CMS Price Transparency Data

CT scan, pelvis

Facility: Mercyone Elkader Medical Center

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,462
  • Cash Discount Price: $1,291
  • vs. Medicare Baseline: 13.69x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercyone Elkader Medical Center is $1,462. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,291. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.69x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$1,291

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,462

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: $1,291 (1209%)
Insurance Median: $1,462 (1369%)
Cash: $1,291 (1209% of Medicare)
Ins. Median: $1,462 (1369% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1369% of the Medicare baseline (a markup of 1269%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $1,022 957%
Aetna $1,033 - $1,462 967%
Medicare (plans) $1,043 - $1,073 977%
UnitedHealthcare $1,095 - $1,490 1025%
Iowa Total Care $1,236 1157%
Medicaid / KanCare $1,254 - $1,260 1174%
Amish Hospital Aid $1,374 1286%
1199 National Benefit Fund $1,462 1369%
Allied Benefit Systems $1,462 1369%
Asr Health Benefits $1,462 1369%
Christian Brother Services $1,462 1369%
Coventry $1,462 1369%
First Health $1,462 1369%
Lucent Health $1,462 1369%
Luminare Health $1,462 1369%
Medical Mutual $1,462 1369%
Meritain $1,462 1369%
Trustmark Small Business Benefits $1,462 1369%
Webtpa $1,462 1369%
Geha $1,490 1395%
Centivo $1,549 1450%
Health Choices $1,589 1488%
Medical Associates $1,589 1488%
Ambetter / Centene $1,735 1624%
Health Partners $1,911 1789%
Auxiant $1,946 1822%
Cigna $1,946 1822%
Medica $1,946 1822%
Midlands $1,946 1822%
Midlands Choice $1,946 1822%
Crime Victim Assistance $1,986 1859%
Iowa Dept Of Public Health $1,986 1859%
Claimdoc $2,076 1944%
Nova $2,076 1944%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals