CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Mercyone Waterloo Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,543

about 1.3× the $5,676 Medicare rate · typically $6,220–$8,725

modeled estimate · not a bill or quote

What this hospital charges insurers

$9,190

Above the fair price

about $1,647 over the fair price · 1.6× Medicare

Medicare pays $5,676 Fair price $7,543 This hospital $9,190 Cash price $18,390

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 $5,245 Priciest $9,190

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

A fair price for a Digestive disorders treatment (inpatient stay) is about $7,543 (about 1.3× the $5,676 Medicare rate). Mercyone Waterloo Medical Center charges insurers about $9,190, or about $18,390 in cash — above the fair price. Located in Waterloo, IA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $7,543. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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	$6,868 - $9,241	121%
Blue Cross Blue Shieldmajor	$6,801	120%
Aetnamajor	$6,734	119%
Ambetter (Centene)	$11,543	203%
GEHA	$9,241	163%
Oscar Health	$8,922	157%
+ 5 smaller / regional plans	$5,081 - $13,811

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 18,390), 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: 392.

Insurance Before you use insurance

Call your insurance company to confirm Mercyone Waterloo Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
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 Waterloo Medical Center

Compare: Digestive disorders treatment (inpatient stay) at other IA hospitals

Henry County Health Center · Mount Pleasant $5,245
Grinnell Regional Medical Center · Grinnell $5,426
Mary Greeley Medical Center · Ames $5,456
University of Iowa Health Care Medical Center Down · Iowa City $5,841
St Lukes Hospital · Cedar Rapids $5,977
Ottumwa Regional Health Center · Ottumwa $6,053
Finley Hospital · Dubuque $6,098
Spencer Municipal Hospital · Spencer $6,167

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