CMS Price Transparency Data

X-ray, lower back

Facility: Mercyone Dyersville Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $470
  • Cash Discount Price: $369
  • vs. Medicare Baseline: 4.40x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Mercyone Dyersville Medical Center is $470. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $369. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.40x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.
Cash / Self-Pay
$369

Average discount available for prompt cash payment at this facility.

Insurance Median
$470

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $369 (345%)
Insurance Median: $470 (440%)
Cash: $369 (345% of Medicare)
Ins. Median: $470 (440% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 440% of the Medicare baseline (a markup of 340%). 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
Health Choices $215 201%
Blue Cross Blue Shield $315 295%
Medicare (plans) $321 - $351 301%
UnitedHealthcare $337 - $398 316%
The Alliance $345 323%
Iowa Total Care $394 369%
Geha $398 373%
Medicaid / KanCare $400 - $402 374%
Amish Hospital Aid $423 396%
1199 National Benefit Fund $470 440%
Aetna $470 440%
Allied Benefit Systems $470 440%
Asr Health Benefits $470 440%
Christian Brother Services $470 440%
Coventry $470 440%
First Health $470 440%
Luminare Health $470 440%
Medical Mutual $470 440%
Meritain $470 440%
Trustmark Small Business Benefits $470 440%
Webtpa $470 440%
Auxiant $511 478%
Cigna $511 478%
Medica $511 478%
Midlands $511 478%
Midlands Choice $511 478%
Multiplan $511 478%
Ambetter / Centene $534 500%
Crime Victim Assistance $568 532%
Iowa Dept Of Public Health $568 532%
Claimdoc $639 598%
Nova $639 598%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 3Rd Street Sw, Dyersville, IA 52040
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals