
Wc Srs $33 - $209 24%
Wc Taconic (Mro) $33 - $209 24%
Wc Taconic Farms $33 - $209 24%
Wc Travelers $33 - $209 24%
Wc Triad Group $33 - $209 24%
Wc Tristar $33 - $209 24%
Wc Troy Ny $33 - $209 24%
Wc Tyson $33 - $209 24%
Wc Unified Health Services $33 - $209 24%
Wc United Heartland $33 - $209 24%
Wc Us Dept Of Labor $33 - $209 24%
Wc Walmart $33 - $209 24%
Wc West Bend $33 - $209 24%
Wc West Bend Mutual/Argent $33 - $209 24%
Wc Winnebago Industries $33 - $209 24%
Wc Yankee Trails $33 - $209 24%
Wc York Risk $33 - $209 24%
Wc Zenith $33 - $209 24%
Wc Zurich $33 - $209 24%
Albany County Correctional Facility $42 - $49 31%
Amish Mennonite $42 - $49 31%
Ascension St. Vincent Public Safety Medical $42 - $49 31%
Bcccp-Michigan $42 - $49 31%
Bccp $42 - $49 31%
Bmc Healthnet $42 - $49 31%
Breast Grant-Connecticut $42 - $49 31%
Broward County Dept Of Health $42 - $49 31%
California Health And Wellness $42 - $49 31%
Can Community Health Inc $42 - $49 31%
Cardinal Innovations Lme $42 - $49 31%
Care Connections Of Northern Iowa $42 - $49 31%
Care Oregon Ohp $42 - $49 31%
Cencal Health Plan $42 - $49 31%
Cenpatico $42 - $49 31%
Chhuny $42 - $49 31%
Childrens Comm Health Plan $42 - $49 31%
Childrens Medical Services Title 19 $42 - $49 31%
City Of Philadelphia $42 - $49 31%
Cmh Allegan County $42 - $49 31%
Cmh Ausable Valley $42 - $49 31%
Cmh Barry County $42 - $49 31%
Cmh Bay-Arenac County $42 - $49 31%
Cmh Berrien County $42 - $49 31%
Cmh Cass County $42 - $49 31%
Cmh Central Mi County $42 - $49 31%
Cmh Clinton-Eaton-Ingham County $42 - $49 31%
Cmh Detroit Wayne Integrated Health Network $42 - $49 31%
Cmh Genesee County $42 - $49 31%
Cmh Ionia County $42 - $49 31%
Cmh Jackson County/Lifeways $42 - $49 31%
Cmh Kalamazoo $42 - $49 31%
Cmh Kent County $42 - $49 31%
Cmh Lenawee County $42 - $49 31%
Cmh Livingston County $42 - $49 31%
Cmh Macomb $42 - $49 31%
Cmh Misc $42 - $49 31%
Cmh Monroe County $42 - $49 31%
Cmh Montcalm County $42 - $49 31%
Cmh Muskegon County $42 - $49 31%
Cmh Newaygo County $42 - $49 31%
Cmh North Country $42 - $49 31%
Cmh Northern Lakes County $42 - $49 31%
Cmh Oakland County $42 - $49 31%
Cmh Ottawa County $42 - $49 31%
Cmh Van Buren County $42 - $49 31%
Cmh Washtenaw County $42 - $49 31%
Cmh Wayne County/Carelink $42 - $49 31%
Cmh Wayne Cty/Com Liv Svcs $42 - $49 31%
Cmh West Mi County $42 - $49 31%
Community Benefit Health $42 - $49 31%
Community Care Behavorial Health $42 - $49 31%
Community Care Partners $42 - $49 31%
Community Health Choice $42 - $49 31%
Connections Csp $42 - $49 31%
County Coroner $42 - $49 31%
County Funding Generic $42 - $49 31%
Covid19 Hrsa Uninsured Testing And Treatment Fund $42 - $49 31%
Dean Wi Badgercare $42 - $49 31%
Delaware County Department Of Health $42 - $49 31%
Delaware First Health $42 - $49 31%
Delta Dental Nj $42 - $49 31%
Dph Tb Program $42 - $49 31%
Dscc $42 - $49 31%
Eastpointe Lme $42 - $49 31%
Family Health Network $42 - $49 31%
Freedom First Healthcare $42 - $49 31%
Fresno County Ccs $42 - $49 31%
Ghc Scw Wi Badgercare $42 - $49 31%
Harbor Health $42 - $49 31%
Health Safety Net $42 - $49 31%
Healthy Blue Ne $42 - $49 31%
Hennepin Health $42 - $49 31%
Id County Ada $42 - $49 31%
Id County Canyon $42 - $49 31%
Id County Cat Fund $42 - $49 31%
Id County Other $42 - $49 31%
Id County Payette $42 - $49 31%
Idaho Dept Health And Wellfare $42 - $49 31%
Idaho Womens Health Check $42 - $49 31%
Indiana Breast Cervical Cancer $42 - $49 31%
Inland Empire Health Plan $42 - $49 31%
Intercommunity Health Ohp $42 - $49 31%
Jai Medical System $42 - $49 31%
Kern Family Health Plan $42 - $49 31%
Keystone First $42 - $49 31%
Keystone First Chip $42 - $49 31%
La Care Health Plan $42 - $49 31%
Lakeland Care Inc $42 - $49 31%
Managed Health Services - Indiana $42 - $49 31%
Maryland Breast & Cervical Program $42 - $49 31%
Maryland Healthy Smiles - Scion Dental $42 - $49 31%
Maryland Physicians Care $42 - $49 31%
Massachusetts Behavioral Health Partnership $42 - $49 31%
Mdwise $42 - $49 31%
Medi-Cal $42 - $49 31%
Medi-Cal Healthnet $42 - $49 31%
Medstar Dc Healthy Family $42 - $49 31%
Medstar Md Health Choice $42 - $49 31%
Mo Home State Health Plan $42 - $49 31%
Molina Centennial Care $42 - $49 31%
Nascentia Health Options $42 - $49 31%
New York Cancer Services Program $42 - $49 31%
Nextlevel Health $42 - $49 31%
Oregon Screenwise $42 - $49 31%
Pace Of Southwest Michigan $42 - $79 31%
Paramount Advantage $42 - $49 31%
Parkland Community Health Plan $42 - $49 31%
Partners Behavioral Lme $42 - $49 31%
Peach State Healthplan $42 - $49 31%
Philadelphia County Funding $42 - $49 31%
Presbyterian Centennial Care $42 - $49 31%
Prestige Health Choice $42 - $49 31%
Priority Partners $42 - $49 31%
Robert F Sing Program $42 - $49 31%
Rx 340B Pass Along $42 - $49 31%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $42 - $49 31%
Rx Medi-Cal $42 - $49 31%
Rx Meridian Rx $42 - $49 31%
Ryan White Florida Mssrp $42 - $49 31%
Sandhills Center Lme $42 - $49 31%
Screening For Life $42 - $49 31%
St Joseph County Hlth Dpt $42 - $49 31%
Sunshine State Health Plan $42 - $49 31%
Superior Health $42 - $49 31%
Tenncare $42 - $49 31%
Texas Children'S Health Plan $42 - $49 31%
Trillium Community Ohp $42 - $49 31%
Tufts Health Public Plans $42 - $49 31%
Vaya Health Lme $42 - $49 31%
Washtenaw Health Plan $42 - $49 31%
Wellsense Health Plan $42 - $49 31%
Wi Womens Wellness $42 - $49 31%
Iowa Total Care $43 - $50 32%
Wellpoint $43 - $51 32%
Align Senior Care $67 - $79 49%
Ally Align Care Adv $67 - $79 49%
American Health Advantage Of Idaho $67 - $79 49%
Aurora Special Needs $67 - $79 49%
Blue Care Network Advantage $67 - $79 49%
Blue Shield - De (Highmark) Medciare Advantage $67 - $79 49%
Care Dimensions $67 - $79 49%
Care Improvement Plus $67 - $79 49%
Care Resources Pace $67 - $79 49%
Careplus Health Plans $67 - $79 49%
Cca - Zing Health $67 - $79 49%
Cca Senior Care Options $67 - $79 49%
Central Valley Medical Services Corp Pace $67 - $79 49%
Champion Health Plan Mcr Advantage $67 - $79 49%
Clear Spring Health $67 - $79 49%
Clover Health $67 - $79 49%
Commonwealth Care Alliance $67 - $79 49%
Community Pace At Home $67 - $79 49%
Eddy Senior Care-Pace $67 - $79 49%
Eddy Seniorcare Pace $67 - $79 49%
Elementcare $67 - $79 49%
Evercare $67 - $79 49%
Everence $67 - $79 49%
Gateway Health Plan $67 - $79 49%
Genesys Pace Of Genesee County $67 - $79 49%
Georgia Health Advantage $67 - $79 49%
Gold Advantage $67 - $79 49%
Gpa Croell Redi Mix $67 - $79 49%
Health America Advantra $67 - $79 49%
Highmark Health Options Dual Plan $67 - $79 49%
Hope Select Pace $67 - $79 49%
Horizon Nj Total Care $67 - $79 49%
Hudson Headwaters Pace $67 - $79 49%
Huron Valley Pace $67 - $79 49%
Innovative Integrated Health Community Plans $67 - $79 49%
Johns Hopkins Advantage Md $67 - $79 49%
Lasso Healthcare Msa $67 - $79 49%
Life St Marys Pace $67 - $79 49%
Lifecircles Pace $67 - $79 49%
Longevity Health Plan $67 - $79 49%
Longevity Ipa Of Michigan Llc Health Plan Isnp $67 - $79 49%
Martins Point Generations Advantage $67 - $79 49%
Mass General Brigham Mcr Adv $67 - $79 49%
Medicare (plans) $67 - $84 49%
Medipak Advantage $67 - $79 49%
Mercy Life $67 - $79 49%
Mercyone Cedar Valley $67 - $79 49%
Meridian Complete $67 - $79 49%
Michigan Complete Health $67 - $79 49%
Nascentia Health Plus $67 - $79 49%
New Centry Health Careplus $67 - $79 49%
Osu Prime Care Advantage $67 - $79 49%
Pace Cny $67 - $79 49%
Pace Iowa Immanuel Pathways $67 - $79 49%
Pace Southeast $67 - $79 49%
Pace-Trinity Health $67 - $79 49%
Peak Pace Solutions $67 - $79 49%
Perennial Advantage $67 - $79 49%
Preferred Care Partners $67 - $79 49%
Presbyterian Senior Plan $67 - $79 49%
Provider Partners Health Plan Of Illinois $67 - $79 49%
Provider Partners Health Plan Of Indiana $67 - $79 49%
Pruitthealth Premier $67 - $79 49%
Reliance Community Care Partners Care Resources Pace $67 - $79 49%
Rx Allwin $67 - $79 49%
Rx Grane Grnmedd $67 - $79 49%
Rx Retiree Rx Care $67 - $79 49%
Scan Health Plan Mcr Ipa Meritage Oon $67 - $79 49%
Secure Horizons Ma Pffs $67 - $79 49%
Serenity Pace $67 - $79 49%
Siouxland Pace $67 - $79 49%
Solis Health Plans $67 - $79 49%
Sunnyview-Pace Finance Dept $67 - $79 49%
Texan Plus $67 - $79 49%
The Health Plan $67 - $79 49%
Thome Pace $67 - $79 49%
Todays Options $67 - $79 49%
Tribute Health Plans $67 - $79 49%
Um Health Advantage $67 - $79 49%
Union Health Service $67 - $79 49%
Welbe Health $67 - $79 49%
Wellmed $67 - $79 49%
Veterans Administration $68 - $80 50%
American Health Plan $70 - $83 52%
Iowa Health Advantage $70 - $83 52%
Wc Corvel $76 56%

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