CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Medical Center-New Hampton

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $869
  • Cash Discount Price: $598
  • vs. Medicare Baseline: 8.14x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Medical Center-New Hampton is $869. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $598. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.14x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$598

Average discount available for prompt cash payment at this facility.

Insurance Median
$869

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: $598 (560%)
Insurance Median: $869 (814%)
Cash: $598 (560% of Medicare)
Ins. Median: $869 (814% 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 814% of the Medicare baseline (a markup of 714%). 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 $364 341%
Aetna $368 - $869 345%
Medicare (plans) $372 - $411 348%
UnitedHealthcare $390 - $552 365%
Health Choices $465 435%
Medical Associates $465 435%
Amish Hospital Aid $489 458%
Oscar $541 507%
Geha $552 517%
Ambetter / Centene $618 579%
Iowa Total Care $629 589%
Medicaid / KanCare $638 - $641 597%
Claimdoc $740 693%
Nova $740 693%
1199 National Benefit Fund $869 814%
Allied Benefit Systems $869 814%
Asr Health Benefits $869 814%
Coventry $869 814%
First Health $869 814%
Lucent Health $869 814%
Luminare Health $869 814%
Medical Mutual $869 814%
Meritain $869 814%
Trustmark Small Business Benefits $869 814%
Webtpa $869 814%
First Choice Health $874 818%
Health Partners $884 828%
Auxiant $892 835%
Cigna $892 835%
Medica $892 835%
Midlands $892 835%
Midlands Choice $892 835%
Crime Victim Assistance $920 861%
Iowa Dept Of Public Health $920 861%

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