CMS Price Transparency Data

CT scan, abdomen and pelvis (no contrast)

Facility: Mercy Medical Center-New Hampton

Billing Code: 74176 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74176
  • Insurance Median: $4,438
  • Cash Discount Price: $3,052
  • vs. Medicare Baseline: 18.21x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (no contrast) at Mercy Medical Center-New Hampton is $4,438. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,052. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 18.21x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$3,052

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,438

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $3,052 (1252%)
Insurance Median: $4,438 (1821%)
Cash: $3,052 (1252% of Medicare)
Ins. Median: $4,438 (1821% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 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 1821% of the Medicare baseline (a markup of 1721%). 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 $1,859 763%
Aetna $1,878 - $4,438 770%
Medicare (plans) $1,897 - $2,098 778%
UnitedHealthcare $1,991 - $2,818 817%
Health Choices $2,371 973%
Medical Associates $2,371 973%
Amish Hospital Aid $2,498 1025%
Oscar $2,761 1133%
Geha $2,818 1156%
Ambetter / Centene $3,156 1295%
Iowa Total Care $3,209 1316%
Medicaid / KanCare $3,256 - $3,272 1336%
Claimdoc $3,776 1549%
Nova $3,776 1549%
1199 National Benefit Fund $4,438 1821%
Allied Benefit Systems $4,438 1821%
Asr Health Benefits $4,438 1821%
Coventry $4,438 1821%
First Health $4,438 1821%
Lucent Health $4,438 1821%
Luminare Health $4,438 1821%
Medical Mutual $4,438 1821%
Meritain $4,438 1821%
Trustmark Small Business Benefits $4,438 1821%
Webtpa $4,438 1821%
First Choice Health $4,461 1830%
Health Partners $4,513 1851%
Auxiant $4,555 1869%
Cigna $4,555 1869%
Medica $4,555 1869%
Midlands $4,555 1869%
Midlands Choice $4,555 1869%
Crime Victim Assistance $4,696 1926%
Iowa Dept Of Public Health $4,696 1926%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 308 North Maple Avenue, New Hampton, IA 50659
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals