CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: Mercy Rehabilitation Hospital

Billing Code: 99213 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99213
  • Insurance Median: $121
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (20-29 min) at Mercy Rehabilitation Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $95.19, this hospital’s rate is 1.27x the Medicare baseline. Located in 1401 Campus Dr, Clive, IA.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$95.19

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $95.19 (100%)
Cash / Self-Pay: $121 (127%)
Insurance Median: $121 (127%)
Cash: $121 (127% of Medicare)
Ins. Median: $121 (127% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $95.19 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
Medicare (plans) $121 127%
UnitedHealthcare $121 127%
Oscar Health - Commercial $121 127%
Cigna $121 127%
Aetna $121 127%
Medical Associates Health Plan $121 127%
Humana $121 127%
Health Partners - Commercial (Unitypoint) $121 127%
Consociate Health $121 127%
Blue Cross Blue Shield $121 127%
Medicaid / KanCare $121 127%
Medica - Midlands Choice $121 127%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 Campus Dr, Clive, IA 50325
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL