How many shoppable procedure prices are published for Mercyone Newton Medical Center?

Mercyone Newton Medical Center in Newton, IA currently has 106 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Mercyone Newton Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Mercyone Newton Medical Center's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Mercyone Newton Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Mercyone Newton Medical Center an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 48 Beds · urban Updated: 2026-03-31

Mercyone Newton Medical Center

204 N 4Th Ave E, Newton, IA 50208 · 106 Priced Procedures · 58% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

Above Fair Market · Negotiate

1.07×vs. Fair Market Price

Typical commercial prices here are +7% above the fair benchmark (1.07×) even after accounting for local nurse/doctor wages and patient complexity.

59/100 · Caution

59/100Self-Pay Cash Beats Insurance 38% of the Time

File Completeness56

Price Logic28

Peer Alignment72

Clean Billing80

Real Cash Discount70

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.07× fair market pricing.

Behavioral Pricing FingerprintHigh Insurer Rate · Deep Cash Discount

Cash-Arbitrage Bifurcated Pricer

Mercyone Newton Medical Center maintains elevated commercial insurance contracts (1.07× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 38% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.

#40 of 87 in IA · 44th State Percentile#1,583 of 3,385 in U.S. · 46th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.85× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 38% of shoppable procedures (70/100 Cash Honesty)
4-Star CMS clinical rating with 58% patient recommendation (65/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (32.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (0.5×) & laboratory (2.5×) services average 1.40× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.25×) jump +30% above the median procedure ratio (Q50 0.96×)
Consolidated metro market (HHI 4,157) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.40× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+30% Upper Tail

Q25 0.85× · Q50 0.96× · Q75 1.25×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.6× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

0.5× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.5× MedicareFair

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.7× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

38% Cash Edge · 70/100Fair

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 65/100Fair

Procedure Prices at Mercyone Newton Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 106 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$50,263	$18,106	$19,432	0.9×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$36,964	$17,618	$19,087	0.9×
Total knee replacement CPT Code: `27447`	—	—	$13,523	—
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$24,358	$7,071	$8,223	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$18,286	$6,176	$6,109	unverified
Inguinal hernia repair CPT Code: `49505`	$19,941	$5,807	$3,629	unverified
Total hip replacement CPT Code: `27130`	$2,825	$2,825	$13,413	0.2×
Trauma team activation HCPCS Code: `G0390`	$2,518	$2,518	$1,453	1.7×
Cataract surgery with lens implant CPT Code: `66984`	$7,795	$2,358	$2,540	0.9×
Injection procedure for pain management HCPCS Code: `G0260`	$1,404	$1,404	$855	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,220	$1,220	$3,372	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	—	—	$987	—
Sleep study (overnight, in lab) CPT Code: `95810`	$3,901	$877	$1,021	0.9×
Colonoscopy with biopsy CPT Code: `45380`	$730	$730	$1,256	0.6×
Rabies immune globulin HCPCS Code: `90375`	$3,214	$533	$322	unverified
Blood transfusion CPT Code: `36430`	—	$451	$498	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,664	$356	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$3,607	$356	$511	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$3,953	$317	$369	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$987	$244	$272	0.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,052	$244	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$2,599	$244	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$2,297	$244	$343	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$1,509	$179	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,747	$179	$258	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	—	$179	$583	0.3×
Breathing treatment (nebulizer) CPT Code: `94640`	—	—	$201	unverified
Diagnostic mammogram (both breasts) CPT Code: `77066`	$446	$143	$148	1.0×
Speech therapy (language evaluation) CPT Code: `92507`	$246	$102	$86	1.2×
X-ray, pelvis CPT Code: `72170`	—	$107	$110	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$507	$116	$123	0.9×
X-ray, chest (single view) CPT Code: `71045`	—	$89	$92	1.0×
X-ray, shoulder CPT Code: `73030`	$386	$89	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$207	$89	$93	1.0×
X-ray, hand CPT Code: `73130`	$306	$89	$93	1.0×
X-ray, hip CPT Code: `73502`	$222	$89	$93	1.0×
Ultrasound, abdomen (limited) CPT Code: `76705`	$556	$107	$126	0.8×
Ultrasound, pelvis CPT Code: `76856`	$598	$107	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$554	$107	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$693	$107	$134	0.8×
CT scan, head (no contrast) CPT Code: `70450`	$1,737	$107	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$1,638	$107	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$1,619	$107	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$1,442	$107	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,517	$107	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,506	$107	$169	0.6×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$104	$981	0.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$252	$89	$93	unverified
X-ray, lower back CPT Code: `72110`	$369	$107	$112	unverified
X-ray, ankle CPT Code: `73610`	$340	$89	$93	unverified
X-ray, foot CPT Code: `73630`	$283	$89	$92	unverified
Typhoid vaccine HCPCS Code: `90675`	—	$312	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$149	$183	$203	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$407	$133	$140	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$273	$95	$111	0.9×
Orthotic fitting and training CPT Code: `97760`	$129	$61	$51	1.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$79	$79	$86	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$155	$45	$38	1.2×
Physical therapy (gait training) CPT Code: `97116`	$92	$39	$33	1.2×
Prosthetic fitting and training CPT Code: `97761`	$69	$53	$45	1.2×
Blood antibody screen CPT Code: `86850`	$86	$53	$46	1.2×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$129	$27	$20	1.4×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$129	$46	$40	1.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	—	$43	$38	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	—	$39	$35	1.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	—	$60	$64	0.9×
Culture, blood CPT Code: `87040`	—	$20	$11	1.8×
Blood test, vitamin D CPT Code: `82306`	$175	$41	$31	1.3×
Occupational therapy (self-care training) CPT Code: `97535`	$94	$43	$38	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$129	$37	$34	1.1×
Flu vaccine injection HCPCS Code: `G0008`	$35	$48	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$35	$48	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$35	$48	$49	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$207	$49	$123	0.4×
Urinalysis (automated, with microscopy) CPT Code: `81001`	—	$5	$3	1.7×
Blood test, glucose (blood sugar) CPT Code: `82947`	—	$6	$4	1.5×
Blood test, calcium CPT Code: `82310`	—	$7	$5	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	—	$7	$5	1.4×
Blood test, potassium CPT Code: `84132`	—	$7	$5	1.4×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$11	$8	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$107	$19	$14	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$103	$12	$9	1.3×
Hepatitis C antibody test CPT Code: `86803`	$127	$20	$15	1.3×
Culture, bacterial CPT Code: `87070`	—	$12	$9	1.3×
Blood test, PSA (prostate screen) CPT Code: `84153`	$122	$25	$19	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$95	$21	$16	1.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$174	$40	$56	0.7×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$79	$13	$10	1.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$111	$18	$14	1.3×
Blood test, amylase CPT Code: `82150`	$76	$9	$7	1.3×
Blood test, lipase CPT Code: `83690`	$83	$9	$7	1.3×
Blood test, magnesium CPT Code: `83735`	—	$9	$7	1.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	—	$14	$11	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	—	$5	$4	1.3×
Blood test, liver function panel CPT Code: `80076`	$111	$11	$9	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	—	$22	$18	1.2×
Hepatitis B vaccine HCPCS Code: `90744`	$99	$32	$37	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	—	$6	$5	1.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$61	$23	$25	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$75	$12	$14	0.9×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$33	$30	$39	0.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$140	$31	$87	0.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	$185	$12	$35	0.3×
Blood test, sodium CPT Code: `84295`	—	—	$5	unverified
Blood test, hemoglobin CPT Code: `85018`	—	—	$3	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	—	—	$6	—

Showing top 25 high-impact procedures of 106 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 32.5%

Audit a Bill or Quote at Mercyone Newton Medical Center (Zero PHI Required)

CMS CCN: 160032

CPT 470

Select Procedure to Audit:

Fair BaseRate™ $19,432

Medicare Rate $14,044

Self-Pay Cash $50,263

Insurer Median $18,106

1. Amount on Your Bill or Quote ($) Pre-filled with Mercyone Newton Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $14,144 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $14,144

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (32.5% of gross = $14,144).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $50,263

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Mercyone Newton Medical Center's published 45 CFR § 180 self-pay cash rate is $50,263 (vs. $18,106 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$24,022 Above Fair BaseRate

Negotiate Toward $19,432 Fair BaseRate ($14,044 Medicare)

Your bill ($43,454) is $24,022 above the denoised Fair BaseRate ($19,432) and 3.1× the $14,044 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (32.5% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite65/100

Would Recommend58%

Rated 9 or 10 (HCAHPS)62%

Median ER Wait158 min

Left ER Before Seen3%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Mercyone Newton Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-07-18·administrative_or_closure
Closure Notice
Recorded
2025-04-16·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (83 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Mercyone Newton Medical Center.

Price Index: 1.16× regional baseline

Quality: 64/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Blue Cross Blue Shield

-54.6%

Centivo

-45.8%

Nova

-42.5%

Health Alliance

+69.6%

Median Household Income$70,128U.S. Census ACS

Local Uninsured Share4.1%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 59/100 · Caution CMS CCN 160032

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 160032) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-31

Validated Rate Rows11,096 (CMS v3.0.0)

File Integrity DigestVerified · CCN 160032

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy