CMS Price Transparency Data

Blood antibody screen

Facility: Mercyone Newton Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $85
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.60x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercyone Newton Medical Center is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.60x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $86 (162%)
Insurance Median: $85 (160%)
Cash: $86 (162% of Medicare)
Ins. Median: $85 (160% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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
Aetna $49 - $124 92%
Medicare (plans) $49 - $51 92%
Blue Cross Blue Shield $50 - $53 94%
UnitedHealthcare $50 - $75 94%
Blue Benefit Administrators Of Massachusetts $53 100%
Blue Care Network $53 100%
Blue Distinction Transplant $53 100%
Blue Shield - Ca $53 100%
Blue Shield - Id (Regence) $53 100%
Blue Shield - Ny Highmark Northeastern $53 100%
Blue Shield - Ny Highmark Western $53 100%
Blue Shield - Pa (Highmark) $53 100%
Blue Shield - Wa (Regence) $53 100%
Iowa Total Care $60 113%
Medicaid / KanCare $61 115%
Amish Hospital Aid $67 126%
Oscar $72 135%
Centivo $73 137%
Geha $75 141%
Ambetter / Centene $85 160%
Newton Correctional Facility $86 162%
Health Choices $100 188%
Medical Associates $100 188%
Claimdoc $101 190%
Nova $101 190%
Health Partners $116 218%
Auxiant $121 227%
Cigna $121 227%
Health Alliance $121 227%
Medica $121 227%
Midlands $121 227%
Midlands Choice $121 227%
1199 National Benefit Fund $124 233%
Allied Benefit Systems $124 233%
Asr Health Benefits $124 233%
Christian Brother Services $124 233%
Coventry $124 233%
First Health $124 233%
Lucent Health $124 233%
Luminare Health $124 233%
Medical Mutual $124 233%
Meritain $124 233%
Trustmark Small Business Benefits $124 233%
Webtpa $124 233%
Crime Victim Assistance $132 248%
Iowa Dept Of Public Health $132 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals