CMS Price Transparency Data

Culture, blood

Facility: Mercyone North Iowa Medical Center

Billing Code: 87040 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$30

about 3.0× the $10 Medicare rate · typically $11–$97

modeled estimate · not a bill or quote

Medicare pays $10 Fair price $30 Hospital's list price $214

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$10 - $214	97%
Blue Cross Blue Shieldmajor	$10 - $141	97%
Aetnamajor	$10 - $140	97%
Cignamajor	$150	1453%
Kaiser Permanentemajor	$89	862%
Ambetter (Centene)	$17 - $240	165%
GEHA	$10	97%
HealthPartners	$143	1386%
Medica	$150	1453%
Medical Mutual	$112	1085%
Oscar Health	$14 - $188	136%
+ 25 smaller / regional plans	$9 - $287

Government programs also on file: Medicare, Medicaid.

Excludes 4 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 87040.

Insurance Before you use insurance

Call your insurance company to confirm Mercyone North Iowa Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 87040.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Other Procedures at Mercyone North Iowa Medical Center

Compare: Culture, blood at other IA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.