CMS Price Transparency Data

Blood test, hemoglobin

Facility: Mercyone Newton Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $37
  • Cash Discount Price: $314
  • vs. Medicare Baseline: 15.61x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mercyone Newton Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $314. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 15.61x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$314

Average discount available for prompt cash payment at this facility.

Insurance Median
$37

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $314 (13249%)
Insurance Median: $37 (1561%)
Cash: $314 (13249% of Medicare)
Ins. Median: $37 (1561% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1561% of the Medicare baseline (a markup of 1461%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $2 - $82 84%
Blue Cross Blue Shield $2 - $89 84%
Iowa Total Care $2 - $100 84%
Medicaid / KanCare $2 - $102 84%
Medicare (plans) $2 - $86 84%
UnitedHealthcare $2 - $84 84%
Amish Hospital Aid $3 - $112 127%
Centivo $3 - $121 127%
Oscar $3 - $119 127%
Ambetter / Centene $4 - $141 169%
Claimdoc $5 - $169 211%
Nova $5 - $169 211%
Iowa Dept Of Public Health $9 - $39 380%
Geha $22 928%
Newton Correctional Facility $25 1055%
Health Choices $29 1224%
Medical Associates $29 1224%
Health Partners $34 1435%
Auxiant $36 1519%
Cigna $36 1519%
Health Alliance $36 1519%
Medica $36 1519%
Midlands $36 1519%
Midlands Choice $36 1519%
1199 National Benefit Fund $37 1561%
Allied Benefit Systems $37 1561%
Asr Health Benefits $37 1561%
Christian Brother Services $37 1561%
Coventry $37 1561%
First Health $37 1561%
Lucent Health $37 1561%
Luminare Health $37 1561%
Medical Mutual $37 1561%
Meritain $37 1561%
Trustmark Small Business Benefits $37 1561%
Webtpa $37 1561%
Crime Victim Assistance $39 1646%
Blue Benefit Administrators Of Massachusetts $89 3755%
Blue Care Network $89 3755%
Blue Distinction Transplant $89 3755%
Blue Shield - Ca $89 3755%
Blue Shield - Id (Regence) $89 3755%
Blue Shield - Ny Highmark Northeastern $89 3755%
Blue Shield - Ny Highmark Western $89 3755%
Blue Shield - Pa (Highmark) $89 3755%
Blue Shield - Wa (Regence) $89 3755%

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