CMS Price Transparency Data

Blood test, clotting time (PTT)

Facility: Mercyone North Iowa Medical Center

Billing Code: 85730 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85730
  • Insurance Median: $10
  • Cash Discount Price: $999
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Blood test, clotting time (PTT) at Mercyone North Iowa Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $999. Compared to the federal Medicare reimbursement reference rate of $6.01, this hospital’s rate is 1.66x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$999

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$6.01

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $6.01 (100%)
Cash / Self-Pay: $999 (16622%)
Insurance Median: $10 (166%)
Cash: $999 (16622% of Medicare)
Ins. Median: $10 (166% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $6.01 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 $6 - $52 100%
Blue Cross Blue Shield $6 100%
Geha $6 100%
Iowa Total Care $6 100%
Medicaid / KanCare $6 100%
Medicare (plans) $6 100%
UnitedHealthcare $6 - $99 100%
Centivo $7 116%
Amish Hospital Aid $8 133%
Oscar $8 133%
Iowa Dept Of Public Health $9 - $99 150%
Ambetter / Centene $10 166%
Claimdoc $12 200%
Nova $12 200%
Health Choices $25 416%
Medical Associates $25 416%
1199 National Benefit Fund $52 865%
Allied Benefit Systems $52 865%
Asr Health Benefits $52 865%
Christian Brother Services $52 865%
Coventry $52 865%
First Health $52 865%
Lucent Health $52 865%
Luminare Health $52 865%
Medical Mutual $52 865%
Meritain $52 865%
Trustmark Small Business Benefits $52 865%
Webtpa $52 865%
Preferred One $64 1065%
Health Partners $66 1098%
Auxiant $69 1148%
Cigna $69 1148%
Medica $69 1148%
Midlands $69 1148%
Midlands Choice $69 1148%
Mhnet $79 1314%
Multiplan $89 1481%
Crime Victim Assistance $99 1647%

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