CMS Price Transparency Data

Blood test, liver function panel

Facility: Mercyone Newton Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $150
  • Cash Discount Price: $111
  • vs. Medicare Baseline: 18.36x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Mercyone Newton Medical Center is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 18.36x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$111

Average discount available for prompt cash payment at this facility.

Insurance Median
$150

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $111 (1359%)
Insurance Median: $150 (1836%)
Cash: $111 (1359% of Medicare)
Ins. Median: $150 (1836% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 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 1836% of the Medicare baseline (a markup of 1736%). 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 $8 - $159 98%
Blue Cross Blue Shield $8 98%
Iowa Total Care $8 98%
Medicaid / KanCare $8 98%
Medicare (plans) $8 98%
UnitedHealthcare $8 - $97 98%
Amish Hospital Aid $11 135%
Centivo $12 147%
Oscar $12 147%
Ambetter / Centene $14 171%
Claimdoc $16 196%
Nova $16 196%
Geha $97 1187%
Newton Correctional Facility $110 1346%
Health Choices $128 1567%
Medical Associates $128 1567%
Health Partners $150 1836%
Auxiant $156 1909%
Cigna $156 1909%
Health Alliance $156 1909%
Medica $156 1909%
Midlands $156 1909%
Midlands Choice $156 1909%
1199 National Benefit Fund $159 1946%
Allied Benefit Systems $159 1946%
Asr Health Benefits $159 1946%
Christian Brother Services $159 1946%
Coventry $159 1946%
First Health $159 1946%
Lucent Health $159 1946%
Luminare Health $159 1946%
Medical Mutual $159 1946%
Meritain $159 1946%
Trustmark Small Business Benefits $159 1946%
Webtpa $159 1946%
Crime Victim Assistance $170 2081%
Iowa Dept Of Public Health $170 2081%

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