CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone North Iowa Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $835
  • Cash Discount Price: $1,292
  • vs. Medicare Baseline: 3.43x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone North Iowa Medical Center is $835. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,292. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 3.43x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$1,292

Average discount available for prompt cash payment at this facility.

Insurance Median
$835

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: $1,292 (530%)
Insurance Median: $835 (343%)
Cash: $1,292 (530% of Medicare)
Ins. Median: $835 (343% 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 343% of the Medicare baseline (a markup of 243%). 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 $127 - $1,252 52%
Medicare (plans) $127 - $262 52%
Blue Cross Blue Shield $128 - $542 53%
UnitedHealthcare $129 - $2,385 53%
Centivo $159 65%
Oscar $170 70%
Amish Hospital Aid $172 71%
Ambetter / Centene $217 89%
Claimdoc $260 107%
Nova $260 107%
Iowa Total Care $388 159%
Medicaid / KanCare $391 - $393 160%
Health Choices $407 - $611 167%
Medical Associates $407 - $611 167%
Bcn Domestic $538 - $542 221%
Blue Benefit Administrators Of Massachusetts $538 - $542 221%
Blue Care Network $538 - $542 221%
Blue Distinction Transplant $538 - $542 221%
Blue Shield - Ca $538 - $542 221%
Blue Shield - Id (Regence) $538 - $542 221%
Blue Shield - Ny Highmark Northeastern $538 - $542 221%
Blue Shield - Ny Highmark Western $538 - $542 221%
Blue Shield - Pa (Highmark) $538 - $542 221%
Blue Shield - Wa (Regence) $538 - $542 221%
Kaiser Domestic $538 - $542 221%
Pre-Employment $538 - $542 221%
Wc Domestic $538 - $542 221%
1199 National Benefit Fund $835 - $1,252 343%
Allied Benefit Systems $835 - $1,252 343%
Asr Health Benefits $835 - $1,252 343%
Christian Brother Services $835 - $1,252 343%
Coventry $835 - $1,252 343%
First Health $835 - $1,252 343%
Lucent Health $835 - $1,252 343%
Luminare Health $835 - $1,252 343%
Medical Mutual $835 - $1,252 343%
Meritain $835 - $1,252 343%
Trustmark Small Business Benefits $835 - $1,252 343%
Webtpa $835 - $1,252 343%
Preferred One $1,034 - $1,550 424%
Geha $1,051 431%
Health Partners $1,064 - $1,596 436%
Auxiant $1,113 - $1,670 457%
Cigna $1,113 - $1,670 457%
Medica $1,113 - $1,670 457%
Midlands $1,113 - $1,670 457%
Midlands Choice $1,113 - $1,670 457%
Mhnet $1,272 - $1,908 522%
Multiplan $1,431 - $2,146 587%
Crime Victim Assistance $1,590 - $2,385 652%
Iowa Dept Of Public Health $1,590 - $2,385 652%

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