CMS Price Transparency Data

Blood antibody screen

Facility: Mercyone Waterloo Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $53
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercyone Waterloo Medical Center is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.00x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $163 (306%)
Insurance Median: $53 (100%)
Cash: $163 (306% of Medicare)
Ins. Median: $53 (100% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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.

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
Geha $10 19%
UnitedHealthcare $10 - $250 19%
Aetna $27 - $49 51%
Allied Benefit Systems $27 51%
Asr Health Benefits $27 51%
Christian Brother Services $27 51%
Coventry $27 51%
First Health $27 51%
Lucent Health $27 51%
Luminare Health $27 51%
Medical Mutual $27 51%
Meritain $27 51%
Webtpa $27 51%
Medicare (plans) $49 - $51 92%
Blue Cross Blue Shield $50 - $53 94%
Iowa Total Care $50 94%
Medicaid / KanCare $50 - $51 94%
Bcn Domestic $53 100%
Blue Benefit Administrators Of Massachusetts $53 100%
Blue Care Network $53 100%
Blue Distinction Transplant $53 100%
Blue Shield - Ca $53 100%
Blue Shield - Id (Regence) $53 100%
Blue Shield - Ny Highmark Northeastern $53 100%
Blue Shield - Ny Highmark Western $53 100%
Blue Shield - Pa (Highmark) $53 100%
Blue Shield - Wa (Regence) $53 100%
Kaiser Domestic $53 100%
Pre-Employment $53 100%
Wc Domestic $53 100%
Health Choices $59 111%
Medical Associates $59 111%
Amish Hospital Aid $67 126%
Oscar $77 145%
Centivo $83 156%
Ambetter / Centene $84 158%
Claimdoc $101 190%
Nova $101 190%
Health Partners $164 308%
Auxiant $178 334%
Cigna $178 334%
Medica $178 334%
Midlands $178 334%
Midlands Choice $178 334%
Iowa Dept Of Public Health $250 470%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals