CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercyone Oelwein Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $232
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 1.97x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercyone Oelwein Medical Center is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.97x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $164 (139%)
Insurance Median: $232 (197%)
Cash: $164 (139% of Medicare)
Ins. Median: $232 (197% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 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.

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
Iowa Dept Of Public Health $74 63%
Aetna $77 - $232 65%
Medicare (plans) $96 - $107 82%
Iowa Total Care $98 83%
Medicaid / KanCare $99 - $100 84%
Blue Cross Blue Shield $102 87%
UnitedHealthcare $110 - $217 94%
Amish Hospital Aid $137 117%
Centivo $155 132%
Ambetter / Centene $174 148%
Health Choices $185 157%
Medical Associates $185 157%
Claimdoc $208 177%
Nova $208 177%
Geha $217 185%
1199 National Benefit Fund $232 197%
Allied Benefit Systems $232 197%
Asr Health Benefits $232 197%
Christian Brother Services $232 197%
Coventry $232 197%
First Health $232 197%
Lucent Health $232 197%
Luminare Health $232 197%
Medical Mutual $232 197%
Meritain $232 197%
Trustmark Small Business Benefits $232 197%
Webtpa $232 197%
Health Partners $242 206%
Multiplan $244 208%
Auxiant $247 210%
Cigna $247 210%
Medica $247 210%
Midlands $247 210%
Midlands Choice $247 210%
Crime Victim Assistance $252 214%

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