CMS Price Transparency Data

Psychiatric evaluation (first visit)

Facility: Mercyone North Iowa Medical Center

Billing Code: 90791 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90791
  • Insurance Median: $150
  • Cash Discount Price: $358
  • vs. Medicare Baseline: 0.83x Medicare
The contracted insurance negotiated median rate for a Psychiatric evaluation (first visit) at Mercyone North Iowa Medical Center is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 0.83x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$358

Average discount available for prompt cash payment at this facility.

Insurance Median
$150

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)
Cash / Self-Pay: $358 (197%)
Insurance Median: $150 (83%)
Cash: $358 (197% of Medicare)
Ins. Median: $150 (83% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 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
Mhnet $75 41%
Medicaid / KanCare $85 - $219 47%
UnitedHealthcare $98 - $586 54%
American Health Plan $119 66%
Wc Corvel $129 71%
Aetna $133 - $377 73%
Align Senior Care $133 73%
Ally Align Care Adv $133 73%
American Health Advantage Of Idaho $133 73%
Aurora Special Needs $133 73%
Blue Care Network Advantage $133 73%
Blue Cross Blue Shield $133 - $208 73%
Blue Shield - De (Highmark) Medciare Advantage $133 73%
Care Dimensions $133 73%
Care Improvement Plus $133 73%
Care Resources Pace $133 73%
Careplus Health Plans $133 73%
Cca - Zing Health $133 73%
Cca Senior Care Options $133 73%
Central Valley Medical Services Corp Pace $133 73%
Champion Health Plan Mcr Advantage $133 73%
Cigna $133 - $366 73%
Clear Spring Health $133 73%
Clover Health $133 73%
Commonwealth Care Alliance $133 73%
Community Pace At Home $133 73%
Eddy Senior Care-Pace $133 73%
Eddy Seniorcare Pace $133 73%
Elementcare $133 73%
Evercare $133 73%
Everence $133 73%
Gateway Health Plan $133 73%
Genesys Pace Of Genesee County $133 73%
Georgia Health Advantage $133 73%
Gold Advantage $133 73%
Gpa Croell Redi Mix $133 73%
Health America Advantra $133 73%
Highmark Health Options Dual Plan $133 73%
Hope Select Pace $133 73%
Horizon Nj Total Care $133 73%
Hudson Headwaters Pace $133 73%
Humana $133 - $218 73%
Huron Valley Pace $133 73%
Innovative Integrated Health Community Plans $133 73%
Johns Hopkins Advantage Md $133 73%
Lasso Healthcare Msa $133 73%
Life St Marys Pace $133 73%
Lifecircles Pace $133 73%
Longevity Health Plan $133 73%
Longevity Ipa Of Michigan Llc Health Plan Isnp $133 73%
Martins Point Generations Advantage $133 73%
Mass General Brigham Mcr Adv $133 73%
Medicare (plans) $133 - $142 73%
Medipak Advantage $133 73%
Mercy Life $133 73%
Mercyone Cedar Valley $133 73%
Meridian Complete $133 73%
Michigan Complete Health $133 73%
Nascentia Health Plus $133 73%
New Centry Health Careplus $133 73%
Osu Prime Care Advantage $133 73%
Pace Cny $133 73%
Pace Iowa Immanuel Pathways $133 73%
Pace Of Southwest Michigan $133 - $150 73%
Pace Southeast $133 73%
Pace-Trinity Health $133 73%
Peak Pace Solutions $133 73%
Perennial Advantage $133 73%
Preferred Care Partners $133 73%
Presbyterian Senior Plan $133 73%
Provider Partners Health Plan Of Illinois $133 73%
Provider Partners Health Plan Of Indiana $133 73%
Pruitthealth Premier $133 73%
Reliance Community Care Partners Care Resources Pace $133 73%
Rx Allwin $133 73%
Rx Grane Grnmedd $133 73%
Rx Retiree Rx Care $133 73%
Scan Health Plan Mcr Ipa Meritage Oon $133 73%
Secure Horizons Ma Pffs $133 73%
Serenity Pace $133 73%
Siouxland Pace $133 73%
Solis Health Plans $133 73%
Sunnyview-Pace Finance Dept $133 73%
Texan Plus $133 73%
The Health Plan $133 73%
Thome Pace $133 73%
Todays Options $133 73%
Tribute Health Plans $133 73%
Um Health Advantage $133 73%
Union Health Service $133 73%
Welbe Health $133 73%
Wellmed $133 73%
Health Choices $134 - $216 74%
Medical Associates $134 - $227 74%
Veterans Administration $136 75%
Champva $140 77%
Iowa Health Advantage $140 77%
Tricare $140 77%
Triwest Health Alliance $140 77%
Us Family Health Plan $140 77%
Veterans Eval Services $140 77%
Amps $147 81%
Albany County Correctional Facility $150 83%
Ambetter / Centene $150 - $231 83%
Amish Mennonite $150 83%
Ascension St. Vincent Public Safety Medical $150 83%
Bcccp-Michigan $150 83%
Bccp $150 83%
Bmc Healthnet $150 83%
Breast Grant-Connecticut $150 83%
Broward County Dept Of Health $150 83%
California Health And Wellness $150 83%
Cardinal Innovations Lme $150 83%
Care Connections Of Northern Iowa $150 83%
Care Oregon Ohp $150 83%
Cencal Health Plan $150 83%
Cenpatico $150 83%
Chhuny $150 83%
Childrens Comm Health Plan $150 83%
Childrens Medical Services Title 19 $150 83%
City Of Philadelphia $150 83%
Cmh Allegan County $150 83%
Cmh Ausable Valley $150 83%
Cmh Barry County $150 83%
Cmh Bay-Arenac County $150 83%
Cmh Berrien County $150 83%
Cmh Cass County $150 83%
Cmh Central Mi County $150 83%
Cmh Clinton-Eaton-Ingham County $150 83%
Cmh Detroit Wayne Integrated Health Network $150 83%
Cmh Genesee County $150 83%
Cmh Ionia County $150 83%
Cmh Jackson County/Lifeways $150 83%
Cmh Kalamazoo $150 83%
Cmh Kent County $150 83%
Cmh Lenawee County $150 83%
Cmh Livingston County $150 83%
Cmh Macomb $150 83%
Cmh Misc $150 83%
Cmh Monroe County $150 83%
Cmh Montcalm County $150 83%
Cmh Muskegon County $150 83%
Cmh Newaygo County $150 83%
Cmh North Country $150 83%
Cmh Northern Lakes County $150 83%
Cmh Oakland County $150 83%
Cmh Ottawa County $150 83%
Cmh Van Buren County $150 83%
Cmh Washtenaw County $150 83%
Cmh Wayne County/Carelink $150 83%
Cmh Wayne Cty/Com Liv Svcs $150 83%
Cmh West Mi County $150 83%
Community Benefit Health $150 83%
Community Care Behavorial Health $150 83%
Community Care Partners $150 83%
Community Health Choice $150 83%
Connections Csp $150 83%
County Coroner $150 83%
County Funding Generic $150 83%
Covid19 Hrsa Uninsured Testing And Treatment Fund $150 83%
Dean Wi Badgercare $150 83%
Delaware County Department Of Health $150 83%
Delaware First Health $150 83%
Delta Dental Nj $150 83%
Dph Tb Program $150 83%
Dscc $150 83%
Eastpointe Lme $150 83%
Family Health Network $150 83%
Freedom First Healthcare $150 83%
Fresno County Ccs $150 83%
Ghc Scw Wi Badgercare $150 83%
Harbor Health $150 83%
Health Safety Net $150 83%
Healthy Blue Ne $150 83%
Hennepin Health $150 83%
Id County Ada $150 83%
Id County Canyon $150 83%
Id County Cat Fund $150 83%
Id County Other $150 83%
Id County Payette $150 83%
Idaho Dept Health And Wellfare $150 83%
Idaho Womens Health Check $150 83%
Indiana Breast Cervical Cancer $150 83%
Inland Empire Health Plan $150 83%
Intercommunity Health Ohp $150 83%
Jai Medical System $150 83%
Kern Family Health Plan $150 83%
Keystone First $150 83%
Keystone First Chip $150 83%
La Care Health Plan $150 83%
Lakeland Care Inc $150 83%
Managed Health Services - Indiana $150 83%
Maryland Breast & Cervical Program $150 83%
Maryland Healthy Smiles - Scion Dental $150 83%
Maryland Physicians Care $150 83%
Massachusetts Behavioral Health Partnership $150 83%
Mdwise $150 83%
Medi-Cal $150 83%
Medi-Cal Healthnet $150 83%
Medstar Dc Healthy Family $150 83%
Medstar Md Health Choice $150 83%
Mo Home State Health Plan $150 83%
Molina Centennial Care $150 83%
Nascentia Health Options $150 83%
New York Cancer Services Program $150 83%
Nextlevel Health $150 83%
Oregon Screenwise $150 83%
Paramount Advantage $150 83%
Parkland Community Health Plan $150 83%
Partners Behavioral Lme $150 83%
Peach State Healthplan $150 83%
Philadelphia County Funding $150 83%
Presbyterian Centennial Care $150 83%
Prestige Health Choice $150 83%
Priority Partners $150 83%
Robert F Sing Program $150 83%
Rx 340B Pass Along $150 83%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $150 83%
Rx Medi-Cal $150 83%
Rx Meridian Rx $150 83%
Ryan White Florida Mssrp $150 83%
Sandhills Center Lme $150 83%
Screening For Life $150 83%
St Joseph County Hlth Dpt $150 83%
Sunshine State Health Plan $150 83%
Superior Health $150 83%
Tenncare $150 83%
Texas Children'S Health Plan $150 83%
Trillium Community Ohp $150 83%
Tufts Health Public Plans $150 83%
Vaya Health Lme $150 83%
Washtenaw Health Plan $150 83%
Wellsense Health Plan $150 83%
Wi Womens Wellness $150 83%
Iowa Total Care $153 84%
Wellpoint $155 85%
Stephenson Cty Health $175 97%
Amish Hospital Aid $181 100%
Bcn Domestic $181 - $208 100%
Blue Benefit Administrators Of Massachusetts $181 - $208 100%
Blue Care Network $181 - $208 100%
Blue Distinction Transplant $181 - $208 100%
Blue Shield - Ca $181 - $208 100%
Blue Shield - Id (Regence) $181 - $208 100%
Blue Shield - Ny Highmark Northeastern $181 - $208 100%
Blue Shield - Ny Highmark Western $181 - $208 100%
Blue Shield - Pa (Highmark) $181 - $208 100%
Blue Shield - Wa (Regence) $181 - $208 100%
Kaiser Domestic $181 - $208 100%
Pre-Employment $181 - $208 100%
Wc Domestic $181 - $208 100%
Nebraska Total Care $199 110%
Avera $205 113%
Health Partners $206 - $350 114%
Allied Benefit Systems $216 - $275 119%
Auxiant $216 - $366 119%
First Choice Health $216 119%
Group Administrators $216 119%
Midlands $216 - $366 119%
Midlands Choice $216 - $366 119%
Sanford Health Plan $220 121%
Preferred Health Choice $225 124%
Health Smart $236 - $252 130%
Ucare $240 132%
Lucent Health $245 - $275 135%
Newton Correctional Facility $245 135%
Usa Managed Care $264 146%
Centivo $265 146%
1199 National Benefit Fund $275 152%
Asr Health Benefits $275 152%
Christian Brother Services $275 152%
Coventry $275 152%
First Health $275 152%
Luminare Health $275 152%
Medical Mutual $275 152%
Meritain $275 - $302 152%
Trustmark Small Business Benefits $275 152%
Webtpa $275 152%
Genex Wc $283 156%
Claimdoc $285 157%
Wc Align Network $302 167%
Preferred One $304 - $340 168%
Global Excel $308 170%
Velocity $320 176%
Wc Praxis Health Network $320 176%
Wc Reny Company $328 181%
Wc Velocity $328 181%
Quiktrip $330 182%
Multiplan $336 - $471 185%
Geha $337 - $586 186%
Auto Velocity $339 187%
Wc O'Hara Corp $339 187%
The Alliance $355 196%
Medica $366 - $377 202%
Andrie Inc $377 208%
East Greenbush Central School District $377 208%
Healthsmart Workers Comp $377 208%
Iowa Dept Of Public Health $377 - $523 208%
Jag Source $377 208%
New York State Insurance Fund $377 208%
Njm Insurance Group $377 208%
Oscar $377 208%
Rx Heatlhcomp $377 208%
Rx Restat $377 208%
Rx Saif Opdp Wc $377 208%
Rx Worker'S Comp $377 208%
Wc Accident Fund $377 208%
Wc Ace $377 208%
Wc Acs Federal Employees $377 208%
Wc Acuity $377 208%
Wc Advantage $377 208%
Wc Aegis $377 208%
Wc Aig $377 208%
Wc Aims $377 208%
Wc Alaska National Ins $377 208%
Wc Allied $377 208%
Wc Am Trust N America $377 208%
Wc American Claims Mgmt $377 208%
Wc Amerisure $377 208%
Wc Amtrust $377 208%
Wc Asu Risk Mgt $377 208%
Wc Benetech $377 208%
Wc Berkley Admin $377 208%
Wc Broadspire $377 208%
Wc Broward County $377 208%
Wc Bunch & Associates $377 208%
Wc California State Comp Ins $377 208%
Wc California State Ins Fund $377 208%
Wc Capitol Area Health Consortium $377 208%
Wc Ccmsi $377 208%
Wc Chartis $377 208%
Wc Chubb $377 208%
Wc Cirma $377 208%
Wc City Of Albany $377 208%
Wc City Of Sioux City $377 208%
Wc Claims Mgmt Inc $377 208%
Wc Cna $377 208%
Wc Comp One Admin C/O Manageability $377 208%
Wc Compone Admin $377 208%
Wc Ct Healthcare Trust $377 208%
Wc Donegal Insurance Group $377 208%
Wc Emc Insurance Company $377 208%
Wc Employee Mutual $377 208%
Wc Enablecomp $377 208%
Wc Encore Health Network $377 208%
Wc Erie $377 208%
Wc Esis $377 208%
Wc Evolutions $377 208%
Wc Fcci $377 208%
Wc Fed Ex $377 208%
Wc Federal Black Lung $377 208%
Wc Federated $377 208%
Wc Finley Occupational Health $377 208%
Wc First Agency/Occunet $377 208%
Wc Ford Motor $377 208%
Wc Fresno Unified Emp $377 208%
Wc Gallagher Bassett $377 208%
Wc General Motors $377 208%
Wc Generic $377 208%
Wc Genex Care For Ohio $377 208%
Wc Great West Casualty $377 208%
Wc Guarantee Insurance $377 208%
Wc Guard Insurance Company $377 208%
Wc Hab $377 208%
Wc Hartford $377 208%
Wc Hastings $377 208%
Wc Health Management $377 208%
Wc Heritage Summit $377 208%
Wc Hireright $377 208%
Wc Horizon $377 208%
Wc Icw Group $377 208%
Wc Idaho State Ins Fund $377 208%
Wc Intercare Insurance $377 208%
Wc Intermountain $377 208%
Wc Johns Eastern $377 208%
Wc Kemberton $377 208%
Wc Key Ins & Benefit Solutions $377 208%
Wc Liberty Mutual $377 208%
Wc Mac Risk Management $377 208%
Wc Massachusetts $377 208%
Wc Mdia $377 208%
Wc Meadowbrook Claim $377 208%
Wc Medical Administrators $377 208%
Wc Meijers $377 208%
Wc Memic $377 208%
Wc Mercy Workcare $377 208%
Wc Michigan $377 208%
Wc Michigan Millers Mutual $377 208%
Wc Mitchell Frankenmuth $377 208%
Wc Mra $377 208%
Wc Nationwide $377 208%
Wc Nca Comp $377 208%
Wc New York $377 208%
Wc New York Special Funds $377 208%
Wc North American Rishces $377 208%
Wc Northeast Health $377 208%
Wc Notre Dame $377 208%
Wc Novanet $377 208%
Wc Occ Health Allen $377 208%
Wc Ohio Bureau $377 208%
Wc One Call Medical $377 208%
Wc Paradigm $377 208%
Wc Peerless $377 208%
Wc Pma $377 208%
Wc Price Chopper $377 208%
Wc Procura Management $377 208%
Wc Qualcare $377 208%
Wc Quiktrip $377 208%
Wc Rev Claims $377 208%
Wc Risico $377 208%
Wc Rural Mutual $377 208%
Wc Saif Oregon $377 208%
Wc Secura $377 208%
Wc Sedgwick $377 208%
Wc Sentry $377 208%
Wc Sheakley Unicomp $377 208%
Wc Smile Lodge $377 208%
Wc Society $377 208%
Wc Srs $377 208%
Wc Taconic (Mro) $377 208%
Wc Taconic Farms $377 208%
Wc Travelers $377 208%
Wc Triad Group $377 208%
Wc Tristar $377 208%
Wc Troy Ny $377 208%
Wc Tyson $377 208%
Wc Unified Health Services $377 208%
Wc United Heartland $377 208%
Wc Us Dept Of Labor $377 208%
Wc Walmart $377 208%
Wc West Bend $377 208%
Wc West Bend Mutual/Argent $377 208%
Wc Winnebago Industries $377 208%
Wc Yankee Trails $377 208%
Wc York Risk $377 208%
Wc Zenith $377 208%
Wc Zurich $377 208%
Crime Victim Assistance $523 288%

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