CMS Price Transparency Data

CT scan, pelvis

Facility: Mercy Medical Center-New Hampton

Billing Code: 72192 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72192
  • Insurance Median: $1,877
  • Cash Discount Price: $1,291
  • vs. Medicare Baseline: 17.57x Medicare
The contracted insurance negotiated median rate for a CT scan, pelvis at Mercy Medical Center-New Hampton is $1,877. 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 17.57x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$1,291

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,877

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: $1,877 (1757%)
Cash: $1,291 (1209% of Medicare)
Ins. Median: $1,877 (1757% 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 1757% of the Medicare baseline (a markup of 1657%). 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 $786 736%
Aetna $794 - $1,877 743%
Medicare (plans) $802 - $887 751%
UnitedHealthcare $842 - $1,192 788%
Health Choices $1,003 939%
Medical Associates $1,003 939%
Amish Hospital Aid $1,057 990%
Oscar $1,168 1094%
Geha $1,192 1116%
Ambetter / Centene $1,335 1250%
Iowa Total Care $1,357 1270%
Medicaid / KanCare $1,377 - $1,384 1289%
Claimdoc $1,597 1495%
Nova $1,597 1495%
1199 National Benefit Fund $1,877 1757%
Allied Benefit Systems $1,877 1757%
Asr Health Benefits $1,877 1757%
Coventry $1,877 1757%
First Health $1,877 1757%
Lucent Health $1,877 1757%
Luminare Health $1,877 1757%
Medical Mutual $1,877 1757%
Meritain $1,877 1757%
Trustmark Small Business Benefits $1,877 1757%
Webtpa $1,877 1757%
First Choice Health $1,887 1767%
Health Partners $1,909 1787%
Auxiant $1,926 1803%
Cigna $1,926 1803%
Medica $1,926 1803%
Midlands $1,926 1803%
Midlands Choice $1,926 1803%
Crime Victim Assistance $1,986 1859%
Iowa Dept Of Public Health $1,986 1859%

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