CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: Mercyone Dyersville Medical Center

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99203
Insurance Median: $208
Cash Discount Price: $164
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at Mercyone Dyersville Medical Center is $208. 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 1.77x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.

Cash / Self-Pay

$164

Average discount available for prompt cash payment at this facility.

Insurance Median

$208

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: $208 (177%)

Cash: $164 (139% of Medicare)

Ins. Median: $208 (177% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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%
Health Choices	$95	81%
Blue Cross Blue Shield	$140	119%
Medicare (plans)	$143 - $156	122%
UnitedHealthcare	$150 - $227	128%
The Alliance	$153	130%
Iowa Total Care	$175	149%
Medicaid / KanCare	$177 - $178	151%
Amish Hospital Aid	$188	160%
1199 National Benefit Fund	$208	177%
Aetna	$208	177%
Allied Benefit Systems	$208	177%
Asr Health Benefits	$208	177%
Christian Brother Services	$208	177%
Coventry	$208	177%
First Health	$208	177%
Luminare Health	$208	177%
Medical Mutual	$208	177%
Meritain	$208	177%
Trustmark Small Business Benefits	$208	177%
Webtpa	$208	177%
Auxiant	$227	193%
Cigna	$227	193%
Geha	$227	193%
Medica	$227	193%
Midlands	$227	193%
Midlands Choice	$227	193%
Multiplan	$227	193%
Ambetter / Centene	$237	202%
Crime Victim Assistance	$252	214%
Claimdoc	$284	242%
Nova	$284	242%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $164.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99203.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercyone Dyersville Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 99203.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.