CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Mercyone North Iowa Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $89
  • Cash Discount Price: $449
  • vs. Medicare Baseline: 11.45x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Mercyone North Iowa Medical Center is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $449. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 11.45x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$449

Average discount available for prompt cash payment at this facility.

Insurance Median
$89

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)
Cash / Self-Pay: $449 (5779%)
Insurance Median: $89 (1145%)
Cash: $449 (5779% of Medicare)
Ins. Median: $89 (1145% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 1145% of the Medicare baseline (a markup of 1045%). 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 - $92 103%
Blue Cross Blue Shield $8 - $93 103%
Geha $8 103%
Iowa Total Care $8 - $84 103%
Medicaid / KanCare $8 - $85 103%
Medicare (plans) $8 - $96 103%
UnitedHealthcare $8 - $137 103%
Iowa Dept Of Public Health $9 - $137 116%
Amish Hospital Aid $10 - $125 129%
Centivo $10 - $115 129%
Oscar $10 - $124 129%
Ambetter / Centene $13 - $158 167%
Claimdoc $16 - $189 206%
Nova $16 - $189 206%
Health Choices $35 450%
Medical Associates $35 450%
1199 National Benefit Fund $72 927%
Allied Benefit Systems $72 927%
Asr Health Benefits $72 927%
Christian Brother Services $72 927%
Coventry $72 927%
First Health $72 927%
Lucent Health $72 927%
Luminare Health $72 927%
Medical Mutual $72 927%
Meritain $72 927%
Trustmark Small Business Benefits $72 927%
Webtpa $72 927%
Bcn Domestic $89 1145%
Blue Benefit Administrators Of Massachusetts $89 1145%
Blue Care Network $89 1145%
Blue Distinction Transplant $89 1145%
Blue Shield - Ca $89 1145%
Blue Shield - Id (Regence) $89 1145%
Blue Shield - Ny Highmark Northeastern $89 1145%
Blue Shield - Ny Highmark Western $89 1145%
Blue Shield - Pa (Highmark) $89 1145%
Blue Shield - Wa (Regence) $89 1145%
Kaiser Domestic $89 1145%
Pre-Employment $89 1145%
Preferred One $89 1145%
Wc Domestic $89 1145%
Health Partners $92 1184%
Auxiant $96 1236%
Cigna $96 1236%
Medica $96 1236%
Midlands $96 1236%
Midlands Choice $96 1236%
Mhnet $110 1416%
Multiplan $123 1583%
Crime Victim Assistance $137 1763%

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