CMS Price Transparency Data

MRI, knee or other leg joint

Facility: Mercyone Oelwein Medical Center

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $3,679
  • Cash Discount Price: $3,253
  • vs. Medicare Baseline: 15.09x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at Mercyone Oelwein Medical Center is $3,679. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,253. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 15.09x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$3,253

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,679

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: $3,253 (1334%)
Insurance Median: $3,679 (1509%)
Cash: $3,253 (1334% of Medicare)
Ins. Median: $3,679 (1509% 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 1509% of the Medicare baseline (a markup of 1409%). 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) $1,530 - $2,558 628%
Iowa Total Care $1,552 - $2,328 637%
Medicaid / KanCare $1,574 - $2,373 646%
Blue Cross Blue Shield $1,624 - $2,437 666%
UnitedHealthcare $1,740 - $4,264 714%
Aetna $1,887 - $5,519 774%
Amish Hospital Aid $2,183 - $3,275 896%
Centivo $2,462 - $3,693 1010%
Ambetter / Centene $2,757 - $4,136 1131%
Geha $2,842 - $4,264 1166%
Health Choices $2,946 - $4,420 1209%
Medical Associates $2,946 - $4,420 1209%
Claimdoc $3,299 - $4,949 1353%
Nova $3,299 - $4,949 1353%
1199 National Benefit Fund $3,679 - $5,519 1509%
Allied Benefit Systems $3,679 - $5,519 1509%
Asr Health Benefits $3,679 - $5,519 1509%
Christian Brother Services $3,679 - $5,519 1509%
Coventry $3,679 - $5,519 1509%
First Health $3,679 - $5,519 1509%
Lucent Health $3,679 - $5,519 1509%
Luminare Health $3,679 - $5,519 1509%
Medical Mutual $3,679 - $5,519 1509%
Meritain $3,679 - $5,519 1509%
Trustmark Small Business Benefits $3,679 - $5,519 1509%
Webtpa $3,679 - $5,519 1509%
Health Partners $3,851 - $5,777 1580%
Multiplan $3,883 - $5,825 1593%
Auxiant $3,923 - $5,885 1609%
Cigna $3,923 - $5,885 1609%
Medica $3,923 - $5,885 1609%
Midlands $3,923 - $5,885 1609%
Midlands Choice $3,923 - $5,885 1609%
Crime Victim Assistance $4,003 - $6,005 1642%
Iowa Dept Of Public Health $4,003 - $6,005 1642%

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