CMS Price Transparency Data

Blood test, sodium

Facility: Mercyone North Iowa Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $19
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 3.95x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercyone North Iowa Medical Center is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 3.95x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $142 (2952%)
Insurance Median: $19 (395%)
Cash: $142 (2952% of Medicare)
Ins. Median: $19 (395% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 395% of the Medicare baseline (a markup of 295%). 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 $5 - $131 104%
Blue Cross Blue Shield $5 - $136 104%
Geha $5 104%
Iowa Total Care $5 - $129 104%
Medicaid / KanCare $5 - $131 104%
Medicare (plans) $5 - $141 104%
UnitedHealthcare $5 - $135 104%
Amish Hospital Aid $6 125%
Centivo $6 125%
Oscar $6 125%
Ambetter / Centene $8 166%
Health Choices $9 187%
Medical Associates $9 187%
Claimdoc $10 208%
Nova $10 208%
1199 National Benefit Fund $19 395%
Allied Benefit Systems $19 395%
Asr Health Benefits $19 395%
Christian Brother Services $19 395%
Coventry $19 395%
First Health $19 395%
Lucent Health $19 395%
Luminare Health $19 395%
Medical Mutual $19 395%
Meritain $19 395%
Trustmark Small Business Benefits $19 395%
Webtpa $19 395%
Iowa Dept Of Public Health $22 - $37 457%
Preferred One $24 499%
Health Partners $25 520%
Auxiant $26 541%
Cigna $26 541%
Medica $26 541%
Midlands $26 541%
Midlands Choice $26 541%
Mhnet $30 624%
Multiplan $33 686%
Crime Victim Assistance $37 769%
Bcn Domestic $136 2827%
Blue Benefit Administrators Of Massachusetts $136 2827%
Blue Care Network $136 2827%
Blue Distinction Transplant $136 2827%
Blue Shield - Ca $136 2827%
Blue Shield - Id (Regence) $136 2827%
Blue Shield - Ny Highmark Northeastern $136 2827%
Blue Shield - Ny Highmark Western $136 2827%
Blue Shield - Pa (Highmark) $136 2827%
Blue Shield - Wa (Regence) $136 2827%
Kaiser Domestic $136 2827%
Pre-Employment $136 2827%
Wc Domestic $136 2827%

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