CMS Price Transparency Data

Blood test, vitamin B12

Facility: Mercyone Newton Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $129
  • Cash Discount Price: $95
  • vs. Medicare Baseline: 8.55x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Mercyone Newton Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 8.55x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$95

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$15.08

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.08 (100%)
Cash / Self-Pay: $95 (630%)
Insurance Median: $129 (855%)
Cash: $95 (630% of Medicare)
Ins. Median: $129 (855% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $15.08 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 855% of the Medicare baseline (a markup of 755%). 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 $15 - $137 99%
Blue Cross Blue Shield $15 99%
Iowa Total Care $15 99%
Medicaid / KanCare $15 99%
Medicare (plans) $15 99%
UnitedHealthcare $15 - $83 99%
Amish Hospital Aid $20 133%
Oscar $21 139%
Centivo $22 146%
Ambetter / Centene $25 166%
Claimdoc $30 199%
Nova $30 199%
Geha $83 550%
Newton Correctional Facility $95 630%
Health Choices $110 729%
Medical Associates $110 729%
Health Partners $129 855%
Auxiant $134 889%
Cigna $134 889%
Health Alliance $134 889%
Medica $134 889%
Midlands $134 889%
Midlands Choice $134 889%
1199 National Benefit Fund $137 908%
Allied Benefit Systems $137 908%
Asr Health Benefits $137 908%
Christian Brother Services $137 908%
Coventry $137 908%
First Health $137 908%
Lucent Health $137 908%
Luminare Health $137 908%
Medical Mutual $137 908%
Meritain $137 908%
Trustmark Small Business Benefits $137 908%
Webtpa $137 908%
Crime Victim Assistance $146 968%
Iowa Dept Of Public Health $146 968%

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