CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Mercyone Dyersville Medical Center

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 99214
Insurance Median: $213
Cash Discount Price: $168
vs. Medicare Baseline: 1.57x Medicare

The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Mercyone Dyersville Medical Center is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.57x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.

Cash / Self-Pay

$168

Average discount available for prompt cash payment at this facility.

Insurance Median

$213

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)

Cash / Self-Pay: $168 (124%)

Insurance Median: $213 (157%)

Cash: $168 (124% of Medicare)

Ins. Median: $213 (157% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 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	$89	66%
Health Choices	$98	72%
Blue Cross Blue Shield	$143	105%
Medicare (plans)	$146 - $159	108%
UnitedHealthcare	$153 - $232	113%
The Alliance	$157	116%
Iowa Total Care	$179	132%
Medicaid / KanCare	$182	134%
Amish Hospital Aid	$192	142%
1199 National Benefit Fund	$213	157%
Aetna	$213	157%
Allied Benefit Systems	$213	157%
Asr Health Benefits	$213	157%
Christian Brother Services	$213	157%
Coventry	$213	157%
First Health	$213	157%
Luminare Health	$213	157%
Medical Mutual	$213	157%
Meritain	$213	157%
Trustmark Small Business Benefits	$213	157%
Webtpa	$213	157%
Auxiant	$232	171%
Cigna	$232	171%
Geha	$232	171%
Medica	$232	171%
Midlands	$232	171%
Midlands Choice	$232	171%
Multiplan	$232	171%
Ambetter / Centene	$243	179%
Crime Victim Assistance	$258	190%
Claimdoc	$290	214%
Nova	$290	214%

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 $168.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 99214.

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 99214.
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.