CMS Price Transparency Data
Office visit, established patient (30-39 min)
Facility: Mercyone Elkader Medical Center
Billing Code: 99214 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 99214
- Insurance Median: $106
- Cash Discount Price: $272
- vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercyone Elkader Medical Center is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $272. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 0.78x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$272
Average discount available for prompt cash payment at this facility.
Insurance Median
$106
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$135.6
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $272 (201%)
Insurance Median: $106 (78%)
Cash: $272 (201% of Medicare)
Ins. Median: $106 (78% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $135.6 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Albany County Correctional Facility | $57 | 42% |
| Ambetter / Centene | $57 - $225 | 42% |
| Amish Mennonite | $57 | 42% |
| Ascension St. Vincent Public Safety Medical | $57 | 42% |
| Bcccp-Michigan | $57 | 42% |
| Bccp | $57 | 42% |
| Blue Cross Blue Shield | $57 - $156 | 42% |
| Bmc Healthnet | $57 | 42% |
| Breast Grant-Connecticut | $57 | 42% |
| Broward County Dept Of Health | $57 | 42% |
| California Health And Wellness | $57 | 42% |
| Can Community Health Inc | $57 | 42% |
| Cardinal Innovations Lme | $57 | 42% |
| Care Connections Of Northern Iowa | $57 | 42% |
| Care Oregon Ohp | $57 | 42% |
| Cencal Health Plan | $57 | 42% |
| Cenpatico | $57 | 42% |
| Chhuny | $57 | 42% |
| Childrens Comm Health Plan | $57 | 42% |
| Childrens Medical Services Title 19 | $57 | 42% |
| Cigna | $57 - $253 | 42% |
| City Of Philadelphia | $57 | 42% |
| Cmh Allegan County | $57 | 42% |
| Cmh Ausable Valley | $57 | 42% |
| Cmh Barry County | $57 | 42% |
| Cmh Bay-Arenac County | $57 | 42% |
| Cmh Berrien County | $57 | 42% |
| Cmh Cass County | $57 | 42% |
| Cmh Central Mi County | $57 | 42% |
| Cmh Clinton-Eaton-Ingham County | $57 | 42% |
| Cmh Detroit Wayne Integrated Health Network | $57 | 42% |
| Cmh Genesee County | $57 | 42% |
| Cmh Ionia County | $57 | 42% |
| Cmh Jackson County/Lifeways | $57 | 42% |
| Cmh Kalamazoo | $57 | 42% |
| Cmh Kent County | $57 | 42% |
| Cmh Lenawee County | $57 | 42% |
| Cmh Livingston County | $57 | 42% |
| Cmh Macomb | $57 | 42% |
| Cmh Misc | $57 | 42% |
| Cmh Monroe County | $57 | 42% |
| Cmh Montcalm County | $57 | 42% |
| Cmh Muskegon County | $57 | 42% |
| Cmh Newaygo County | $57 | 42% |
| Cmh North Country | $57 | 42% |
| Cmh Northern Lakes County | $57 | 42% |
| Cmh Oakland County | $57 | 42% |
| Cmh Ottawa County | $57 | 42% |
| Cmh Van Buren County | $57 | 42% |
| Cmh Washtenaw County | $57 | 42% |
| Cmh Wayne County/Carelink | $57 | 42% |
| Cmh Wayne Cty/Com Liv Svcs | $57 | 42% |
| Cmh West Mi County | $57 | 42% |
| Community Benefit Health | $57 | 42% |
| Community Care Behavorial Health | $57 | 42% |
| Community Care Partners | $57 | 42% |
| Community Health Choice | $57 | 42% |
| Connections Csp | $57 | 42% |
| County Coroner | $57 | 42% |
| County Funding Generic | $57 | 42% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $57 | 42% |
| Dean Wi Badgercare | $57 | 42% |
| Delaware County Department Of Health | $57 | 42% |
| Delaware First Health | $57 | 42% |
| Delta Dental Nj | $57 | 42% |
| Dph Tb Program | $57 | 42% |
| Dscc | $57 | 42% |
| Eastpointe Lme | $57 | 42% |
| Family Health Network | $57 | 42% |
| Freedom First Healthcare | $57 | 42% |
| Fresno County Ccs | $57 | 42% |
| Ghc Scw Wi Badgercare | $57 | 42% |
| Harbor Health | $57 | 42% |
| Health Safety Net | $57 | 42% |
| Healthy Blue Ne | $57 | 42% |
| Hennepin Health | $57 | 42% |
| Humana | $57 - $173 | 42% |
| Id County Ada | $57 | 42% |
| Id County Canyon | $57 | 42% |
| Id County Cat Fund | $57 | 42% |
| Id County Other | $57 | 42% |
| Id County Payette | $57 | 42% |
| Idaho Dept Health And Wellfare | $57 | 42% |
| Idaho Womens Health Check | $57 | 42% |
| Indiana Breast Cervical Cancer | $57 | 42% |
| Inland Empire Health Plan | $57 | 42% |
| Intercommunity Health Ohp | $57 | 42% |
| Jai Medical System | $57 | 42% |
| Kern Family Health Plan | $57 | 42% |
| Keystone First | $57 | 42% |
| Keystone First Chip | $57 | 42% |
| La Care Health Plan | $57 | 42% |
| Lakeland Care Inc | $57 | 42% |
| Managed Health Services - Indiana | $57 | 42% |
| Maryland Breast & Cervical Program | $57 | 42% |
| Maryland Healthy Smiles - Scion Dental | $57 | 42% |
| Maryland Physicians Care | $57 | 42% |
| Massachusetts Behavioral Health Partnership | $57 | 42% |
| Mdwise | $57 | 42% |
| Medi-Cal | $57 | 42% |
| Medi-Cal Healthnet | $57 | 42% |
| Medicaid / KanCare | $57 - $164 | 42% |
| Medstar Dc Healthy Family | $57 | 42% |
| Medstar Md Health Choice | $57 | 42% |
| Mo Home State Health Plan | $57 | 42% |
| Molina Centennial Care | $57 | 42% |
| Nascentia Health Options | $57 | 42% |
| New York Cancer Services Program | $57 | 42% |
| Nextlevel Health | $57 | 42% |
| Oregon Screenwise | $57 | 42% |
| Pace Of Southwest Michigan | $57 - $106 | 42% |
| Paramount Advantage | $57 | 42% |
| Parkland Community Health Plan | $57 | 42% |
| Partners Behavioral Lme | $57 | 42% |
| Peach State Healthplan | $57 | 42% |
| Philadelphia County Funding | $57 | 42% |
| Presbyterian Centennial Care | $57 | 42% |
| Prestige Health Choice | $57 | 42% |
| Priority Partners | $57 | 42% |
| Robert F Sing Program | $57 | 42% |
| Rx 340B Pass Along | $57 | 42% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $57 | 42% |
| Rx Medi-Cal | $57 | 42% |
| Rx Meridian Rx | $57 | 42% |
| Ryan White Florida Mssrp | $57 | 42% |
| Sandhills Center Lme | $57 | 42% |
| Screening For Life | $57 | 42% |
| St Joseph County Hlth Dpt | $57 | 42% |
| Sunshine State Health Plan | $57 | 42% |
| Superior Health | $57 | 42% |
| Tenncare | $57 | 42% |
| Texas Children'S Health Plan | $57 | 42% |
| Trillium Community Ohp | $57 | 42% |
| Tufts Health Public Plans | $57 | 42% |
| UnitedHealthcare | $57 - $226 | 42% |
| Vaya Health Lme | $57 | 42% |
| Washtenaw Health Plan | $57 | 42% |
| Wellsense Health Plan | $57 | 42% |
| Wi Womens Wellness | $57 | 42% |
| Iowa Total Care | $58 - $161 | 43% |
| Wellpoint | $58 | 43% |
| Nebraska Total Care | $75 | 55% |
| Aetna | $80 - $272 | 59% |
| Iowa Dept Of Public Health | $89 | 66% |
| Champva | $100 | 74% |
| Tricare | $100 | 74% |
| Triwest Health Alliance | $100 | 74% |
| Us Family Health Plan | $100 | 74% |
| Veterans Eval Services | $100 | 74% |
| Align Senior Care | $106 | 78% |
| Ally Align Care Adv | $106 | 78% |
| American Health Advantage Of Idaho | $106 | 78% |
| Aurora Special Needs | $106 | 78% |
| Blue Care Network Advantage | $106 | 78% |
| Blue Shield - De (Highmark) Medciare Advantage | $106 | 78% |
| Care Dimensions | $106 | 78% |
| Care Improvement Plus | $106 | 78% |
| Care Resources Pace | $106 | 78% |
| Careplus Health Plans | $106 | 78% |
| Cca - Zing Health | $106 | 78% |
| Cca Senior Care Options | $106 | 78% |
| Central Valley Medical Services Corp Pace | $106 | 78% |
| Champion Health Plan Mcr Advantage | $106 | 78% |
| Clear Spring Health | $106 | 78% |
| Clover Health | $106 | 78% |
| Commonwealth Care Alliance | $106 | 78% |
| Community Pace At Home | $106 | 78% |
| Eddy Senior Care-Pace | $106 | 78% |
| Eddy Seniorcare Pace | $106 | 78% |
| Elementcare | $106 | 78% |
| Evercare | $106 | 78% |
| Everence | $106 | 78% |
| Gateway Health Plan | $106 | 78% |
| Genesys Pace Of Genesee County | $106 | 78% |
| Georgia Health Advantage | $106 | 78% |
| Gold Advantage | $106 | 78% |
| Gpa Croell Redi Mix | $106 | 78% |
| Health America Advantra | $106 | 78% |
| Highmark Health Options Dual Plan | $106 | 78% |
| Hope Select Pace | $106 | 78% |
| Horizon Nj Total Care | $106 | 78% |
| Hudson Headwaters Pace | $106 | 78% |
| Huron Valley Pace | $106 | 78% |
| Innovative Integrated Health Community Plans | $106 | 78% |
| Johns Hopkins Advantage Md | $106 | 78% |
| Lasso Healthcare Msa | $106 | 78% |
| Life St Marys Pace | $106 | 78% |
| Lifecircles Pace | $106 | 78% |
| Longevity Health Plan | $106 | 78% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $106 | 78% |
| Martins Point Generations Advantage | $106 | 78% |
| Mass General Brigham Mcr Adv | $106 | 78% |
| Medicare (plans) | $106 - $139 | 78% |
| Medipak Advantage | $106 | 78% |
| Mercy Life | $106 | 78% |
| Mercyone Cedar Valley | $106 | 78% |
| Meridian Complete | $106 | 78% |
| Michigan Complete Health | $106 | 78% |
| Nascentia Health Plus | $106 | 78% |
| New Centry Health Careplus | $106 | 78% |
| Osu Prime Care Advantage | $106 | 78% |
| Pace Cny | $106 | 78% |
| Pace Iowa Immanuel Pathways | $106 | 78% |
| Pace Southeast | $106 | 78% |
| Pace-Trinity Health | $106 | 78% |
| Peak Pace Solutions | $106 | 78% |
| Perennial Advantage | $106 | 78% |
| Preferred Care Partners | $106 | 78% |
| Presbyterian Senior Plan | $106 | 78% |
| Provider Partners Health Plan Of Illinois | $106 | 78% |
| Provider Partners Health Plan Of Indiana | $106 | 78% |
| Pruitthealth Premier | $106 | 78% |
| Reliance Community Care Partners Care Resources Pace | $106 | 78% |
| Rx Allwin | $106 | 78% |
| Rx Grane Grnmedd | $106 | 78% |
| Rx Retiree Rx Care | $106 | 78% |
| Scan Health Plan Mcr Ipa Meritage Oon | $106 | 78% |
| Secure Horizons Ma Pffs | $106 | 78% |
| Serenity Pace | $106 | 78% |
| Siouxland Pace | $106 | 78% |
| Solis Health Plans | $106 | 78% |
| Sunnyview-Pace Finance Dept | $106 | 78% |
| Texan Plus | $106 | 78% |
| The Health Plan | $106 | 78% |
| Thome Pace | $106 | 78% |
| Todays Options | $106 | 78% |
| Tribute Health Plans | $106 | 78% |
| Um Health Advantage | $106 | 78% |
| Union Health Service | $106 | 78% |
| Welbe Health | $106 | 78% |
| Wellmed | $106 | 78% |
| Veterans Administration | $108 | 80% |
| American Health Plan | $111 | 82% |
| Iowa Health Advantage | $111 | 82% |
| Wc Corvel | $121 | 89% |
| Amps | $137 | 101% |
| Stephenson Cty Health | $142 | 105% |
| Amish Hospital Aid | $144 - $178 | 106% |
| Bcn Domestic | $156 | 115% |
| Blue Benefit Administrators Of Massachusetts | $156 | 115% |
| Blue Care Network | $156 | 115% |
| Blue Distinction Transplant | $156 | 115% |
| Blue Shield - Ca | $156 | 115% |
| Blue Shield - Id (Regence) | $156 | 115% |
| Blue Shield - Ny Highmark Northeastern | $156 | 115% |
| Blue Shield - Ny Highmark Western | $156 | 115% |
| Blue Shield - Pa (Highmark) | $156 | 115% |
| Blue Shield - Wa (Regence) | $156 | 115% |
| Health Choices | $156 - $216 | 115% |
| Kaiser Domestic | $156 | 115% |
| Pre-Employment | $156 | 115% |
| Wc Domestic | $156 | 115% |
| Avera | $169 | 125% |
| Newton Correctional Facility | $177 | 131% |
| Medical Associates | $180 - $206 | 133% |
| Sanford Health Plan | $184 | 136% |
| 1199 National Benefit Fund | $190 | 140% |
| Allied Benefit Systems | $190 - $216 | 140% |
| Asr Health Benefits | $190 | 140% |
| Christian Brother Services | $190 | 140% |
| Coventry | $190 | 140% |
| First Health | $190 | 140% |
| Lucent Health | $190 - $194 | 140% |
| Luminare Health | $190 | 140% |
| Medical Mutual | $190 | 140% |
| Meritain | $190 - $198 | 140% |
| Trustmark Small Business Benefits | $190 | 140% |
| Webtpa | $190 | 140% |
| Geha | $194 - $226 | 143% |
| Oscar | $199 | 147% |
| Health Partners | $200 - $248 | 147% |
| Health Smart | $200 | 147% |
| Ucare | $200 | 147% |
| Centivo | $201 - $248 | 148% |
| Genex Wc | $204 | 150% |
| Usa Managed Care | $210 | 155% |
| Quiktrip | $211 | 156% |
| Auxiant | $216 - $253 | 159% |
| First Choice Health | $216 | 159% |
| Group Administrators | $216 | 159% |
| Midlands | $216 - $253 | 159% |
| Midlands Choice | $216 - $253 | 159% |
| Preferred One | $217 | 160% |
| Wc Align Network | $218 | 161% |
| Claimdoc | $226 - $270 | 167% |
| The Alliance | $227 | 167% |
| Wc Praxis Health Network | $231 | 170% |
| Wc Reny Company | $237 | 175% |
| Wc Velocity | $237 | 175% |
| Global Excel | $244 | 180% |
| Auto Velocity | $245 | 181% |
| Wc O'Hara Corp | $245 | 181% |
| Multiplan | $247 | 182% |
| Medica | $253 | 187% |
| Velocity | $254 | 187% |
| Crime Victim Assistance | $258 | 190% |
| Nova | $270 | 199% |
| Andrie Inc | $272 | 201% |
| East Greenbush Central School District | $272 | 201% |
| Healthsmart Workers Comp | $272 | 201% |
| Jag Source | $272 | 201% |
| New York State Insurance Fund | $272 | 201% |
| Njm Insurance Group | $272 | 201% |
| Rx Heatlhcomp | $272 | 201% |
| Rx Restat | $272 | 201% |
| Rx Saif Opdp Wc | $272 | 201% |
| Rx Worker'S Comp | $272 | 201% |
| Wc Accident Fund | $272 | 201% |
| Wc Ace | $272 | 201% |
| Wc Acs Federal Employees | $272 | 201% |
| Wc Acuity | $272 | 201% |
| Wc Advantage | $272 | 201% |
| Wc Aegis | $272 | 201% |
| Wc Aig | $272 | 201% |
| Wc Aims | $272 | 201% |
| Wc Alaska National Ins | $272 | 201% |
| Wc Allied | $272 | 201% |
| Wc Am Trust N America | $272 | 201% |
| Wc American Claims Mgmt | $272 | 201% |
| Wc Amerisure | $272 | 201% |
| Wc Amtrust | $272 | 201% |
| Wc Asu Risk Mgt | $272 | 201% |
| Wc Benetech | $272 | 201% |
| Wc Berkley Admin | $272 | 201% |
| Wc Broadspire | $272 | 201% |
| Wc Broward County | $272 | 201% |
| Wc Bunch & Associates | $272 | 201% |
| Wc California State Comp Ins | $272 | 201% |
| Wc California State Ins Fund | $272 | 201% |
| Wc Capitol Area Health Consortium | $272 | 201% |
| Wc Ccmsi | $272 | 201% |
| Wc Chartis | $272 | 201% |
| Wc Chubb | $272 | 201% |
| Wc Cirma | $272 | 201% |
| Wc City Of Albany | $272 | 201% |
| Wc City Of Sioux City | $272 | 201% |
| Wc Claims Mgmt Inc | $272 | 201% |
| Wc Cna | $272 | 201% |
| Wc Comp One Admin C/O Manageability | $272 | 201% |
| Wc Compone Admin | $272 | 201% |
| Wc Ct Healthcare Trust | $272 | 201% |
| Wc Donegal Insurance Group | $272 | 201% |
| Wc Emc Insurance Company | $272 | 201% |
| Wc Employee Mutual | $272 | 201% |
| Wc Enablecomp | $272 | 201% |
| Wc Encore Health Network | $272 | 201% |
| Wc Erie | $272 | 201% |
| Wc Esis | $272 | 201% |
| Wc Evolutions | $272 | 201% |
| Wc Fcci | $272 | 201% |
| Wc Fed Ex | $272 | 201% |
| Wc Federal Black Lung | $272 | 201% |
| Wc Federated | $272 | 201% |
| Wc Finley Occupational Health | $272 | 201% |
| Wc First Agency/Occunet | $272 | 201% |
| Wc Ford Motor | $272 | 201% |
| Wc Fresno Unified Emp | $272 | 201% |
| Wc Gallagher Bassett | $272 | 201% |
| Wc General Motors | $272 | 201% |
| Wc Generic | $272 | 201% |
| Wc Genex Care For Ohio | $272 | 201% |
| Wc Great West Casualty | $272 | 201% |
| Wc Guarantee Insurance | $272 | 201% |
| Wc Guard Insurance Company | $272 | 201% |
| Wc Hab | $272 | 201% |
| Wc Hartford | $272 | 201% |
| Wc Hastings | $272 | 201% |
| Wc Health Management | $272 | 201% |
| Wc Heritage Summit | $272 | 201% |
| Wc Hireright | $272 | 201% |
| Wc Horizon | $272 | 201% |
| Wc Icw Group | $272 | 201% |
| Wc Idaho State Ins Fund | $272 | 201% |
| Wc Intercare Insurance | $272 | 201% |
| Wc Intermountain | $272 | 201% |
| Wc Johns Eastern | $272 | 201% |
| Wc Kemberton | $272 | 201% |
| Wc Key Ins & Benefit Solutions | $272 | 201% |
| Wc Liberty Mutual | $272 | 201% |
| Wc Mac Risk Management | $272 | 201% |
| Wc Massachusetts | $272 | 201% |
| Wc Mdia | $272 | 201% |
| Wc Meadowbrook Claim | $272 | 201% |
| Wc Medical Administrators | $272 | 201% |
| Wc Meijers | $272 | 201% |
| Wc Memic | $272 | 201% |
| Wc Mercy Workcare | $272 | 201% |
| Wc Michigan | $272 | 201% |
| Wc Michigan Millers Mutual | $272 | 201% |
| Wc Mitchell Frankenmuth | $272 | 201% |
| Wc Mra | $272 | 201% |
| Wc Nationwide | $272 | 201% |
| Wc Nca Comp | $272 | 201% |
| Wc New York | $272 | 201% |
| Wc New York Special Funds | $272 | 201% |
| Wc North American Rishces | $272 | 201% |
| Wc Northeast Health | $272 | 201% |
| Wc Notre Dame | $272 | 201% |
| Wc Novanet | $272 | 201% |
| Wc Occ Health Allen | $272 | 201% |
| Wc Ohio Bureau | $272 | 201% |
| Wc One Call Medical | $272 | 201% |
| Wc Paradigm | $272 | 201% |
| Wc Peerless | $272 | 201% |
| Wc Pma | $272 | 201% |
| Wc Price Chopper | $272 | 201% |
| Wc Procura Management | $272 | 201% |
| Wc Qualcare | $272 | 201% |
| Wc Quiktrip | $272 | 201% |
| Wc Rev Claims | $272 | 201% |
| Wc Risico | $272 | 201% |
| Wc Rural Mutual | $272 | 201% |
| Wc Saif Oregon | $272 | 201% |
| Wc Secura | $272 | 201% |
| Wc Sedgwick | $272 | 201% |
| Wc Sentry | $272 | 201% |
| Wc Sheakley Unicomp | $272 | 201% |
| Wc Smile Lodge | $272 | 201% |
| Wc Society | $272 | 201% |
| Wc Srs | $272 | 201% |
| Wc Taconic (Mro) | $272 | 201% |
| Wc Taconic Farms | $272 | 201% |
| Wc Travelers | $272 | 201% |
| Wc Triad Group | $272 | 201% |
| Wc Tristar | $272 | 201% |
| Wc Troy Ny | $272 | 201% |
| Wc Tyson | $272 | 201% |
| Wc Unified Health Services | $272 | 201% |
| Wc United Heartland | $272 | 201% |
| Wc Us Dept Of Labor | $272 | 201% |
| Wc Walmart | $272 | 201% |
| Wc West Bend | $272 | 201% |
| Wc West Bend Mutual/Argent | $272 | 201% |
| Wc Winnebago Industries | $272 | 201% |
| Wc Yankee Trails | $272 | 201% |
| Wc York Risk | $272 | 201% |
| Wc Zenith | $272 | 201% |
| Wc Zurich | $272 | 201% |