CMS Price Transparency Data

Culture, bacterial

Facility: Mercyone North Iowa Medical Center

Billing Code: 87070 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87070
  • Insurance Median: $90
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 10.44x Medicare
The contracted insurance negotiated median rate for a Culture, bacterial at Mercyone North Iowa Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $8.62, this hospital’s rate is 10.44x the Medicare baseline. Located in 1000 Fourth Street Sw, Mason City, IA.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.62

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.62 (100%)
Cash / Self-Pay: $254 (2947%)
Insurance Median: $90 (1044%)
Cash: $254 (2947% of Medicare)
Ins. Median: $90 (1044% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.62 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 1044% of the Medicare baseline (a markup of 944%). 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 - $141 93%
Iowa Total Care $8 - $129 93%
Medicaid / KanCare $8 - $131 93%
Medicare (plans) $8 - $146 93%
Blue Cross Blue Shield $9 - $142 104%
Geha $9 104%
UnitedHealthcare $9 - $172 104%
Amish Hospital Aid $11 128%
Centivo $11 128%
Oscar $11 128%
Ambetter / Centene $14 162%
Claimdoc $17 197%
Nova $17 197%
Health Choices $40 - $44 464%
Medical Associates $40 - $44 464%
Iowa Dept Of Public Health $60 - $172 696%
1199 National Benefit Fund $83 - $90 963%
Allied Benefit Systems $83 - $90 963%
Asr Health Benefits $83 - $90 963%
Christian Brother Services $83 - $90 963%
Coventry $83 - $90 963%
First Health $83 - $90 963%
Lucent Health $83 - $90 963%
Luminare Health $83 - $90 963%
Medical Mutual $83 - $90 963%
Meritain $83 - $90 963%
Trustmark Small Business Benefits $83 - $90 963%
Webtpa $83 - $90 963%
Preferred One $103 - $112 1195%
Health Partners $106 - $115 1230%
Auxiant $111 - $120 1288%
Cigna $111 - $120 1288%
Medica $111 - $120 1288%
Midlands $111 - $120 1288%
Midlands Choice $111 - $120 1288%
Mhnet $126 - $138 1462%
Bcn Domestic $136 1578%
Blue Benefit Administrators Of Massachusetts $136 1578%
Blue Care Network $136 1578%
Blue Distinction Transplant $136 1578%
Blue Shield - Ca $136 1578%
Blue Shield - Id (Regence) $136 1578%
Blue Shield - Ny Highmark Northeastern $136 1578%
Blue Shield - Ny Highmark Western $136 1578%
Blue Shield - Pa (Highmark) $136 1578%
Blue Shield - Wa (Regence) $136 1578%
Kaiser Domestic $136 1578%
Pre-Employment $136 1578%
Wc Domestic $136 1578%
Multiplan $142 - $155 1647%
Crime Victim Assistance $158 - $172 1833%

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