CMS Price Transparency Data

Blood test, liver function panel

Facility: Mercyone North Iowa Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $206
  • Cash Discount Price: $255
  • vs. Medicare Baseline: 25.21x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Mercyone North Iowa Medical Center is $206. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 25.21x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$255

Average discount available for prompt cash payment at this facility.

Insurance Median
$206

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: $255 (3121%)
Insurance Median: $206 (2521%)
Cash: $255 (3121% of Medicare)
Ins. Median: $206 (2521% 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 2521% of the Medicare baseline (a markup of 2421%). 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 - $206 98%
Blue Cross Blue Shield $8 98%
Geha $8 98%
Iowa Total Care $8 98%
Medicaid / KanCare $8 98%
Medicare (plans) $8 98%
UnitedHealthcare $8 - $393 98%
Centivo $10 122%
Amish Hospital Aid $11 135%
Oscar $11 135%
Ambetter / Centene $14 171%
Claimdoc $16 196%
Nova $16 196%
Health Choices $101 1236%
Medical Associates $101 1236%
1199 National Benefit Fund $206 2521%
Allied Benefit Systems $206 2521%
Asr Health Benefits $206 2521%
Christian Brother Services $206 2521%
Coventry $206 2521%
First Health $206 2521%
Lucent Health $206 2521%
Luminare Health $206 2521%
Medical Mutual $206 2521%
Meritain $206 2521%
Trustmark Small Business Benefits $206 2521%
Webtpa $206 2521%
Preferred One $255 3121%
Health Partners $263 3219%
Auxiant $275 3366%
Cigna $275 3366%
Medica $275 3366%
Midlands $275 3366%
Midlands Choice $275 3366%
Mhnet $314 3843%
Multiplan $354 4333%
Crime Victim Assistance $393 4810%
Iowa Dept Of Public Health $393 4810%

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