CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Mercyone Dubuque Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $31
  • Cash Discount Price: $140
  • vs. Medicare Baseline: 0.33x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercyone Dubuque Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.33x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$140

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $140 (147%)
Insurance Median: $31 (33%)
Cash: $140 (147% of Medicare)
Ins. Median: $31 (33% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 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
Champva $10 - $60 11%
Humana $10 - $88 11%
Tricare $10 - $60 11%
Triwest Health Alliance $10 - $60 11%
Us Family Health Plan $10 - $60 11%
Veterans Eval Services $10 - $60 11%
Medicaid / KanCare $11 - $75 12%
Amish Hospital Aid $12 - $73 13%
Amps $12 - $74 13%
Avera $13 - $83 14%
Multiplan $13 - $127 14%
Health Partners $14 - $101 15%
Ambetter / Centene $15 - $93 16%
Bcn Domestic $15 - $93 16%
Blue Benefit Administrators Of Massachusetts $15 - $93 16%
Blue Care Network $15 - $93 16%
Blue Cross Blue Shield $15 - $93 16%
Blue Distinction Transplant $15 - $93 16%
Blue Shield - Ca $15 - $93 16%
Blue Shield - Id (Regence) $15 - $93 16%
Blue Shield - Ny Highmark Northeastern $15 - $93 16%
Blue Shield - Ny Highmark Western $15 - $93 16%
Blue Shield - Pa (Highmark) $15 - $93 16%
Blue Shield - Wa (Regence) $15 - $93 16%
Health Choices $15 - $112 16%
Kaiser Domestic $15 - $93 16%
Newton Correctional Facility $15 - $92 16%
Pre-Employment $15 - $93 16%
Sanford Health Plan $15 - $92 16%
Wc Domestic $15 - $93 16%
Health Smart $16 - $101 17%
Lucent Health $16 - $98 17%
Medical Associates $16 - $98 17%
Oscar $16 - $101 17%
Stephenson Cty Health $16 - $100 17%
Ucare $16 - $97 17%
Centivo $17 - $107 18%
Geha $17 - $109 18%
Genex Wc $17 - $106 18%
UnitedHealthcare $17 - $109 18%
Usa Managed Care $17 - $106 18%
Claimdoc $18 - $114 19%
The Alliance $18 - $115 19%
Wc Align Network $18 - $113 19%
Aetna $19 - $141 20%
Meritain $19 - $121 20%
Wc Praxis Health Network $19 - $120 20%
Wc Reny Company $19 - $123 20%
Wc Velocity $19 - $123 20%
Auto Velocity $20 - $127 21%
Global Excel $20 - $124 21%
Wc O'Hara Corp $20 - $127 21%
Preferred One $21 - $132 22%
Velocity $21 - $129 22%
Allied Benefit Systems $22 - $112 23%
Andrie Inc $22 - $141 23%
Auxiant $22 - $112 23%
Cigna $22 - $112 23%
East Greenbush Central School District $22 - $141 23%
First Choice Health $22 - $112 23%
Group Administrators $22 - $112 23%
Healthsmart Workers Comp $22 - $141 23%
Iowa Dept Of Public Health $22 - $60 23%
Jag Source $22 - $141 23%
Midlands $22 - $112 23%
Midlands Choice $22 - $112 23%
Nebraska Total Care $22 - $73 23%
New York State Insurance Fund $22 - $141 23%
Njm Insurance Group $22 - $141 23%
Quiktrip $22 - $141 23%
Rx Heatlhcomp $22 - $141 23%
Rx Restat $22 - $141 23%
Rx Saif Opdp Wc $22 - $141 23%
Rx Worker'S Comp $22 - $141 23%
Wc Accident Fund $22 - $141 23%
Wc Ace $22 - $141 23%
Wc Acs Federal Employees $22 - $141 23%
Wc Acuity $22 - $141 23%
Wc Advantage $22 - $141 23%
Wc Aegis $22 - $141 23%
Wc Aig $22 - $141 23%
Wc Aims $22 - $141 23%
Wc Alaska National Ins $22 - $141 23%
Wc Allied $22 - $141 23%
Wc Am Trust N America $22 - $141 23%
Wc American Claims Mgmt $22 - $141 23%
Wc Amerisure $22 - $141 23%
Wc Amtrust $22 - $141 23%
Wc Asu Risk Mgt $22 - $141 23%
Wc Benetech $22 - $141 23%
Wc Berkley Admin $22 - $141 23%
Wc Broadspire $22 - $141 23%
Wc Broward County $22 - $141 23%
Wc Bunch & Associates $22 - $141 23%
Wc California State Comp Ins $22 - $141 23%
Wc California State Ins Fund $22 - $141 23%
Wc Capitol Area Health Consortium $22 - $141 23%
Wc Ccmsi $22 - $141 23%
Wc Chartis $22 - $141 23%
Wc Chubb $22 - $141 23%
Wc Cirma $22 - $141 23%
Wc City Of Albany $22 - $141 23%
Wc City Of Sioux City $22 - $141 23%
Wc Claims Mgmt Inc $22 - $141 23%
Wc Cna $22 - $141 23%
Wc Comp One Admin C/O Manageability $22 - $141 23%
Wc Compone Admin $22 - $141 23%
Wc Ct Healthcare Trust $22 - $141 23%
Wc Donegal Insurance Group $22 - $141 23%
Wc Emc Insurance Company $22 - $141 23%
Wc Employee Mutual $22 - $141 23%
Wc Enablecomp $22 - $141 23%
Wc Encore Health Network $22 - $141 23%
Wc Erie $22 - $141 23%
Wc Esis $22 - $141 23%
Wc Evolutions $22 - $141 23%
Wc Fcci $22 - $141 23%
Wc Fed Ex $22 - $141 23%
Wc Federal Black Lung $22 - $141 23%
Wc Federated $22 - $141 23%
Wc Finley Occupational Health $22 - $141 23%
Wc First Agency/Occunet $22 - $141 23%
Wc Ford Motor $22 - $141 23%
Wc Fresno Unified Emp $22 - $141 23%
Wc Gallagher Bassett $22 - $141 23%
Wc General Motors $22 - $141 23%
Wc Generic $22 - $141 23%
Wc Genex Care For Ohio $22 - $141 23%
Wc Great West Casualty $22 - $141 23%
Wc Guarantee Insurance $22 - $141 23%
Wc Guard Insurance Company $22 - $141 23%
Wc Hab $22 - $141 23%
Wc Hartford $22 - $141 23%
Wc Hastings $22 - $141 23%
Wc Health Management $22 - $141 23%
Wc Heritage Summit $22 - $141 23%
Wc Hireright $22 - $141 23%
Wc Horizon $22 - $141 23%
Wc Icw Group $22 - $141 23%
Wc Idaho State Ins Fund $22 - $141 23%
Wc Intercare Insurance $22 - $141 23%
Wc Intermountain $22 - $141 23%
Wc Johns Eastern $22 - $141 23%
Wc Kemberton $22 - $141 23%
Wc Key Ins & Benefit Solutions $22 - $141 23%
Wc Liberty Mutual $22 - $141 23%
Wc Mac Risk Management $22 - $141 23%
Wc Massachusetts $22 - $141 23%
Wc Mdia $22 - $141 23%
Wc Meadowbrook Claim $22 - $141 23%
Wc Medical Administrators $22 - $141 23%
Wc Meijers $22 - $141 23%
Wc Memic $22 - $141 23%
Wc Mercy Workcare $22 - $141 23%
Wc Michigan $22 - $141 23%
Wc Michigan Millers Mutual $22 - $141 23%
Wc Mitchell Frankenmuth $22 - $141 23%
Wc Mra $22 - $141 23%
Wc Nationwide $22 - $141 23%
Wc Nca Comp $22 - $141 23%
Wc New York $22 - $141 23%
Wc New York Special Funds $22 - $141 23%
Wc North American Rishces $22 - $141 23%
Wc Northeast Health $22 - $141 23%
Wc Notre Dame $22 - $141 23%
Wc Novanet $22 - $141 23%
Wc Occ Health Allen $22 - $141 23%
Wc Ohio Bureau $22 - $141 23%
Wc One Call Medical $22 - $141 23%
Wc Paradigm $22 - $141 23%
Wc Peerless $22 - $141 23%
Wc Pma $22 - $141 23%
Wc Price Chopper $22 - $141 23%
Wc Procura Management $22 - $141 23%
Wc Qualcare $22 - $141 23%
Wc Quiktrip $22 - $141 23%
Wc Rev Claims $22 - $141 23%
Wc Risico $22 - $141 23%
Wc Rural Mutual $22 - $141 23%
Wc Saif Oregon $22 - $141 23%
Wc Secura $22 - $141 23%
Wc Sedgwick $22 - $141 23%
Wc Sentry $22 - $141 23%
Wc Sheakley Unicomp $22 - $141 23%
Wc Smile Lodge $22 - $141 23%
Wc Society $22 - $141 23%
Wc Srs $22 - $141 23%
Wc Taconic (Mro) $22 - $141 23%
Wc Taconic Farms $22 - $141 23%
Wc Travelers $22 - $141 23%
Wc Triad Group $22 - $141 23%
Wc Tristar $22 - $141 23%
Wc Troy Ny $22 - $141 23%
Wc Tyson $22 - $141 23%
Wc Unified Health Services $22 - $141 23%
Wc United Heartland $22 - $141 23%
Wc Us Dept Of Labor $22 - $141 23%
Wc Walmart $22 - $141 23%
Wc West Bend $22 - $141 23%
Wc West Bend Mutual/Argent $22 - $141 23%
Wc Winnebago Industries $22 - $141 23%
Wc Yankee Trails $22 - $141 23%
Wc York Risk $22 - $141 23%
Wc Zenith $22 - $141 23%
Wc Zurich $22 - $141 23%
Albany County Correctional Facility $26 - $31 27%
Amish Mennonite $26 - $31 27%
Ascension St. Vincent Public Safety Medical $26 - $31 27%
Bcccp-Michigan $26 - $31 27%
Bccp $26 - $31 27%
Bmc Healthnet $26 - $31 27%
Breast Grant-Connecticut $26 - $31 27%
Broward County Dept Of Health $26 - $31 27%
California Health And Wellness $26 - $31 27%
Can Community Health Inc $26 - $31 27%
Cardinal Innovations Lme $26 - $31 27%
Care Connections Of Northern Iowa $26 - $31 27%
Care Oregon Ohp $26 - $31 27%
Cencal Health Plan $26 - $31 27%
Cenpatico $26 - $31 27%
Chhuny $26 - $31 27%
Childrens Comm Health Plan $26 - $31 27%
Childrens Medical Services Title 19 $26 - $31 27%
City Of Philadelphia $26 - $31 27%
Cmh Allegan County $26 - $31 27%
Cmh Ausable Valley $26 - $31 27%
Cmh Barry County $26 - $31 27%
Cmh Bay-Arenac County $26 - $31 27%
Cmh Berrien County $26 - $31 27%
Cmh Cass County $26 - $31 27%
Cmh Central Mi County $26 - $31 27%
Cmh Clinton-Eaton-Ingham County $26 - $31 27%
Cmh Detroit Wayne Integrated Health Network $26 - $31 27%
Cmh Genesee County $26 - $31 27%
Cmh Ionia County $26 - $31 27%
Cmh Jackson County/Lifeways $26 - $31 27%
Cmh Kalamazoo $26 - $31 27%
Cmh Kent County $26 - $31 27%
Cmh Lenawee County $26 - $31 27%
Cmh Livingston County $26 - $31 27%
Cmh Macomb $26 - $31 27%
Cmh Misc $26 - $31 27%
Cmh Monroe County $26 - $31 27%
Cmh Montcalm County $26 - $31 27%
Cmh Muskegon County $26 - $31 27%
Cmh Newaygo County $26 - $31 27%
Cmh North Country $26 - $31 27%
Cmh Northern Lakes County $26 - $31 27%
Cmh Oakland County $26 - $31 27%
Cmh Ottawa County $26 - $31 27%
Cmh Van Buren County $26 - $31 27%
Cmh Washtenaw County $26 - $31 27%
Cmh Wayne County/Carelink $26 - $31 27%
Cmh Wayne Cty/Com Liv Svcs $26 - $31 27%
Cmh West Mi County $26 - $31 27%
Community Benefit Health $26 - $31 27%
Community Care Behavorial Health $26 - $31 27%
Community Care Partners $26 - $31 27%
Community Health Choice $26 - $31 27%
Connections Csp $26 - $31 27%
County Coroner $26 - $31 27%
County Funding Generic $26 - $31 27%
Covid19 Hrsa Uninsured Testing And Treatment Fund $26 - $31 27%
Dean Wi Badgercare $26 - $31 27%
Delaware County Department Of Health $26 - $31 27%
Delaware First Health $26 - $31 27%
Delta Dental Nj $26 - $31 27%
Dph Tb Program $26 - $31 27%
Dscc $26 - $31 27%
Eastpointe Lme $26 - $31 27%
Family Health Network $26 - $31 27%
Freedom First Healthcare $26 - $31 27%
Fresno County Ccs $26 - $31 27%
Ghc Scw Wi Badgercare $26 - $31 27%
Harbor Health $26 - $31 27%
Health Safety Net $26 - $31 27%
Healthy Blue Ne $26 - $31 27%
Hennepin Health $26 - $31 27%
Id County Ada $26 - $31 27%
Id County Canyon $26 - $31 27%
Id County Cat Fund $26 - $31 27%
Id County Other $26 - $31 27%
Id County Payette $26 - $31 27%
Idaho Dept Health And Wellfare $26 - $31 27%
Idaho Womens Health Check $26 - $31 27%
Indiana Breast Cervical Cancer $26 - $31 27%
Inland Empire Health Plan $26 - $31 27%
Intercommunity Health Ohp $26 - $31 27%
Jai Medical System $26 - $31 27%
Kern Family Health Plan $26 - $31 27%
Keystone First $26 - $31 27%
Keystone First Chip $26 - $31 27%
La Care Health Plan $26 - $31 27%
Lakeland Care Inc $26 - $31 27%
Managed Health Services - Indiana $26 - $31 27%
Maryland Breast & Cervical Program $26 - $31 27%
Maryland Healthy Smiles - Scion Dental $26 - $31 27%
Maryland Physicians Care $26 - $31 27%
Massachusetts Behavioral Health Partnership $26 - $31 27%
Mdwise $26 - $31 27%
Medi-Cal $26 - $31 27%
Medi-Cal Healthnet $26 - $31 27%
Medstar Dc Healthy Family $26 - $31 27%
Medstar Md Health Choice $26 - $31 27%
Mo Home State Health Plan $26 - $31 27%
Molina Centennial Care $26 - $31 27%
Nascentia Health Options $26 - $31 27%
New York Cancer Services Program $26 - $31 27%
Nextlevel Health $26 - $31 27%
Oregon Screenwise $26 - $31 27%
Pace Of Southwest Michigan $26 - $54 27%
Paramount Advantage $26 - $31 27%
Parkland Community Health Plan $26 - $31 27%
Partners Behavioral Lme $26 - $31 27%
Peach State Healthplan $26 - $31 27%
Philadelphia County Funding $26 - $31 27%
Presbyterian Centennial Care $26 - $31 27%
Prestige Health Choice $26 - $31 27%
Priority Partners $26 - $31 27%
Robert F Sing Program $26 - $31 27%
Rx 340B Pass Along $26 - $31 27%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $26 - $31 27%
Rx Medi-Cal $26 - $31 27%
Rx Meridian Rx $26 - $31 27%
Ryan White Florida Mssrp $26 - $31 27%
Sandhills Center Lme $26 - $31 27%
Screening For Life $26 - $31 27%
St Joseph County Hlth Dpt $26 - $31 27%
Sunshine State Health Plan $26 - $31 27%
Superior Health $26 - $31 27%
Tenncare $26 - $31 27%
Texas Children'S Health Plan $26 - $31 27%
Trillium Community Ohp $26 - $31 27%
Tufts Health Public Plans $26 - $31 27%
Vaya Health Lme $26 - $31 27%
Washtenaw Health Plan $26 - $31 27%
Wellsense Health Plan $26 - $31 27%
Wi Womens Wellness $26 - $31 27%
Iowa Total Care $27 - $31 28%
Wellpoint $27 - $32 28%
Align Senior Care $46 - $54 48%
Ally Align Care Adv $46 - $54 48%
American Health Advantage Of Idaho $46 - $54 48%
Aurora Special Needs $46 - $54 48%
Blue Care Network Advantage $46 - $54 48%
Blue Shield - De (Highmark) Medciare Advantage $46 - $54 48%
Care Dimensions $46 - $54 48%
Care Improvement Plus $46 - $54 48%
Care Resources Pace $46 - $54 48%
Careplus Health Plans $46 - $54 48%
Cca - Zing Health $46 - $54 48%
Cca Senior Care Options $46 - $54 48%
Central Valley Medical Services Corp Pace $46 - $54 48%
Champion Health Plan Mcr Advantage $46 - $54 48%
Clear Spring Health $46 - $54 48%
Clover Health $46 - $54 48%
Commonwealth Care Alliance $46 - $54 48%
Community Pace At Home $46 - $54 48%
Eddy Senior Care-Pace $46 - $54 48%
Eddy Seniorcare Pace $46 - $54 48%
Elementcare $46 - $54 48%
Evercare $46 - $54 48%
Everence $46 - $54 48%
Gateway Health Plan $46 - $54 48%
Genesys Pace Of Genesee County $46 - $54 48%
Georgia Health Advantage $46 - $54 48%
Gold Advantage $46 - $54 48%
Gpa Croell Redi Mix $46 - $54 48%
Health America Advantra $46 - $54 48%
Highmark Health Options Dual Plan $46 - $54 48%
Hope Select Pace $46 - $54 48%
Horizon Nj Total Care $46 - $54 48%
Hudson Headwaters Pace $46 - $54 48%
Huron Valley Pace $46 - $54 48%
Innovative Integrated Health Community Plans $46 - $54 48%
Johns Hopkins Advantage Md $46 - $54 48%
Lasso Healthcare Msa $46 - $54 48%
Life St Marys Pace $46 - $54 48%
Lifecircles Pace $46 - $54 48%
Longevity Health Plan $46 - $54 48%
Longevity Ipa Of Michigan Llc Health Plan Isnp $46 - $54 48%
Martins Point Generations Advantage $46 - $54 48%
Mass General Brigham Mcr Adv $46 - $54 48%
Medicare (plans) $46 - $57 48%
Medipak Advantage $46 - $54 48%
Mercy Life $46 - $54 48%
Mercyone Cedar Valley $46 - $54 48%
Meridian Complete $46 - $54 48%
Michigan Complete Health $46 - $54 48%
Nascentia Health Plus $46 - $54 48%
New Centry Health Careplus $46 - $54 48%
Osu Prime Care Advantage $46 - $54 48%
Pace Cny $46 - $54 48%
Pace Iowa Immanuel Pathways $46 - $54 48%
Pace Southeast $46 - $54 48%
Pace-Trinity Health $46 - $54 48%
Peak Pace Solutions $46 - $54 48%
Perennial Advantage $46 - $54 48%
Preferred Care Partners $46 - $54 48%
Presbyterian Senior Plan $46 - $54 48%
Provider Partners Health Plan Of Illinois $46 - $54 48%
Provider Partners Health Plan Of Indiana $46 - $54 48%
Pruitthealth Premier $46 - $54 48%
Reliance Community Care Partners Care Resources Pace $46 - $54 48%
Rx Allwin $46 - $54 48%
Rx Grane Grnmedd $46 - $54 48%
Rx Retiree Rx Care $46 - $54 48%
Scan Health Plan Mcr Ipa Meritage Oon $46 - $54 48%
Secure Horizons Ma Pffs $46 - $54 48%
Serenity Pace $46 - $54 48%
Siouxland Pace $46 - $54 48%
Solis Health Plans $46 - $54 48%
Sunnyview-Pace Finance Dept $46 - $54 48%
Texan Plus $46 - $54 48%
The Health Plan $46 - $54 48%
Thome Pace $46 - $54 48%
Todays Options $46 - $54 48%
Tribute Health Plans $46 - $54 48%
Um Health Advantage $46 - $54 48%
Union Health Service $46 - $54 48%
Veterans Administration $46 - $55 48%
Welbe Health $46 - $54 48%
Wellmed $46 - $54 48%
American Health Plan $48 - $56 50%
Iowa Health Advantage $48 - $56 50%
Wc Corvel $52 55%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals