CMS Price Transparency Data

Hip or knee replacement (inpatient stay)

Facility: Mercyone North Iowa Medical Center

Billing Code: 470 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$18,543

about 1.3× the $14,044 Medicare rate · typically $16,171–$27,287

modeled estimate · not a bill or quote

What this hospital charges insurers

$18,502

About the fair price

about $41 under the fair price · 1.3× Medicare

Medicare pays $14,044 Fair price $18,543 This hospital $18,502 Cash price $88,101

How we calculate the fair BaseRate →

How this hospital compares to other IA hospitals

Highest price of the 9 IA hospitals we have prices for — worth calling around.

Cheapest $12,978 Priciest $18,502

Black dot = this hospital, among the 9 IA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Hip or knee replacement (inpatient stay) is about $18,543 (about 1.3× the $14,044 Medicare rate). Mercyone North Iowa Medical Center charges insurers about $18,502, or about $88,101 in cash — about the fair price. Located in Mason City, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser 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	$14,351 - $33,843	102%
Blue Cross Blue Shieldmajor	$14,210	101%
Aetnamajor	$14,070	100%
Ambetter (Centene)	$24,119	172%
GEHA	$33,843	241%
Oscar Health	$18,502	132%
+ 6 smaller / regional plans	$16,408 - $28,857

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 88,101), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 470.

Insurance Before you use insurance

Call your insurance company to confirm Mercyone North Iowa Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 470.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercyone North Iowa Medical Center

Compare: Hip or knee replacement (inpatient stay) at other IA hospitals

Henry County Health Center · Mount Pleasant $12,978
Grinnell Regional Medical Center · Grinnell $13,111
Mary Greeley Medical Center · Ames $13,242
St Lukes Hospital · Cedar Rapids $14,029
University of Iowa Health Care Medical Center Down · Iowa City $14,100
Allen Hospital · Waterloo $14,206
Finley Hospital · Dubuque $14,734
Spencer Municipal Hospital · Spencer $14,970

Insurance negotiated median for the same procedure, sorted lowest first.