Ot evaluation moderate complexity patient/family at MercyOne Clinton Medical Center
1410 N. Fourth St, Clinton, IA · MercyOne · · NPI 1427093962
$1,175.85
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$303.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$72.58 with IOWA TOTAL CARE vs $303.00 with UNITED HEALTHCARE — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $72.58 | ↓ -94% |
| MOLINA MEDICAID | MOLINA MEDICAID | $73.29 | ↓ -94% |
| WELLPOINT MEDICAID | WELLPOINT MEDICAID | $73.58 | ↓ -94% |
| MEDICAL ASSOCIATES | MEDICAL ASSOCIATES | $85.75 | ↓ -93% |
| HEALTH CHOICES | MEDICAL ASSOCIATES | $85.75 | ↓ -93% |
| PREFERRED HEALTH CHOICE | PREFERRED HEALTH CHOICES | $87.57 | ↓ -93% |
| AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $94.74 | ↓ -92% |
| MEDIGOLD MEDICARE ADVANTAGE | MERCYONE HEALTH PLAN MEDICARE ADVANTAGE | $94.74 | ↓ -92% |
| MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $94.74 | ↓ -92% |
| BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE | WELLMARK MEDICARE ADVANTAGE | $95.68 | ↓ -92% |
| UNITED HEALTHCARE MEDICARE | UNITED HEALTHCARE MEDICARE ADVANTAGE | $96.63 | ↓ -92% |
| WELLPOINT MEDICARE ADVANTAGE | WELLPOINT MEDICARE ADVANTAGE | $98.60 | ↓ -92% |
| AMISH HOSPITAL AID | AMISH HOSPITAL AID | $128.57 | ↓ -89% |
| OSCAR | OSCAR | $131.88 | ↓ -89% |
| AMBETTER | AMBETTER MARKETPLACE | $162.41 | ↓ -86% |
| THE ALLIANCE | THE ALLIANCE | $183.77 | ↓ -84% |
| NOVA | CLAIMDOC | $194.31 | ↓ -83% |
| CLAIMDOC | CLAIMDOC | $194.31 | ↓ -83% |
| GEHA | UNITED HEALTHCARE | $195.00 | ↓ -83% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $195.00 | ↓ -83% |
| AETNA | AETNA | $265.13 | ↓ -77% |
| MEDICAL MUTUAL | AETNA | $265.13 | ↓ -77% |
| LUCENT HEALTH | AETNA | $265.13 | ↓ -77% |
| TRUSTMARK SMALL BUSINESS BENEFITS | AETNA | $265.13 | ↓ -77% |
| CHRISTIAN BROTHER SERVICES | AETNA | $265.13 | ↓ -77% |
| COVENTRY | AETNA | $265.13 | ↓ -77% |
| ALLIED BENEFIT SYSTEMS | AETNA | $265.13 | ↓ -77% |
| MERITAIN | AETNA | $265.13 | ↓ -77% |
| 1199 NATIONAL BENEFIT FUND | AETNA | $265.13 | ↓ -77% |
| LUMINARE HEALTH | AETNA | $265.13 | ↓ -77% |
| FIRST HEALTH | AETNA | $265.13 | ↓ -77% |
| ASR HEALTH BENEFITS | AETNA | $265.13 | ↓ -77% |
| AETNA EAP | AETNA | $265.13 | ↓ -77% |
| AETNA DOMESTIC | AETNA | $265.13 | ↓ -77% |
| WEBTPA | AETNA | $265.13 | ↓ -77% |
| HEALTH PARTNERS | HEALTH PARTNERS | $265.73 | ↓ -77% |
| MIDLANDS | MIDLANDS CHOICE PPO | $272.70 | ↓ -77% |
| CIGNA EAP | MIDLANDS CHOICE PPO | $272.70 | ↓ -77% |
| QUALCARE | QCCH | $272.70 | ↓ -77% |
| MIDLANDS CHOICE | MIDLANDS CHOICE PPO | $272.70 | ↓ -77% |
| AUXIANT | MIDLANDS CHOICE PPO | $272.70 | ↓ -77% |
| MEDICA | MIDLANDS CHOICE PPO | $272.70 | ↓ -77% |
| CIGNA | MIDLANDS CHOICE PPO | $272.70 | ↓ -77% |
| MULTIPLAN | MULTIPLAN | $272.70 | ↓ -77% |
| USA MANAGED CARE | USA MANAGED CARE | $287.85 | ↓ -76% |
| CRIME VICTIM ASSISTANCE | CRIME VICTIMS | $303.00 | ↓ -74% |
| IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $303.00 | ↓ -74% |
| UNITED HEALTHCARE | UHC OPTUM BEHAVIORAL HEALTH | $303.00 | ↓ -74% |
Visitor-reported prices
Comments
Ot evaluation moderate complexity patient/family at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $213.00 | $128.99 – $128.99 |
| MercyOne New Hampton Medical Center | New Hampton | $198.90 | $121.15 – $306.00 |
| MercyOne Dyersville Medical Center | Dyersville | $198.90 | $115.67 – $344.43 |
| MercyOne Oelwein Medical Center | Oelwein | $198.90 | $116.95 – $306.00 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $229.45 | $72.58 – $353.00 |
| MercyOne Elkader Medical Center | Elkader | $198.90 | $157.50 – $319.83 |
| MercyOne West Des Moines Medical Center | West Des Moines | $407.00 | $72.58 – $407.00 |
| MercyOne Des Moines Medical Center | Des Moines | $264.55 | $72.58 – $407.00 |