CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercyone North Iowa Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $113
  • Cash Discount Price: $1,471
  • vs. Medicare Baseline: 1.06x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercyone North Iowa Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,471. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$1,471

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $1,471 (1377%)
Insurance Median: $113 (106%)
Cash: $1,471 (1377% of Medicare)
Ins. Median: $113 (106% 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.

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 - $604 103%
Medicare (plans) $110 - $115 103%
UnitedHealthcare $113 - $1,150 106%
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 $294 275%
Medical Associates $294 275%
1199 National Benefit Fund $604 565%
Allied Benefit Systems $604 565%
Asr Health Benefits $604 565%
Christian Brother Services $604 565%
Coventry $604 565%
First Health $604 565%
Lucent Health $604 565%
Luminare Health $604 565%
Medical Mutual $604 565%
Meritain $604 565%
Trustmark Small Business Benefits $604 565%
Webtpa $604 565%
Preferred One $748 700%
Health Partners $769 720%
Auxiant $805 754%
Cigna $805 754%
Medica $805 754%
Midlands $805 754%
Midlands Choice $805 754%
Mhnet $920 861%
Multiplan $1,035 969%
Crime Victim Assistance $1,150 1077%
Iowa Dept Of Public Health $1,150 1077%

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