CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Mercyone Elkader Medical Center

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $76
  • Cash Discount Price: $192
  • vs. Medicare Baseline: 0.80x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercyone Elkader Medical Center is $76. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 0.80x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$192

Average discount available for prompt cash payment at this facility.

Insurance Median
$76

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: $192 (202%)
Insurance Median: $76 (80%)
Cash: $192 (202% of Medicare)
Ins. Median: $76 (80% 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
UnitedHealthcare $36 - $159 38%
Albany County Correctional Facility $37 - $43 39%
Ambetter / Centene $37 - $159 39%
Amish Mennonite $37 - $43 39%
Ascension St. Vincent Public Safety Medical $37 - $43 39%
Bcccp-Michigan $37 - $43 39%
Bccp $37 - $43 39%
Blue Cross Blue Shield $37 - $130 39%
Bmc Healthnet $37 - $43 39%
Breast Grant-Connecticut $37 - $43 39%
Broward County Dept Of Health $37 - $43 39%
California Health And Wellness $37 - $43 39%
Can Community Health Inc $37 - $43 39%
Cardinal Innovations Lme $37 - $43 39%
Care Connections Of Northern Iowa $37 - $43 39%
Care Oregon Ohp $37 - $43 39%
Cencal Health Plan $37 - $43 39%
Cenpatico $37 - $43 39%
Chhuny $37 - $43 39%
Childrens Comm Health Plan $37 - $43 39%
Childrens Medical Services Title 19 $37 - $43 39%
Cigna $37 - $178 39%
City Of Philadelphia $37 - $43 39%
Cmh Allegan County $37 - $43 39%
Cmh Ausable Valley $37 - $43 39%
Cmh Barry County $37 - $43 39%
Cmh Bay-Arenac County $37 - $43 39%
Cmh Berrien County $37 - $43 39%
Cmh Cass County $37 - $43 39%
Cmh Central Mi County $37 - $43 39%
Cmh Clinton-Eaton-Ingham County $37 - $43 39%
Cmh Detroit Wayne Integrated Health Network $37 - $43 39%
Cmh Genesee County $37 - $43 39%
Cmh Ionia County $37 - $43 39%
Cmh Jackson County/Lifeways $37 - $43 39%
Cmh Kalamazoo $37 - $43 39%
Cmh Kent County $37 - $43 39%
Cmh Lenawee County $37 - $43 39%
Cmh Livingston County $37 - $43 39%
Cmh Macomb $37 - $43 39%
Cmh Misc $37 - $43 39%
Cmh Monroe County $37 - $43 39%
Cmh Montcalm County $37 - $43 39%
Cmh Muskegon County $37 - $43 39%
Cmh Newaygo County $37 - $43 39%
Cmh North Country $37 - $43 39%
Cmh Northern Lakes County $37 - $43 39%
Cmh Oakland County $37 - $43 39%
Cmh Ottawa County $37 - $43 39%
Cmh Van Buren County $37 - $43 39%
Cmh Washtenaw County $37 - $43 39%
Cmh Wayne County/Carelink $37 - $43 39%
Cmh Wayne Cty/Com Liv Svcs $37 - $43 39%
Cmh West Mi County $37 - $43 39%
Community Benefit Health $37 - $43 39%
Community Care Behavorial Health $37 - $43 39%
Community Care Partners $37 - $43 39%
Community Health Choice $37 - $43 39%
Connections Csp $37 - $43 39%
County Coroner $37 - $43 39%
County Funding Generic $37 - $43 39%
Covid19 Hrsa Uninsured Testing And Treatment Fund $37 - $43 39%
Dean Wi Badgercare $37 - $43 39%
Delaware County Department Of Health $37 - $43 39%
Delaware First Health $37 - $43 39%
Delta Dental Nj $37 - $43 39%
Dph Tb Program $37 - $43 39%
Dscc $37 - $43 39%
Eastpointe Lme $37 - $43 39%
Family Health Network $37 - $43 39%
Freedom First Healthcare $37 - $43 39%
Fresno County Ccs $37 - $43 39%
Ghc Scw Wi Badgercare $37 - $43 39%
Harbor Health $37 - $43 39%
Health Safety Net $37 - $43 39%
Healthy Blue Ne $37 - $43 39%
Hennepin Health $37 - $43 39%
Humana $37 - $143 39%
Id County Ada $37 - $43 39%
Id County Canyon $37 - $43 39%
Id County Cat Fund $37 - $43 39%
Id County Other $37 - $43 39%
Id County Payette $37 - $43 39%
Idaho Dept Health And Wellfare $37 - $43 39%
Idaho Womens Health Check $37 - $43 39%
Indiana Breast Cervical Cancer $37 - $43 39%
Inland Empire Health Plan $37 - $43 39%
Intercommunity Health Ohp $37 - $43 39%
Iowa Total Care $37 - $113 39%
Jai Medical System $37 - $43 39%
Kern Family Health Plan $37 - $43 39%
Keystone First $37 - $43 39%
Keystone First Chip $37 - $43 39%
La Care Health Plan $37 - $43 39%
Lakeland Care Inc $37 - $43 39%
Managed Health Services - Indiana $37 - $43 39%
Maryland Breast & Cervical Program $37 - $43 39%
Maryland Healthy Smiles - Scion Dental $37 - $43 39%
Maryland Physicians Care $37 - $43 39%
Massachusetts Behavioral Health Partnership $37 - $43 39%
Mdwise $37 - $43 39%
Medi-Cal $37 - $43 39%
Medi-Cal Healthnet $37 - $43 39%
Medicaid / KanCare $37 - $115 39%
Medstar Dc Healthy Family $37 - $43 39%
Medstar Md Health Choice $37 - $43 39%
Mo Home State Health Plan $37 - $43 39%
Molina Centennial Care $37 - $43 39%
Nascentia Health Options $37 - $43 39%
New York Cancer Services Program $37 - $43 39%
Nextlevel Health $37 - $43 39%
Oregon Screenwise $37 - $43 39%
Pace Of Southwest Michigan $37 - $87 39%
Paramount Advantage $37 - $43 39%
Parkland Community Health Plan $37 - $43 39%
Partners Behavioral Lme $37 - $43 39%
Peach State Healthplan $37 - $43 39%
Philadelphia County Funding $37 - $43 39%
Presbyterian Centennial Care $37 - $43 39%
Prestige Health Choice $37 - $43 39%
Priority Partners $37 - $43 39%
Robert F Sing Program $37 - $43 39%
Rx 340B Pass Along $37 - $43 39%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $37 - $43 39%
Rx Medi-Cal $37 - $43 39%
Rx Meridian Rx $37 - $43 39%
Ryan White Florida Mssrp $37 - $43 39%
Sandhills Center Lme $37 - $43 39%
Screening For Life $37 - $43 39%
St Joseph County Hlth Dpt $37 - $43 39%
Sunshine State Health Plan $37 - $43 39%
Superior Health $37 - $43 39%
Tenncare $37 - $43 39%
Texas Children'S Health Plan $37 - $43 39%
Trillium Community Ohp $37 - $43 39%
Tufts Health Public Plans $37 - $43 39%
Vaya Health Lme $37 - $43 39%
Washtenaw Health Plan $37 - $43 39%
Wellsense Health Plan $37 - $43 39%
Wi Womens Wellness $37 - $43 39%
Wellpoint $38 - $45 40%
Nebraska Total Care $50 53%
Aetna $55 - $192 58%
Iowa Dept Of Public Health $60 63%
Champva $71 - $83 75%
Tricare $71 - $83 75%
Triwest Health Alliance $71 - $83 75%
Us Family Health Plan $71 - $83 75%
Veterans Eval Services $71 - $83 75%
Align Senior Care $74 - $87 78%
Ally Align Care Adv $74 - $87 78%
American Health Advantage Of Idaho $74 - $87 78%
Aurora Special Needs $74 - $87 78%
Blue Care Network Advantage $74 - $87 78%
Blue Shield - De (Highmark) Medciare Advantage $74 - $87 78%
Care Dimensions $74 - $87 78%
Care Improvement Plus $74 - $87 78%
Care Resources Pace $74 - $87 78%
Careplus Health Plans $74 - $87 78%
Cca - Zing Health $74 - $87 78%
Cca Senior Care Options $74 - $87 78%
Central Valley Medical Services Corp Pace $74 - $87 78%
Champion Health Plan Mcr Advantage $74 - $87 78%
Clear Spring Health $74 - $87 78%
Clover Health $74 - $87 78%
Commonwealth Care Alliance $74 - $87 78%
Community Pace At Home $74 - $87 78%
Eddy Senior Care-Pace $74 - $87 78%
Eddy Seniorcare Pace $74 - $87 78%
Elementcare $74 - $87 78%
Evercare $74 - $87 78%
Everence $74 - $87 78%
Gateway Health Plan $74 - $87 78%
Genesys Pace Of Genesee County $74 - $87 78%
Georgia Health Advantage $74 - $87 78%
Gold Advantage $74 - $87 78%
Gpa Croell Redi Mix $74 - $87 78%
Health America Advantra $74 - $87 78%
Highmark Health Options Dual Plan $74 - $87 78%
Hope Select Pace $74 - $87 78%
Horizon Nj Total Care $74 - $87 78%
Hudson Headwaters Pace $74 - $87 78%
Huron Valley Pace $74 - $87 78%
Innovative Integrated Health Community Plans $74 - $87 78%
Johns Hopkins Advantage Md $74 - $87 78%
Lasso Healthcare Msa $74 - $87 78%
Life St Marys Pace $74 - $87 78%
Lifecircles Pace $74 - $87 78%
Longevity Health Plan $74 - $87 78%
Longevity Ipa Of Michigan Llc Health Plan Isnp $74 - $87 78%
Martins Point Generations Advantage $74 - $87 78%
Mass General Brigham Mcr Adv $74 - $87 78%
Medicare (plans) $74 - $98 78%
Medipak Advantage $74 - $87 78%
Mercy Life $74 - $87 78%
Mercyone Cedar Valley $74 - $87 78%
Meridian Complete $74 - $87 78%
Michigan Complete Health $74 - $87 78%
Nascentia Health Plus $74 - $87 78%
New Centry Health Careplus $74 - $87 78%
Osu Prime Care Advantage $74 - $87 78%
Pace Cny $74 - $87 78%
Pace Iowa Immanuel Pathways $74 - $87 78%
Pace Southeast $74 - $87 78%
Pace-Trinity Health $74 - $87 78%
Peak Pace Solutions $74 - $87 78%
Perennial Advantage $74 - $87 78%
Preferred Care Partners $74 - $87 78%
Presbyterian Senior Plan $74 - $87 78%
Provider Partners Health Plan Of Illinois $74 - $87 78%
Provider Partners Health Plan Of Indiana $74 - $87 78%
Pruitthealth Premier $74 - $87 78%
Reliance Community Care Partners Care Resources Pace $74 - $87 78%
Rx Allwin $74 - $87 78%
Rx Grane Grnmedd $74 - $87 78%
Rx Retiree Rx Care $74 - $87 78%
Scan Health Plan Mcr Ipa Meritage Oon $74 - $87 78%
Secure Horizons Ma Pffs $74 - $87 78%
Serenity Pace $74 - $87 78%
Siouxland Pace $74 - $87 78%
Solis Health Plans $74 - $87 78%
Sunnyview-Pace Finance Dept $74 - $87 78%
Texan Plus $74 - $87 78%
The Health Plan $74 - $87 78%
Thome Pace $74 - $87 78%
Todays Options $74 - $87 78%
Tribute Health Plans $74 - $87 78%
Um Health Advantage $74 - $87 78%
Union Health Service $74 - $87 78%
Welbe Health $74 - $87 78%
Wellmed $74 - $87 78%
Veterans Administration $76 - $89 80%
American Health Plan $78 - $92 82%
Iowa Health Advantage $78 - $92 82%
Wc Corvel $85 89%
Amps $96 - $120 101%
Stephenson Cty Health $100 105%
Amish Hospital Aid $101 - $126 106%
Bcn Domestic $111 - $130 117%
Blue Benefit Administrators Of Massachusetts $111 - $130 117%
Blue Care Network $111 - $130 117%
Blue Distinction Transplant $111 - $130 117%
Blue Shield - Ca $111 - $130 117%
Blue Shield - Id (Regence) $111 - $130 117%
Blue Shield - Ny Highmark Northeastern $111 - $130 117%
Blue Shield - Ny Highmark Western $111 - $130 117%
Blue Shield - Pa (Highmark) $111 - $130 117%
Blue Shield - Wa (Regence) $111 - $130 117%
Health Choices $111 - $153 117%
Kaiser Domestic $111 - $130 117%
Pre-Employment $111 - $130 117%
Wc Domestic $111 - $130 117%
Avera $119 - $140 125%
Newton Correctional Facility $125 131%
Medical Associates $127 - $149 133%
Sanford Health Plan $129 - $152 136%
Geha $133 - $159 140%
1199 National Benefit Fund $134 141%
Allied Benefit Systems $134 - $153 141%
Asr Health Benefits $134 141%
Christian Brother Services $134 141%
Coventry $134 141%
First Health $134 141%
Lucent Health $134 - $161 141%
Luminare Health $134 141%
Medical Mutual $134 141%
Meritain $134 - $164 141%
Trustmark Small Business Benefits $134 141%
Webtpa $134 141%
Oscar $139 - $164 146%
Health Partners $140 - $175 147%
Health Smart $140 - $165 147%
Ucare $141 - $165 148%
Centivo $142 - $174 149%
Genex Wc $144 151%
Usa Managed Care $147 - $173 154%
Quiktrip $148 - $174 155%
Auxiant $153 - $178 161%
First Choice Health $153 161%
Group Administrators $153 161%
Midlands $153 - $178 161%
Midlands Choice $153 - $178 161%
Preferred One $153 - $180 161%
Wc Align Network $154 162%
Claimdoc $159 - $190 167%
The Alliance $159 - $187 167%
Wc Praxis Health Network $163 171%
Wc Reny Company $167 175%
Wc Velocity $167 175%
Global Excel $171 - $192 180%
Auto Velocity $173 182%
Wc O'Hara Corp $173 182%
Multiplan $175 184%
Medica $178 187%
Velocity $178 - $192 187%
Crime Victim Assistance $182 191%
Nova $190 200%
Andrie Inc $192 202%
East Greenbush Central School District $192 202%
Healthsmart Workers Comp $192 202%
Jag Source $192 202%
New York State Insurance Fund $192 202%
Njm Insurance Group $192 202%
Rx Heatlhcomp $192 202%
Rx Restat $192 202%
Rx Saif Opdp Wc $192 202%
Rx Worker'S Comp $192 202%
Wc Accident Fund $192 202%
Wc Ace $192 202%
Wc Acs Federal Employees $192 202%
Wc Acuity $192 202%
Wc Advantage $192 202%
Wc Aegis $192 202%
Wc Aig $192 202%
Wc Aims $192 202%
Wc Alaska National Ins $192 202%
Wc Allied $192 202%
Wc Am Trust N America $192 202%
Wc American Claims Mgmt $192 202%
Wc Amerisure $192 202%
Wc Amtrust $192 202%
Wc Asu Risk Mgt $192 202%
Wc Benetech $192 202%
Wc Berkley Admin $192 202%
Wc Broadspire $192 202%
Wc Broward County $192 202%
Wc Bunch & Associates $192 202%
Wc California State Comp Ins $192 202%
Wc California State Ins Fund $192 202%
Wc Capitol Area Health Consortium $192 202%
Wc Ccmsi $192 202%
Wc Chartis $192 202%
Wc Chubb $192 202%
Wc Cirma $192 202%
Wc City Of Albany $192 202%
Wc City Of Sioux City $192 202%
Wc Claims Mgmt Inc $192 202%
Wc Cna $192 202%
Wc Comp One Admin C/O Manageability $192 202%
Wc Compone Admin $192 202%
Wc Ct Healthcare Trust $192 202%
Wc Donegal Insurance Group $192 202%
Wc Emc Insurance Company $192 202%
Wc Employee Mutual $192 202%
Wc Enablecomp $192 202%
Wc Encore Health Network $192 202%
Wc Erie $192 202%
Wc Esis $192 202%
Wc Evolutions $192 202%
Wc Fcci $192 202%
Wc Fed Ex $192 202%
Wc Federal Black Lung $192 202%
Wc Federated $192 202%
Wc Finley Occupational Health $192 202%
Wc First Agency/Occunet $192 202%
Wc Ford Motor $192 202%
Wc Fresno Unified Emp $192 202%
Wc Gallagher Bassett $192 202%
Wc General Motors $192 202%
Wc Generic $192 202%
Wc Genex Care For Ohio $192 202%
Wc Great West Casualty $192 202%
Wc Guarantee Insurance $192 202%
Wc Guard Insurance Company $192 202%
Wc Hab $192 202%
Wc Hartford $192 202%
Wc Hastings $192 202%
Wc Health Management $192 202%
Wc Heritage Summit $192 202%
Wc Hireright $192 202%
Wc Horizon $192 202%
Wc Icw Group $192 202%
Wc Idaho State Ins Fund $192 202%
Wc Intercare Insurance $192 202%
Wc Intermountain $192 202%
Wc Johns Eastern $192 202%
Wc Kemberton $192 202%
Wc Key Ins & Benefit Solutions $192 202%
Wc Liberty Mutual $192 202%
Wc Mac Risk Management $192 202%
Wc Massachusetts $192 202%
Wc Mdia $192 202%
Wc Meadowbrook Claim $192 202%
Wc Medical Administrators $192 202%
Wc Meijers $192 202%
Wc Memic $192 202%
Wc Mercy Workcare $192 202%
Wc Michigan $192 202%
Wc Michigan Millers Mutual $192 202%
Wc Mitchell Frankenmuth $192 202%
Wc Mra $192 202%
Wc Nationwide $192 202%
Wc Nca Comp $192 202%
Wc New York $192 202%
Wc New York Special Funds $192 202%
Wc North American Rishces $192 202%
Wc Northeast Health $192 202%
Wc Notre Dame $192 202%
Wc Novanet $192 202%
Wc Occ Health Allen $192 202%
Wc Ohio Bureau $192 202%
Wc One Call Medical $192 202%
Wc Paradigm $192 202%
Wc Peerless $192 202%
Wc Pma $192 202%
Wc Price Chopper $192 202%
Wc Procura Management $192 202%
Wc Qualcare $192 202%
Wc Quiktrip $192 202%
Wc Rev Claims $192 202%
Wc Risico $192 202%
Wc Rural Mutual $192 202%
Wc Saif Oregon $192 202%
Wc Secura $192 202%
Wc Sedgwick $192 202%
Wc Sentry $192 202%
Wc Sheakley Unicomp $192 202%
Wc Smile Lodge $192 202%
Wc Society $192 202%
Wc Srs $192 202%
Wc Taconic (Mro) $192 202%
Wc Taconic Farms $192 202%
Wc Travelers $192 202%
Wc Triad Group $192 202%
Wc Tristar $192 202%
Wc Troy Ny $192 202%
Wc Tyson $192 202%
Wc Unified Health Services $192 202%
Wc United Heartland $192 202%
Wc Us Dept Of Labor $192 202%
Wc Walmart $192 202%
Wc West Bend $192 202%
Wc West Bend Mutual/Argent $192 202%
Wc Winnebago Industries $192 202%
Wc Yankee Trails $192 202%
Wc York Risk $192 202%
Wc Zenith $192 202%
Wc Zurich $192 202%

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