CMS Price Transparency Data

Family therapy session

Facility: Mercyone Oelwein Medical Center

Billing Code: 90847 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90847
  • Insurance Median: $428
  • Cash Discount Price: $303
  • vs. Medicare Baseline: 2.36x Medicare
The contracted insurance negotiated median rate for a Family therapy session at Mercyone Oelwein Medical Center is $428. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $303. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 2.36x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$303

Average discount available for prompt cash payment at this facility.

Insurance Median
$428

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)
Cash / Self-Pay: $303 (167%)
Insurance Median: $428 (236%)
Cash: $303 (167% of Medicare)
Ins. Median: $428 (236% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 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 236% of the Medicare baseline (a markup of 136%). 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
Medicare (plans) $178 - $198 98%
Iowa Total Care $181 100%
Medicaid / KanCare $183 - $184 101%
Blue Cross Blue Shield $189 104%
UnitedHealthcare $203 - $402 112%
Aetna $220 - $428 121%
Amish Hospital Aid $254 140%
Centivo $287 158%
Ambetter / Centene $321 177%
Health Choices $343 189%
Medical Associates $343 189%
Claimdoc $384 212%
Nova $384 212%
Geha $402 222%
1199 National Benefit Fund $428 236%
Allied Benefit Systems $428 236%
Asr Health Benefits $428 236%
Christian Brother Services $428 236%
Coventry $428 236%
First Health $428 236%
Lucent Health $428 236%
Luminare Health $428 236%
Medical Mutual $428 236%
Meritain $428 236%
Trustmark Small Business Benefits $428 236%
Webtpa $428 236%
Health Partners $448 247%
Multiplan $452 249%
Auxiant $457 252%
Cigna $457 252%
Medica $457 252%
Midlands $457 252%
Midlands Choice $457 252%
Crime Victim Assistance $466 257%
Iowa Dept Of Public Health $466 257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals