CMS Price Transparency Data

Injection procedure for pain management

Facility: Mercyone Waterloo Medical Center

Billing Code: G0260 (HCPCS)

The BaseRate · fair price high confidence

A fair price for this

$663

about 0.9× the $721 Medicare rate · typically $426–$920

modeled estimate · not a bill or quote

What this hospital charges insurers

$721

About the fair price

about $58 over the fair price · 1.0× Medicare

Medicare pays $721 Fair price $663 This hospital $721 Hospital's list price $2,408

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 $229 Priciest $721

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

A fair price for a Injection procedure for pain management is about $663 (about 0.9× the $721 Medicare rate). Mercyone Waterloo Medical Center charges insurers about $721 — about the fair price. Located in Waterloo, IA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

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	$678 - $2,889	94%
Blue Cross Blue Shieldmajor	$314 - $721	44%
Aetnamajor	$665 - $3,576	92%
Cignamajor	$1,367 - $2,051	190%
Kaiser Permanentemajor	$721	100%
Ambetter (Centene)	$116 - $496	16%
HealthPartners	$1,263 - $1,895	175%
Medica	$1,367 - $2,051	190%
Medical Mutual	$3,576	496%
Oscar Health	$106 - $453	15%
+ 20 smaller / regional plans	$92 - $3,576

Government programs also on file: Medicare, Medicaid.

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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, 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 HCPCS code on your bill matches exactly: G0260.

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 HCPCS code G0260.
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 (%)

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Other Procedures at Mercyone Waterloo Medical Center

Compare: Injection procedure for pain management at other IA hospitals

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