CMS Price Transparency Data

Psychological testing evaluation

Facility: Mercyone North Iowa Medical Center

Billing Code: 96136 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96136
  • Insurance Median: $46
  • Cash Discount Price: $191
  • vs. Medicare Baseline: 0.34x Medicare
The contracted insurance negotiated median rate for a Psychological testing evaluation at Mercyone North Iowa Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $135.93, this hospital’s rate is 0.34x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$191

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.93

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.93 (100%)
Cash / Self-Pay: $191 (141%)
Insurance Median: $46 (34%)
Cash: $191 (141% of Medicare)
Ins. Median: $46 (34% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.93 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
Medicaid / KanCare $13 - $141 10%
American Health Plan $18 13%
Aetna $20 - $194 15%
Align Senior Care $20 15%
Ally Align Care Adv $20 15%
American Health Advantage Of Idaho $20 15%
Aurora Special Needs $20 15%
Blue Care Network Advantage $20 15%
Blue Cross Blue Shield $20 - $136 15%
Blue Shield - De (Highmark) Medciare Advantage $20 15%
Care Dimensions $20 15%
Care Improvement Plus $20 15%
Care Resources Pace $20 15%
Careplus Health Plans $20 15%
Cca - Zing Health $20 15%
Cca Senior Care Options $20 15%
Central Valley Medical Services Corp Pace $20 15%
Champion Health Plan Mcr Advantage $20 15%
Cigna $20 - $259 15%
Clear Spring Health $20 15%
Clover Health $20 15%
Commonwealth Care Alliance $20 15%
Community Pace At Home $20 15%
Eddy Senior Care-Pace $20 15%
Eddy Seniorcare Pace $20 15%
Elementcare $20 15%
Evercare $20 15%
Everence $20 15%
Gateway Health Plan $20 15%
Genesys Pace Of Genesee County $20 15%
Georgia Health Advantage $20 15%
Gold Advantage $20 15%
Gpa Croell Redi Mix $20 15%
Health America Advantra $20 15%
Highmark Health Options Dual Plan $20 15%
Hope Select Pace $20 15%
Horizon Nj Total Care $20 15%
Hudson Headwaters Pace $20 15%
Humana $20 - $46 15%
Huron Valley Pace $20 15%
Innovative Integrated Health Community Plans $20 15%
Johns Hopkins Advantage Md $20 15%
Lasso Healthcare Msa $20 15%
Life St Marys Pace $20 15%
Lifecircles Pace $20 15%
Longevity Health Plan $20 15%
Longevity Ipa Of Michigan Llc Health Plan Isnp $20 15%
Martins Point Generations Advantage $20 15%
Mass General Brigham Mcr Adv $20 15%
Medicare (plans) $20 - $22 15%
Medipak Advantage $20 15%
Mercy Life $20 15%
Mercyone Cedar Valley $20 15%
Meridian Complete $20 15%
Michigan Complete Health $20 15%
Nascentia Health Plus $20 15%
New Centry Health Careplus $20 15%
Osu Prime Care Advantage $20 15%
Pace Cny $20 15%
Pace Iowa Immanuel Pathways $20 15%
Pace Of Southwest Michigan $20 - $46 15%
Pace Southeast $20 15%
Pace-Trinity Health $20 15%
Peak Pace Solutions $20 15%
Perennial Advantage $20 15%
Preferred Care Partners $20 15%
Presbyterian Senior Plan $20 15%
Provider Partners Health Plan Of Illinois $20 15%
Provider Partners Health Plan Of Indiana $20 15%
Pruitthealth Premier $20 15%
Reliance Community Care Partners Care Resources Pace $20 15%
Rx Allwin $20 15%
Rx Grane Grnmedd $20 15%
Rx Retiree Rx Care $20 15%
Scan Health Plan Mcr Ipa Meritage Oon $20 15%
Secure Horizons Ma Pffs $20 15%
Serenity Pace $20 15%
Siouxland Pace $20 15%
Solis Health Plans $20 15%
Sunnyview-Pace Finance Dept $20 15%
Texan Plus $20 15%
The Health Plan $20 15%
Thome Pace $20 15%
Todays Options $20 15%
Tribute Health Plans $20 15%
Um Health Advantage $20 15%
Union Health Service $20 15%
UnitedHealthcare $20 - $586 15%
Wc Corvel $20 15%
Welbe Health $20 15%
Wellmed $20 15%
Iowa Health Advantage $21 15%
Veterans Administration $21 15%
Amps $22 16%
Champva $22 16%
Tricare $22 16%
Triwest Health Alliance $22 16%
Us Family Health Plan $22 16%
Veterans Eval Services $22 16%
Amish Hospital Aid $28 21%
Avera $31 23%
Preferred Health Choice $34 25%
Sanford Health Plan $34 25%
Ambetter / Centene $35 - $46 26%
Medical Associates $35 - $95 26%
Health Smart $36 - $38 26%
Lucent Health $37 - $194 27%
Ucare $37 27%
Centivo $40 29%
Oscar $40 29%
Usa Managed Care $40 29%
Health Partners $42 - $248 31%
Claimdoc $43 32%
Bcn Domestic $45 - $136 33%
Blue Benefit Administrators Of Massachusetts $45 - $136 33%
Blue Care Network $45 - $136 33%
Blue Distinction Transplant $45 - $136 33%
Blue Shield - Ca $45 - $136 33%
Blue Shield - Id (Regence) $45 - $136 33%
Blue Shield - Ny Highmark Northeastern $45 - $136 33%
Blue Shield - Ny Highmark Western $45 - $136 33%
Blue Shield - Pa (Highmark) $45 - $136 33%
Blue Shield - Wa (Regence) $45 - $136 33%
Health Choices $45 - $95 33%
Kaiser Domestic $45 - $136 33%
Pre-Employment $45 - $136 33%
Stephenson Cty Health $45 33%
Wc Domestic $45 - $136 33%
Albany County Correctional Facility $46 34%
Amish Mennonite $46 34%
Ascension St. Vincent Public Safety Medical $46 34%
Bcccp-Michigan $46 34%
Bccp $46 34%
Bmc Healthnet $46 34%
Breast Grant-Connecticut $46 34%
Broward County Dept Of Health $46 34%
California Health And Wellness $46 34%
Cardinal Innovations Lme $46 34%
Care Connections Of Northern Iowa $46 34%
Care Oregon Ohp $46 34%
Cencal Health Plan $46 34%
Cenpatico $46 34%
Chhuny $46 34%
Childrens Comm Health Plan $46 34%
Childrens Medical Services Title 19 $46 34%
City Of Philadelphia $46 34%
Cmh Allegan County $46 34%
Cmh Ausable Valley $46 34%
Cmh Barry County $46 34%
Cmh Bay-Arenac County $46 34%
Cmh Berrien County $46 34%
Cmh Cass County $46 34%
Cmh Central Mi County $46 34%
Cmh Clinton-Eaton-Ingham County $46 34%
Cmh Detroit Wayne Integrated Health Network $46 34%
Cmh Genesee County $46 34%
Cmh Ionia County $46 34%
Cmh Jackson County/Lifeways $46 34%
Cmh Kalamazoo $46 34%
Cmh Kent County $46 34%
Cmh Lenawee County $46 34%
Cmh Livingston County $46 34%
Cmh Macomb $46 34%
Cmh Misc $46 34%
Cmh Monroe County $46 34%
Cmh Montcalm County $46 34%
Cmh Muskegon County $46 34%
Cmh Newaygo County $46 34%
Cmh North Country $46 34%
Cmh Northern Lakes County $46 34%
Cmh Oakland County $46 34%
Cmh Ottawa County $46 34%
Cmh Van Buren County $46 34%
Cmh Washtenaw County $46 34%
Cmh Wayne County/Carelink $46 34%
Cmh Wayne Cty/Com Liv Svcs $46 34%
Cmh West Mi County $46 34%
Community Benefit Health $46 34%
Community Care Behavorial Health $46 34%
Community Care Partners $46 34%
Community Health Choice $46 34%
Connections Csp $46 34%
County Coroner $46 34%
County Funding Generic $46 34%
Covid19 Hrsa Uninsured Testing And Treatment Fund $46 34%
Dean Wi Badgercare $46 34%
Delaware County Department Of Health $46 34%
Delaware First Health $46 34%
Delta Dental Nj $46 34%
Dph Tb Program $46 34%
Dscc $46 34%
Eastpointe Lme $46 34%
Family Health Network $46 34%
Freedom First Healthcare $46 34%
Fresno County Ccs $46 34%
Ghc Scw Wi Badgercare $46 34%
Harbor Health $46 34%
Health Safety Net $46 34%
Healthy Blue Ne $46 34%
Hennepin Health $46 34%
Id County Ada $46 34%
Id County Canyon $46 34%
Id County Cat Fund $46 34%
Id County Other $46 34%
Id County Payette $46 34%
Idaho Dept Health And Wellfare $46 34%
Idaho Womens Health Check $46 34%
Indiana Breast Cervical Cancer $46 34%
Inland Empire Health Plan $46 34%
Intercommunity Health Ohp $46 34%
Jai Medical System $46 34%
Kern Family Health Plan $46 34%
Keystone First $46 34%
Keystone First Chip $46 34%
La Care Health Plan $46 34%
Lakeland Care Inc $46 34%
Managed Health Services - Indiana $46 34%
Maryland Breast & Cervical Program $46 34%
Maryland Healthy Smiles - Scion Dental $46 34%
Maryland Physicians Care $46 34%
Massachusetts Behavioral Health Partnership $46 34%
Mdwise $46 34%
Medi-Cal $46 34%
Medi-Cal Healthnet $46 34%
Medstar Dc Healthy Family $46 34%
Medstar Md Health Choice $46 34%
Mo Home State Health Plan $46 34%
Molina Centennial Care $46 34%
Nascentia Health Options $46 34%
New York Cancer Services Program $46 34%
Nextlevel Health $46 34%
Oregon Screenwise $46 34%
Paramount Advantage $46 34%
Parkland Community Health Plan $46 34%
Partners Behavioral Lme $46 34%
Peach State Healthplan $46 34%
Philadelphia County Funding $46 34%
Presbyterian Centennial Care $46 34%
Prestige Health Choice $46 34%
Priority Partners $46 34%
Robert F Sing Program $46 34%
Rx 340B Pass Along $46 34%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $46 34%
Rx Medi-Cal $46 34%
Rx Meridian Rx $46 34%
Ryan White Florida Mssrp $46 34%
Sandhills Center Lme $46 34%
Screening For Life $46 34%
St Joseph County Hlth Dpt $46 34%
Sunshine State Health Plan $46 34%
Superior Health $46 34%
Tenncare $46 34%
Texas Children'S Health Plan $46 34%
Trillium Community Ohp $46 34%
Tufts Health Public Plans $46 34%
Vaya Health Lme $46 34%
Washtenaw Health Plan $46 34%
Wellsense Health Plan $46 34%
Wi Womens Wellness $46 34%
Global Excel $47 35%
Iowa Total Care $47 35%
Preferred One $47 - $240 35%
Wellpoint $47 35%
Velocity $49 36%
Multiplan $52 - $333 38%
Allied Benefit Systems $60 - $194 44%
Auxiant $60 - $259 44%
First Choice Health $60 44%
Group Administrators $60 44%
Midlands $60 - $259 44%
Midlands Choice $60 - $259 44%
Meritain $65 - $194 48%
Geha $66 - $586 49%
Quiktrip $80 59%
The Alliance $87 64%
Newton Correctional Facility $92 68%
Genex Wc $106 78%
Wc Align Network $113 83%
Wc Praxis Health Network $120 88%
Wc Reny Company $123 90%
Wc Velocity $123 90%
Auto Velocity $127 93%
Wc O'Hara Corp $127 93%
Nebraska Total Care $135 99%
Andrie Inc $141 104%
East Greenbush Central School District $141 104%
Healthsmart Workers Comp $141 104%
Iowa Dept Of Public Health $141 - $370 104%
Jag Source $141 104%
Medica $141 - $259 104%
New York State Insurance Fund $141 104%
Njm Insurance Group $141 104%
Rx Heatlhcomp $141 104%
Rx Restat $141 104%
Rx Saif Opdp Wc $141 104%
Rx Worker'S Comp $141 104%
Wc Accident Fund $141 104%
Wc Ace $141 104%
Wc Acs Federal Employees $141 104%
Wc Acuity $141 104%
Wc Advantage $141 104%
Wc Aegis $141 104%
Wc Aig $141 104%
Wc Aims $141 104%
Wc Alaska National Ins $141 104%
Wc Allied $141 104%
Wc Am Trust N America $141 104%
Wc American Claims Mgmt $141 104%
Wc Amerisure $141 104%
Wc Amtrust $141 104%
Wc Asu Risk Mgt $141 104%
Wc Benetech $141 104%
Wc Berkley Admin $141 104%
Wc Broadspire $141 104%
Wc Broward County $141 104%
Wc Bunch & Associates $141 104%
Wc California State Comp Ins $141 104%
Wc California State Ins Fund $141 104%
Wc Capitol Area Health Consortium $141 104%
Wc Ccmsi $141 104%
Wc Chartis $141 104%
Wc Chubb $141 104%
Wc Cirma $141 104%
Wc City Of Albany $141 104%
Wc City Of Sioux City $141 104%
Wc Claims Mgmt Inc $141 104%
Wc Cna $141 104%
Wc Comp One Admin C/O Manageability $141 104%
Wc Compone Admin $141 104%
Wc Ct Healthcare Trust $141 104%
Wc Donegal Insurance Group $141 104%
Wc Emc Insurance Company $141 104%
Wc Employee Mutual $141 104%
Wc Enablecomp $141 104%
Wc Encore Health Network $141 104%
Wc Erie $141 104%
Wc Esis $141 104%
Wc Evolutions $141 104%
Wc Fcci $141 104%
Wc Fed Ex $141 104%
Wc Federal Black Lung $141 104%
Wc Federated $141 104%
Wc Finley Occupational Health $141 104%
Wc First Agency/Occunet $141 104%
Wc Ford Motor $141 104%
Wc Fresno Unified Emp $141 104%
Wc Gallagher Bassett $141 104%
Wc General Motors $141 104%
Wc Generic $141 104%
Wc Genex Care For Ohio $141 104%
Wc Great West Casualty $141 104%
Wc Guarantee Insurance $141 104%
Wc Guard Insurance Company $141 104%
Wc Hab $141 104%
Wc Hartford $141 104%
Wc Hastings $141 104%
Wc Health Management $141 104%
Wc Heritage Summit $141 104%
Wc Hireright $141 104%
Wc Horizon $141 104%
Wc Icw Group $141 104%
Wc Idaho State Ins Fund $141 104%
Wc Intercare Insurance $141 104%
Wc Intermountain $141 104%
Wc Johns Eastern $141 104%
Wc Kemberton $141 104%
Wc Key Ins & Benefit Solutions $141 104%
Wc Liberty Mutual $141 104%
Wc Mac Risk Management $141 104%
Wc Massachusetts $141 104%
Wc Mdia $141 104%
Wc Meadowbrook Claim $141 104%
Wc Medical Administrators $141 104%
Wc Meijers $141 104%
Wc Memic $141 104%
Wc Mercy Workcare $141 104%
Wc Michigan $141 104%
Wc Michigan Millers Mutual $141 104%
Wc Mitchell Frankenmuth $141 104%
Wc Mra $141 104%
Wc Nationwide $141 104%
Wc Nca Comp $141 104%
Wc New York $141 104%
Wc New York Special Funds $141 104%
Wc North American Rishces $141 104%
Wc Northeast Health $141 104%
Wc Notre Dame $141 104%
Wc Novanet $141 104%
Wc Occ Health Allen $141 104%
Wc Ohio Bureau $141 104%
Wc One Call Medical $141 104%
Wc Paradigm $141 104%
Wc Peerless $141 104%
Wc Pma $141 104%
Wc Price Chopper $141 104%
Wc Procura Management $141 104%
Wc Qualcare $141 104%
Wc Quiktrip $141 104%
Wc Rev Claims $141 104%
Wc Risico $141 104%
Wc Rural Mutual $141 104%
Wc Saif Oregon $141 104%
Wc Secura $141 104%
Wc Sedgwick $141 104%
Wc Sentry $141 104%
Wc Sheakley Unicomp $141 104%
Wc Smile Lodge $141 104%
Wc Society $141 104%
Wc Srs $141 104%
Wc Taconic (Mro) $141 104%
Wc Taconic Farms $141 104%
Wc Travelers $141 104%
Wc Triad Group $141 104%
Wc Tristar $141 104%
Wc Troy Ny $141 104%
Wc Tyson $141 104%
Wc Unified Health Services $141 104%
Wc United Heartland $141 104%
Wc Us Dept Of Labor $141 104%
Wc Walmart $141 104%
Wc West Bend $141 104%
Wc West Bend Mutual/Argent $141 104%
Wc Winnebago Industries $141 104%
Wc Yankee Trails $141 104%
Wc York Risk $141 104%
Wc Zenith $141 104%
Wc Zurich $141 104%
1199 National Benefit Fund $194 143%
Asr Health Benefits $194 143%
Christian Brother Services $194 143%
Coventry $194 143%
First Health $194 143%
Luminare Health $194 143%
Medical Mutual $194 143%
Trustmark Small Business Benefits $194 143%
Webtpa $194 143%
Mhnet $296 218%
Crime Victim Assistance $370 272%

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