CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Mercyone Waterloo Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $17
  • Cash Discount Price: $342
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercyone Waterloo Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $342. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.01x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$342

Average discount available for prompt cash payment at this facility.

Insurance Median
$17

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)
Cash / Self-Pay: $342 (4043%)
Insurance Median: $17 (201%)
Cash: $342 (4043% of Medicare)
Ins. Median: $17 (201% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 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 201% of the Medicare baseline (a markup of 101%). 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 - $23 95%
Blue Cross Blue Shield $8 95%
Geha $8 95%
Iowa Total Care $8 95%
Medicaid / KanCare $8 95%
Medicare (plans) $8 - $9 95%
UnitedHealthcare $8 - $119 95%
Iowa Dept Of Public Health $9 - $119 106%
Amish Hospital Aid $11 130%
Oscar $13 154%
Ambetter / Centene $14 165%
Centivo $14 165%
Claimdoc $17 201%
Nova $17 201%
Allied Benefit Systems $23 272%
Asr Health Benefits $23 272%
Christian Brother Services $23 272%
Coventry $23 272%
First Health $23 272%
Lucent Health $23 272%
Luminare Health $23 272%
Medical Mutual $23 272%
Meritain $23 272%
Webtpa $23 272%
Health Choices $28 331%
Medical Associates $28 331%
Health Partners $78 922%
Auxiant $84 993%
Cigna $84 993%
Medica $84 993%
Midlands $84 993%
Midlands Choice $84 993%

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