CMS Price Transparency Data

Blood antibody screen

Facility: Mercyone Dubuque Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $158
  • Cash Discount Price: $9,395
  • vs. Medicare Baseline: 2.97x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercyone Dubuque Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,395. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 2.97x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$9,395

Average discount available for prompt cash payment at this facility.

Insurance Median
$158

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: $9,395 (17647%)
Insurance Median: $158 (297%)
Cash: $9,395 (17647% of Medicare)
Ins. Median: $158 (297% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 297% of the Medicare baseline (a markup of 197%). 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
Bcn Domestic $2 4%
Blue Benefit Administrators Of Massachusetts $2 4%
Blue Care Network $2 4%
Blue Cross Blue Shield $2 - $5,600 4%
Blue Distinction Transplant $2 4%
Blue Shield - Ca $2 4%
Blue Shield - Id (Regence) $2 4%
Blue Shield - Ny Highmark Northeastern $2 4%
Blue Shield - Ny Highmark Western $2 4%
Blue Shield - Pa (Highmark) $2 4%
Blue Shield - Wa (Regence) $2 4%
Kaiser Domestic $2 4%
Pre-Employment $2 4%
Wc Domestic $2 4%
Iowa Dept Of Public Health $9 - $198 17%
Geha $10 19%
Preferred Health Choice $10 19%
UnitedHealthcare $10 - $5,656 19%
Stephenson Cty Health $34 - $198 64%
Iowa Total Care $47 - $5,106 88%
Medicaid / KanCare $47 - $5,176 88%
Aetna $51 - $5,545 96%
Medicare (plans) $51 - $5,771 96%
Amish Hospital Aid $69 - $7,525 130%
Oscar $71 - $7,718 133%
Health Choices $72 135%
Centivo $81 - $8,860 152%
Ambetter / Centene $87 - $9,505 163%
Claimdoc $104 - $11,372 195%
Nova $104 - $11,372 195%
Midlands Choice $115 - $178 216%
Wps $119 224%
The Alliance $120 225%
Mhnet $158 297%
1199 National Benefit Fund $165 310%
Allied Benefit Systems $165 310%
Asr Health Benefits $165 310%
Christian Brother Services $165 310%
Coventry $165 310%
First Health $165 310%
Lucent Health $165 310%
Luminare Health $165 310%
Medical Mutual $165 310%
Meritain $165 310%
Trustmark Small Business Benefits $165 310%
Webtpa $165 310%
Auxiant $178 334%
Cigna $178 334%
Medica $178 334%
Midlands $178 334%
Multiplan $178 334%
Unity $178 334%
Crime Victim Assistance $198 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals