CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercyone Oelwein Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $356
  • Cash Discount Price: $252
  • vs. Medicare Baseline: 4.00x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercyone Oelwein Medical Center is $356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $252. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.00x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$252

Average discount available for prompt cash payment at this facility.

Insurance Median
$356

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $252 (283%)
Insurance Median: $356 (400%)
Cash: $252 (283% of Medicare)
Ins. Median: $356 (400% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 400% of the Medicare baseline (a markup of 300%). 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) $148 - $165 166%
Iowa Total Care $150 169%
Medicaid / KanCare $152 - $153 171%
Blue Cross Blue Shield $157 177%
UnitedHealthcare $168 - $275 189%
Aetna $182 - $356 205%
Amish Hospital Aid $211 237%
Centivo $238 268%
Ambetter / Centene $267 300%
Geha $275 309%
Health Choices $285 321%
Medical Associates $285 321%
Claimdoc $319 359%
Nova $319 359%
1199 National Benefit Fund $356 400%
Allied Benefit Systems $356 400%
Asr Health Benefits $356 400%
Christian Brother Services $356 400%
Coventry $356 400%
First Health $356 400%
Lucent Health $356 400%
Luminare Health $356 400%
Medical Mutual $356 400%
Meritain $356 400%
Trustmark Small Business Benefits $356 400%
Webtpa $356 400%
Health Partners $372 418%
Multiplan $375 422%
Auxiant $379 426%
Cigna $379 426%
Medica $379 426%
Midlands $379 426%
Midlands Choice $379 426%
Crime Victim Assistance $387 435%
Iowa Dept Of Public Health $387 435%

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