healthcosts.net
Treatment of mouth lesion physical 40820 at MercyOne New Hampton Medical Center
308 North Maple Ave, New Hampton, IA · MercyOne · · NPI 1770651515
$6,324.50
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.
$9,730.00
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.
$141.40 with AETNA MEDICARE ADVANTAGE vs $612.00 with CRIME VICTIM ASSISTANCE — 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 |
|---|---|---|---|
| AETNA MEDICARE ADVANTAGE | AETNA MEDICARE ADVANTAGE | $141.40 | ↓ -98% |
| BLUE CROSS - IA (WELLMARK) MEDICARE ADVANTAGE | WELLMARK MEDICARE ADVANTAGE | $242.29 | ↓ -96% |
| HEALTH PARTNERS MEDICARE ADVANTAGE | UNITYPOINT HEALTH PARTNERS MEDICARE ADV | $247.25 | ↓ -96% |
| WELLPOINT MEDICARE ADVANTAGE | WELLPOINT MEDICARE ADVANTAGE | $249.70 | ↓ -96% |
| MEDICARE MEDICAL ASSOCIATES HEALTH PLANS | MEDICAL ASSOCIATES MEDICARE ADVANTAGE | $257.90 | ↓ -96% |
| UNITED HEALTHCARE MEDICARE | UNITED HEALTHCARE MEDICARE ADVANTAGE | $259.49 | ↓ -96% |
| MEDIGOLD MEDICARE ADVANTAGE | MERCYONE HEALTH PLAN MEDICARE ADVANTAGE | $273.38 | ↓ -96% |
| HEALTH CHOICES | MEDICAL ASSOCIATES | $309.06 | ↓ -95% |
| MEDICAL ASSOCIATES | MEDICAL ASSOCIATES | $309.06 | ↓ -95% |
| AMISH HOSPITAL AID | AMISH HOSPITAL AID | $325.58 | ↓ -95% |
| OSCAR | OSCAR | $359.86 | ↓ -94% |
| AMBETTER | AMBETTER MARKETPLACE | $411.26 | ↓ -93% |
| IOWA TOTAL CARE | IOWA TOTAL CARE MEDICAID | $418.24 | ↓ -93% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $423.50 | ↓ -93% |
| GEHA | UNITED HEALTHCARE | $423.50 | ↓ -93% |
| MOLINA MEDICAID | MOLINA MEDICAID | $424.39 | ↓ -93% |
| WELLPOINT MEDICAID | WELLPOINT MEDICAID | $426.44 | ↓ -93% |
| CLAIMDOC | CLAIMDOC | $492.05 | ↓ -92% |
| NOVA | CLAIMDOC | $492.05 | ↓ -92% |
| ALLIED BENEFIT SYSTEMS | AETNA | $578.34 | ↓ -91% |
| AETNA | AETNA | $578.34 | ↓ -91% |
| AETNA DOMESTIC | AETNA | $578.34 | ↓ -91% |
| AETNA EAP | AETNA | $578.34 | ↓ -91% |
| 1199 NATIONAL BENEFIT FUND | AETNA | $578.34 | ↓ -91% |
| ASR HEALTH BENEFITS | AETNA | $578.34 | ↓ -91% |
| COVENTRY | AETNA | $578.34 | ↓ -91% |
| FIRST HEALTH | AETNA | $578.34 | ↓ -91% |
| LUCENT HEALTH | AETNA | $578.34 | ↓ -91% |
| LUMINARE HEALTH | AETNA | $578.34 | ↓ -91% |
| MEDICAL MUTUAL | AETNA | $578.34 | ↓ -91% |
| MERITAIN | AETNA | $578.34 | ↓ -91% |
| TRUSTMARK SMALL BUSINESS BENEFITS | AETNA | $578.34 | ↓ -91% |
| WEBTPA | AETNA | $578.34 | ↓ -91% |
| FIRST CHOICE HEALTH | FIRST CHOICE | $581.40 | ↓ -91% |
| HEALTH PARTNERS | HEALTH PARTNERS | $588.13 | ↓ -91% |
| MIDLANDS CHOICE | MIDLANDS CHOICE PPO | $593.64 | ↓ -91% |
| AUXIANT | MIDLANDS CHOICE PPO | $593.64 | ↓ -91% |
| MIDLANDS | MIDLANDS CHOICE PPO | $593.64 | ↓ -91% |
| CIGNA | MIDLANDS CHOICE PPO | $593.64 | ↓ -91% |
| CIGNA EAP | MIDLANDS CHOICE PPO | $593.64 | ↓ -91% |
| MEDICA | MIDLANDS CHOICE PPO | $593.64 | ↓ -91% |
| IOWA DEPT OF PUBLIC HEALTH | CARE FOR YOURSELF | $612.00 | ↓ -90% |
| CRIME VICTIM ASSISTANCE | CRIME VICTIMS | $612.00 | ↓ -90% |
Visitor-reported prices
Comments
Treatment of mouth lesion physical 40820 at other Iowa hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| MercyOne Genesis Davenport West Medical Center | Davenport | $489.00 | not published |
| MercyOne Des Moines Medical Center | Des Moines | $642.67 | $14.39 – $612.00 |
| MercyOne Genesis Davenport Medical Center | Davenport | $513.60 | not published |
| MercyOne Genesis DeWitt Medical Center | DeWitt | $513.60 | $624.88 – $2,679.00 |
| UnityPoint Health - Allen Hospital | Waterloo | $638.40 | $148.33 – $2,688.10 |
| UnityPoint Health - Finley Hospital | Dubuque | $638.40 | $148.33 – $2,851.40 |
| UnityPoint Health - Grinnell Regional Medical Center | Grinnell | $638.40 | $148.33 – $3,226.74 |
| UnityPoint Health - Iowa Lutheran Hospital | Des Moines | $638.40 | $148.33 – $3,124.54 |