Pt evaluation moderate complexity patient/family at MercyOne Elkader Medical Center
901 Davidson St. NW, Elkader, IA · MercyOne · · NPI 1184645434
$194.35
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.
$299.00
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.
$153.90 with BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE vs $312.51 with CLAIMDOC — 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 |
|---|---|---|---|
| BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE | WELLMARK MEDICARE ADVANTAGE | $153.90 | ↓ -21% |
| AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $155.48 | ↓ -20% |
| HEALTH PARTNERS MEDICARE ADVANTAGE | UNITYPOINT HEALTH PARTNERS MEDICARE ADV | $157.03 | ↓ -19% |
| WELLPOINT MEDICARE ADVANTAGE | WELLPOINT MEDICARE ADVANTAGE | $158.59 | ↓ -18% |
| MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $161.46 | ↓ -17% |
| MEDIGOLD MEDICARE ADVANTAGE | MERCYONE HEALTH PLAN MEDICARE ADVANTAGE | $161.52 | ↓ -17% |
| UNITED HEALTHCARE MEDICARE | UNITED HEALTHCARE MEDICARE ADVANTAGE | $164.81 | ↓ -15% |
| IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $186.04 | ↓ -4% |
| MOLINA MEDICAID | MOLINA MEDICAID | $188.77 | ↓ -3% |
| WELLPOINT MEDICAID | WELLPOINT MEDICAID | $189.69 | ↓ -2% |
| AMISH HOSPITAL AID | AMISH HOSPITAL AID | $206.79 | ↑ +6% |
| COVENTRY | AETNA | $220.06 | ↑ +13% |
| LUMINARE HEALTH | AETNA | $220.06 | ↑ +13% |
| CHRISTIAN BROTHER SERVICES | AETNA | $220.06 | ↑ +13% |
| TRUSTMARK SMALL BUSINESS BENEFITS | AETNA | $220.06 | ↑ +13% |
| LUCENT HEALTH | AETNA | $220.06 | ↑ +13% |
| AETNA | AETNA | $220.06 | ↑ +13% |
| ASR HEALTH BENEFITS | AETNA | $220.06 | ↑ +13% |
| 1199 NATIONAL BENEFIT FUND | AETNA | $220.06 | ↑ +13% |
| FIRST HEALTH | AETNA | $220.06 | ↑ +13% |
| AETNA DOMESTIC | AETNA | $220.06 | ↑ +13% |
| ALLIED BENEFIT SYSTEMS | AETNA | $220.06 | ↑ +13% |
| MERITAIN | AETNA | $220.06 | ↑ +13% |
| WEBTPA | AETNA | $220.06 | ↑ +13% |
| MEDICAL MUTUAL | AETNA | $220.06 | ↑ +13% |
| CENTIVO | CENTIVO | $233.22 | ↑ +20% |
| MEDICAL ASSOCIATES | MEDICAL ASSOCIATES | $239.20 | ↑ +23% |
| HEALTH CHOICES | MEDICAL ASSOCIATES | $239.20 | ↑ +23% |
| AMBETTER | AMBETTER MARKETPLACE | $261.21 | ↑ +34% |
| GEHA | UNITED HEALTHCARE | $261.63 | ↑ +35% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $261.63 | ↑ +35% |
| HEALTH PARTNERS | HEALTH PARTNERS | $287.64 | ↑ +48% |
| CIGNA EAP | MIDLANDS CHOICE | $293.02 | ↑ +51% |
| MIDLANDS CHOICE | MIDLANDS CHOICE | $293.02 | ↑ +51% |
| AUXIANT | MIDLANDS CHOICE | $293.02 | ↑ +51% |
| MEDICA | MIDLANDS CHOICE | $293.02 | ↑ +51% |
| CIGNA | MIDLANDS CHOICE | $293.02 | ↑ +51% |
| MIDLANDS | MIDLANDS CHOICE | $293.02 | ↑ +51% |
| CRIME VICTIM ASSISTANCE | CRIME VICTIMS | $299.00 | ↑ +54% |
| IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $299.00 | ↑ +54% |
| NOVA | CLAIMDOC | $312.51 | ↑ +61% |
| CLAIMDOC | CLAIMDOC | $312.51 | ↑ +61% |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $233.40 | $126.19 – $126.19 |
| MercyOne Dubuque Medical Center | Dubuque | $1,105.65 | $74.80 – $301.00 |
| MercyOne New Hampton Medical Center | New Hampton | $194.35 | $118.37 – $299.00 |
| MercyOne Dyersville Medical Center | Dyersville | $194.35 | $113.02 – $336.55 |
| MercyOne Clinton Medical Center | Clinton | $820.30 | $74.80 – $461.00 |
| MercyOne Oelwein Medical Center | Oelwein | $194.35 | $114.28 – $299.00 |
| MercyOne Cedar Falls Medical Center | Cedar Falls | $1,782.00 | $74.80 – $608.00 |
| MercyOne West Des Moines Medical Center | West Des Moines | $407.00 | $74.80 – $407.00 |