CMS Price Transparency Data

CT scan, pelvis

Facility: Mercyone North Iowa Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $227
  • Cash Discount Price: $1,158
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercyone North Iowa Medical Center is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,158. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.13x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$1,158

Average discount available for prompt cash payment at this facility.

Insurance Median
$227

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $1,158 (1084%)
Insurance Median: $227 (213%)
Cash: $1,158 (1084% of Medicare)
Ins. Median: $227 (213% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 213% of the Medicare baseline (a markup of 113%). 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
Iowa Total Care $101 95%
Medicaid / KanCare $102 - $103 95%
Bcn Domestic $107 100%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Cross Blue Shield $107 - $112 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Kaiser Domestic $107 100%
Pre-Employment $107 100%
Wc Domestic $107 100%
Aetna $110 - $935 103%
Medicare (plans) $110 - $115 103%
UnitedHealthcare $113 - $1,781 106%
Centivo $139 130%
Oscar $149 140%
Amish Hospital Aid $150 140%
Ambetter / Centene $189 177%
Claimdoc $226 212%
Nova $226 212%
Geha $240 225%
Health Choices $456 427%
Medical Associates $456 427%
1199 National Benefit Fund $935 875%
Allied Benefit Systems $935 875%
Asr Health Benefits $935 875%
Christian Brother Services $935 875%
Coventry $935 875%
First Health $935 875%
Lucent Health $935 875%
Luminare Health $935 875%
Medical Mutual $935 875%
Meritain $935 875%
Trustmark Small Business Benefits $935 875%
Webtpa $935 875%
Preferred One $1,158 1084%
Health Partners $1,191 1115%
Auxiant $1,247 1167%
Cigna $1,247 1167%
Medica $1,247 1167%
Midlands $1,247 1167%
Midlands Choice $1,247 1167%
Mhnet $1,425 1334%
Multiplan $1,603 1501%
Crime Victim Assistance $1,781 1667%
Iowa Dept Of Public Health $1,781 1667%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals