CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Mercyone North Iowa Medical Center

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80061
  • Insurance Median: $56
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 4.18x Medicare
The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Mercyone North Iowa Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 4.18x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)
Cash / Self-Pay: $74 (553%)
Insurance Median: $56 (418%)
Cash: $74 (553% of Medicare)
Ins. Median: $56 (418% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13.39 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 418% of the Medicare baseline (a markup of 318%). 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 $13 - $75 97%
Blue Cross Blue Shield $13 97%
Geha $13 97%
Iowa Total Care $13 97%
Medicaid / KanCare $13 97%
Medicare (plans) $13 - $14 97%
UnitedHealthcare $13 - $142 97%
Centivo $16 119%
Amish Hospital Aid $18 134%
Oscar $18 134%
Ambetter / Centene $22 164%
Health Choices $22 - $36 164%
Medical Associates $22 - $36 164%
Claimdoc $27 202%
Nova $27 202%
1199 National Benefit Fund $45 - $75 336%
Allied Benefit Systems $45 - $75 336%
Asr Health Benefits $45 - $75 336%
Christian Brother Services $45 - $75 336%
Coventry $45 - $75 336%
First Health $45 - $75 336%
Lucent Health $45 - $75 336%
Luminare Health $45 - $75 336%
Medical Mutual $45 - $75 336%
Meritain $45 - $75 336%
Trustmark Small Business Benefits $45 - $75 336%
Webtpa $45 - $75 336%
Preferred One $56 - $92 418%
Health Partners $58 - $95 433%
Auxiant $60 - $99 448%
Cigna $60 - $99 448%
Medica $60 - $99 448%
Midlands $60 - $99 448%
Midlands Choice $60 - $99 448%
Mhnet $69 - $114 515%
Multiplan $77 - $128 575%
Crime Victim Assistance $86 - $142 642%
Iowa Dept Of Public Health $86 - $142 642%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Fourth Street Sw, Mason City, IA 50401
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals