CMS Price Transparency Data

CT scan, abdomen and pelvis (with contrast)

Facility: Mercy Medical Center-New Hampton

Billing Code: 74177 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 74177
  • Insurance Median: $5,327
  • Cash Discount Price: $3,920
  • vs. Medicare Baseline: 14.95x Medicare
The contracted insurance negotiated median rate for a CT scan, abdomen and pelvis (with contrast) at Mercy Medical Center-New Hampton is $5,327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,920. Compared to the federal Medicare reimbursement reference rate of $356.43, this hospital’s rate is 14.95x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$3,920

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,327

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$356.43

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $356.43 (100%)
Cash / Self-Pay: $3,920 (1100%)
Insurance Median: $5,327 (1495%)
Cash: $3,920 (1100% of Medicare)
Ins. Median: $5,327 (1495% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $356.43 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 1495% of the Medicare baseline (a markup of 1395%). 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 $2,232 626%
Aetna $2,255 - $5,327 633%
Medicare (plans) $2,277 - $2,518 639%
UnitedHealthcare $2,390 - $3,382 671%
Health Choices $2,847 799%
Medical Associates $2,847 799%
Amish Hospital Aid $2,999 841%
Oscar $3,315 930%
Geha $3,382 949%
Ambetter / Centene $3,788 1063%
Iowa Total Care $3,852 1081%
Medicaid / KanCare $3,909 - $3,928 1097%
Claimdoc $4,532 1271%
Nova $4,532 1271%
1199 National Benefit Fund $5,327 1495%
Allied Benefit Systems $5,327 1495%
Asr Health Benefits $5,327 1495%
Coventry $5,327 1495%
First Health $5,327 1495%
Lucent Health $5,327 1495%
Luminare Health $5,327 1495%
Medical Mutual $5,327 1495%
Meritain $5,327 1495%
Trustmark Small Business Benefits $5,327 1495%
Webtpa $5,327 1495%
First Choice Health $5,355 1502%
Health Partners $5,417 1520%
Auxiant $5,468 1534%
Cigna $5,468 1534%
Medica $5,468 1534%
Midlands $5,468 1534%
Midlands Choice $5,468 1534%
Crime Victim Assistance $5,637 1582%
Iowa Dept Of Public Health $5,637 1582%

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