CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercyone Des Moines Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $66
  • Cash Discount Price: $180
  • vs. Medicare Baseline: 0.56x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercyone Des Moines Medical Center is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 0.56x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$180

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $180 (153%)
Insurance Median: $66 (56%)
Cash: $180 (153% of Medicare)
Ins. Median: $66 (56% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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 $46 - $81 39%
Aetna $56 - $180 48%
Albany County Correctional Facility $58 49%
Ambetter / Centene $58 - $114 49%
Amish Mennonite $58 49%
Ascension St. Vincent Public Safety Medical $58 49%
Bcccp-Michigan $58 49%
Bccp $58 49%
Blue Cross Blue Shield $58 - $116 49%
Bmc Healthnet $58 49%
Breast Grant-Connecticut $58 49%
Broward County Dept Of Health $58 49%
California Health And Wellness $58 49%
Can Community Health Inc $58 49%
Cardinal Innovations Lme $58 49%
Care Connections Of Northern Iowa $58 49%
Care Oregon Ohp $58 49%
Cencal Health Plan $58 49%
Cenpatico $58 49%
Chhuny $58 49%
Childrens Comm Health Plan $58 49%
Childrens Medical Services Title 19 $58 49%
Cigna $58 - $141 49%
City Of Philadelphia $58 49%
Cmh Allegan County $58 49%
Cmh Ausable Valley $58 49%
Cmh Barry County $58 49%
Cmh Bay-Arenac County $58 49%
Cmh Berrien County $58 49%
Cmh Cass County $58 49%
Cmh Central Mi County $58 49%
Cmh Clinton-Eaton-Ingham County $58 49%
Cmh Detroit Wayne Integrated Health Network $58 49%
Cmh Genesee County $58 49%
Cmh Ionia County $58 49%
Cmh Jackson County/Lifeways $58 49%
Cmh Kalamazoo $58 49%
Cmh Kent County $58 49%
Cmh Lenawee County $58 49%
Cmh Livingston County $58 49%
Cmh Macomb $58 49%
Cmh Misc $58 49%
Cmh Monroe County $58 49%
Cmh Montcalm County $58 49%
Cmh Muskegon County $58 49%
Cmh Newaygo County $58 49%
Cmh North Country $58 49%
Cmh Northern Lakes County $58 49%
Cmh Oakland County $58 49%
Cmh Ottawa County $58 49%
Cmh Van Buren County $58 49%
Cmh Washtenaw County $58 49%
Cmh Wayne County/Carelink $58 49%
Cmh Wayne Cty/Com Liv Svcs $58 49%
Cmh West Mi County $58 49%
Community Benefit Health $58 49%
Community Care Behavorial Health $58 49%
Community Care Partners $58 49%
Community Health Choice $58 49%
Connections Csp $58 49%
County Coroner $58 49%
County Funding Generic $58 49%
Covid19 Hrsa Uninsured Testing And Treatment Fund $58 49%
Dean Wi Badgercare $58 49%
Delaware County Department Of Health $58 49%
Delaware First Health $58 49%
Delta Dental Nj $58 49%
Dph Tb Program $58 49%
Dscc $58 49%
Eastpointe Lme $58 49%
Family Health Network $58 49%
Freedom First Healthcare $58 49%
Fresno County Ccs $58 49%
Ghc Scw Wi Badgercare $58 49%
Harbor Health $58 49%
Health Safety Net $58 49%
Healthy Blue Ne $58 49%
Hennepin Health $58 49%
Humana $58 - $107 49%
Id County Ada $58 49%
Id County Canyon $58 49%
Id County Cat Fund $58 49%
Id County Other $58 49%
Id County Payette $58 49%
Idaho Dept Health And Wellfare $58 49%
Idaho Womens Health Check $58 49%
Indiana Breast Cervical Cancer $58 49%
Inland Empire Health Plan $58 49%
Intercommunity Health Ohp $58 49%
Jai Medical System $58 49%
Kern Family Health Plan $58 49%
Keystone First $58 49%
Keystone First Chip $58 49%
La Care Health Plan $58 49%
Lakeland Care Inc $58 49%
Managed Health Services - Indiana $58 49%
Maryland Breast & Cervical Program $58 49%
Maryland Healthy Smiles - Scion Dental $58 49%
Maryland Physicians Care $58 49%
Massachusetts Behavioral Health Partnership $58 49%
Mdwise $58 49%
Medi-Cal $58 49%
Medi-Cal Healthnet $58 49%
Medstar Dc Healthy Family $58 49%
Medstar Md Health Choice $58 49%
Mo Home State Health Plan $58 49%
Molina Centennial Care $58 49%
Nascentia Health Options $58 49%
New York Cancer Services Program $58 49%
Nextlevel Health $58 49%
Oregon Screenwise $58 49%
Pace Of Southwest Michigan $58 - $66 49%
Paramount Advantage $58 49%
Parkland Community Health Plan $58 49%
Partners Behavioral Lme $58 49%
Peach State Healthplan $58 49%
Philadelphia County Funding $58 49%
Presbyterian Centennial Care $58 49%
Prestige Health Choice $58 49%
Priority Partners $58 49%
Robert F Sing Program $58 49%
Rx 340B Pass Along $58 49%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $58 49%
Rx Medi-Cal $58 49%
Rx Meridian Rx $58 49%
Ryan White Florida Mssrp $58 49%
Sandhills Center Lme $58 49%
Screening For Life $58 49%
St Joseph County Hlth Dpt $58 49%
Sunshine State Health Plan $58 49%
Superior Health $58 49%
Tenncare $58 49%
Texas Children'S Health Plan $58 49%
Trillium Community Ohp $58 49%
Tufts Health Public Plans $58 49%
UnitedHealthcare $58 - $160 49%
Vaya Health Lme $58 49%
Washtenaw Health Plan $58 49%
Wellsense Health Plan $58 49%
Wi Womens Wellness $58 49%
Iowa Total Care $59 50%
Wellpoint $60 51%
Wc Corvel $64 54%
Align Senior Care $66 56%
Ally Align Care Adv $66 56%
American Health Advantage Of Idaho $66 56%
Aurora Special Needs $66 56%
Blue Care Network Advantage $66 56%
Blue Shield - De (Highmark) Medciare Advantage $66 56%
Care Dimensions $66 56%
Care Improvement Plus $66 56%
Care Resources Pace $66 56%
Careplus Health Plans $66 56%
Cca - Zing Health $66 56%
Cca Senior Care Options $66 56%
Central Valley Medical Services Corp Pace $66 56%
Champion Health Plan Mcr Advantage $66 56%
Clear Spring Health $66 56%
Clover Health $66 56%
Commonwealth Care Alliance $66 56%
Community Pace At Home $66 56%
Eddy Senior Care-Pace $66 56%
Eddy Seniorcare Pace $66 56%
Elementcare $66 56%
Evercare $66 56%
Everence $66 56%
Gateway Health Plan $66 56%
Genesys Pace Of Genesee County $66 56%
Georgia Health Advantage $66 56%
Gold Advantage $66 56%
Gpa Croell Redi Mix $66 56%
Health America Advantra $66 56%
Highmark Health Options Dual Plan $66 56%
Hope Select Pace $66 56%
Horizon Nj Total Care $66 56%
Hudson Headwaters Pace $66 56%
Huron Valley Pace $66 56%
Innovative Integrated Health Community Plans $66 56%
Johns Hopkins Advantage Md $66 56%
Lasso Healthcare Msa $66 56%
Life St Marys Pace $66 56%
Lifecircles Pace $66 56%
Longevity Health Plan $66 56%
Longevity Ipa Of Michigan Llc Health Plan Isnp $66 56%
Martins Point Generations Advantage $66 56%
Mass General Brigham Mcr Adv $66 56%
Medicare (plans) $66 - $70 56%
Medipak Advantage $66 56%
Mercy Life $66 56%
Mercyone Cedar Valley $66 56%
Meridian Complete $66 56%
Michigan Complete Health $66 56%
Nascentia Health Plus $66 56%
New Centry Health Careplus $66 56%
Osu Prime Care Advantage $66 56%
Pace Cny $66 56%
Pace Iowa Immanuel Pathways $66 56%
Pace Southeast $66 56%
Pace-Trinity Health $66 56%
Peak Pace Solutions $66 56%
Perennial Advantage $66 56%
Preferred Care Partners $66 56%
Presbyterian Senior Plan $66 56%
Provider Partners Health Plan Of Illinois $66 56%
Provider Partners Health Plan Of Indiana $66 56%
Pruitthealth Premier $66 56%
Reliance Community Care Partners Care Resources Pace $66 56%
Rx Allwin $66 56%
Rx Grane Grnmedd $66 56%
Rx Retiree Rx Care $66 56%
Scan Health Plan Mcr Ipa Meritage Oon $66 56%
Secure Horizons Ma Pffs $66 56%
Serenity Pace $66 56%
Siouxland Pace $66 56%
Solis Health Plans $66 56%
Sunnyview-Pace Finance Dept $66 56%
Texan Plus $66 56%
The Health Plan $66 56%
Thome Pace $66 56%
Todays Options $66 56%
Tribute Health Plans $66 56%
Um Health Advantage $66 56%
Union Health Service $66 56%
Welbe Health $66 56%
Wellmed $66 56%
Veterans Administration $67 57%
American Health Plan $69 59%
Iowa Health Advantage $69 59%
Champva $74 63%
Iowa Dept Of Public Health $74 63%
Tricare $74 63%
Triwest Health Alliance $74 63%
Us Family Health Plan $74 63%
Veterans Eval Services $74 63%
Nebraska Total Care $78 66%
Amish Hospital Aid $89 76%
Amps $91 77%
Avera $102 87%
Preferred Health Choice $111 94%
Medical Associates $112 95%
Sanford Health Plan $114 97%
Bcn Domestic $116 99%
Blue Benefit Administrators Of Massachusetts $116 99%
Blue Care Network $116 99%
Blue Distinction Transplant $116 99%
Blue Shield - Ca $116 99%
Blue Shield - Id (Regence) $116 99%
Blue Shield - Ny Highmark Northeastern $116 99%
Blue Shield - Ny Highmark Western $116 99%
Blue Shield - Pa (Highmark) $116 99%
Blue Shield - Wa (Regence) $116 99%
Health Choices $116 - $141 99%
Kaiser Domestic $116 99%
Pre-Employment $116 99%
Wc Domestic $116 99%
Newton Correctional Facility $117 100%
Ucare $119 101%
Lucent Health $121 103%
Health Partners $124 - $177 105%
Oscar $124 105%
Stephenson Cty Health $125 106%
Usa Managed Care $130 111%
Centivo $131 111%
Genex Wc $135 115%
Claimdoc $140 119%
Allied Benefit Systems $141 120%
Auxiant $141 120%
First Choice Health $141 120%
Group Administrators $141 120%
Midlands $141 120%
Midlands Choice $141 120%
The Alliance $141 120%
Wc Align Network $144 122%
Meritain $150 128%
Global Excel $152 129%
Wc Praxis Health Network $153 130%
Wc Reny Company $157 134%
Wc Velocity $157 134%
Velocity $158 134%
Geha $160 136%
Auto Velocity $162 138%
Health Smart $162 138%
Wc O'Hara Corp $162 138%
Preferred One $164 139%
Andrie Inc $180 153%
East Greenbush Central School District $180 153%
Healthsmart Workers Comp $180 153%
Jag Source $180 153%
Multiplan $180 153%
New York State Insurance Fund $180 153%
Njm Insurance Group $180 153%
Quiktrip $180 153%
Rx Heatlhcomp $180 153%
Rx Restat $180 153%
Rx Saif Opdp Wc $180 153%
Rx Worker'S Comp $180 153%
Wc Accident Fund $180 153%
Wc Ace $180 153%
Wc Acs Federal Employees $180 153%
Wc Acuity $180 153%
Wc Advantage $180 153%
Wc Aegis $180 153%
Wc Aig $180 153%
Wc Aims $180 153%
Wc Alaska National Ins $180 153%
Wc Allied $180 153%
Wc Am Trust N America $180 153%
Wc American Claims Mgmt $180 153%
Wc Amerisure $180 153%
Wc Amtrust $180 153%
Wc Asu Risk Mgt $180 153%
Wc Benetech $180 153%
Wc Berkley Admin $180 153%
Wc Broadspire $180 153%
Wc Broward County $180 153%
Wc Bunch & Associates $180 153%
Wc California State Comp Ins $180 153%
Wc California State Ins Fund $180 153%
Wc Capitol Area Health Consortium $180 153%
Wc Ccmsi $180 153%
Wc Chartis $180 153%
Wc Chubb $180 153%
Wc Cirma $180 153%
Wc City Of Albany $180 153%
Wc City Of Sioux City $180 153%
Wc Claims Mgmt Inc $180 153%
Wc Cna $180 153%
Wc Comp One Admin C/O Manageability $180 153%
Wc Compone Admin $180 153%
Wc Ct Healthcare Trust $180 153%
Wc Donegal Insurance Group $180 153%
Wc Emc Insurance Company $180 153%
Wc Employee Mutual $180 153%
Wc Enablecomp $180 153%
Wc Encore Health Network $180 153%
Wc Erie $180 153%
Wc Esis $180 153%
Wc Evolutions $180 153%
Wc Fcci $180 153%
Wc Fed Ex $180 153%
Wc Federal Black Lung $180 153%
Wc Federated $180 153%
Wc Finley Occupational Health $180 153%
Wc First Agency/Occunet $180 153%
Wc Ford Motor $180 153%
Wc Fresno Unified Emp $180 153%
Wc Gallagher Bassett $180 153%
Wc General Motors $180 153%
Wc Generic $180 153%
Wc Genex Care For Ohio $180 153%
Wc Great West Casualty $180 153%
Wc Guarantee Insurance $180 153%
Wc Guard Insurance Company $180 153%
Wc Hab $180 153%
Wc Hartford $180 153%
Wc Hastings $180 153%
Wc Health Management $180 153%
Wc Heritage Summit $180 153%
Wc Hireright $180 153%
Wc Horizon $180 153%
Wc Icw Group $180 153%
Wc Idaho State Ins Fund $180 153%
Wc Intercare Insurance $180 153%
Wc Intermountain $180 153%
Wc Johns Eastern $180 153%
Wc Kemberton $180 153%
Wc Key Ins & Benefit Solutions $180 153%
Wc Liberty Mutual $180 153%
Wc Mac Risk Management $180 153%
Wc Massachusetts $180 153%
Wc Mdia $180 153%
Wc Meadowbrook Claim $180 153%
Wc Medical Administrators $180 153%
Wc Meijers $180 153%
Wc Memic $180 153%
Wc Mercy Workcare $180 153%
Wc Michigan $180 153%
Wc Michigan Millers Mutual $180 153%
Wc Mitchell Frankenmuth $180 153%
Wc Mra $180 153%
Wc Nationwide $180 153%
Wc Nca Comp $180 153%
Wc New York $180 153%
Wc New York Special Funds $180 153%
Wc North American Rishces $180 153%
Wc Northeast Health $180 153%
Wc Notre Dame $180 153%
Wc Novanet $180 153%
Wc Occ Health Allen $180 153%
Wc Ohio Bureau $180 153%
Wc One Call Medical $180 153%
Wc Paradigm $180 153%
Wc Peerless $180 153%
Wc Pma $180 153%
Wc Price Chopper $180 153%
Wc Procura Management $180 153%
Wc Qualcare $180 153%
Wc Quiktrip $180 153%
Wc Rev Claims $180 153%
Wc Risico $180 153%
Wc Rural Mutual $180 153%
Wc Saif Oregon $180 153%
Wc Secura $180 153%
Wc Sedgwick $180 153%
Wc Sentry $180 153%
Wc Sheakley Unicomp $180 153%
Wc Smile Lodge $180 153%
Wc Society $180 153%
Wc Srs $180 153%
Wc Taconic (Mro) $180 153%
Wc Taconic Farms $180 153%
Wc Travelers $180 153%
Wc Triad Group $180 153%
Wc Tristar $180 153%
Wc Troy Ny $180 153%
Wc Tyson $180 153%
Wc Unified Health Services $180 153%
Wc United Heartland $180 153%
Wc Us Dept Of Labor $180 153%
Wc Walmart $180 153%
Wc West Bend $180 153%
Wc West Bend Mutual/Argent $180 153%
Wc Winnebago Industries $180 153%
Wc Yankee Trails $180 153%
Wc York Risk $180 153%
Wc Zenith $180 153%
Wc Zurich $180 153%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals