CMS Price Transparency Data

Culture, blood

Facility: Mercyone Dubuque Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $280
  • Cash Discount Price: $1,570
  • vs. Medicare Baseline: 27.13x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mercyone Dubuque Medical Center is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,570. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 27.13x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$1,570

Average discount available for prompt cash payment at this facility.

Insurance Median
$280

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.32

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.32 (100%)
Cash / Self-Pay: $1,570 (15213%)
Insurance Median: $280 (2713%)
Cash: $1,570 (15213% of Medicare)
Ins. Median: $280 (2713% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.32 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 2713% of the Medicare baseline (a markup of 2613%). 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
Iowa Dept Of Public Health $9 - $335 87%
Aetna $10 - $2,548 97%
Blue Cross Blue Shield $10 - $2,573 97%
Geha $10 - $5,390 97%
Iowa Total Care $10 - $2,384 97%
Medicaid / KanCare $10 - $2,416 97%
Medicare (plans) $10 - $2,652 97%
UnitedHealthcare $10 - $5,390 97%
Preferred Health Choice $11 107%
Stephenson Cty Health $11 - $335 107%
Amish Hospital Aid $14 - $3,458 136%
Oscar $14 - $3,547 136%
Centivo $16 - $4,072 155%
Ambetter / Centene $17 - $4,368 165%
Claimdoc $21 - $5,226 203%
Nova $21 - $5,226 203%
Health Choices $123 1192%
Midlands Choice $194 - $302 1880%
Wps $201 1948%
The Alliance $202 1957%
Mhnet $268 2597%
1199 National Benefit Fund $280 2713%
Allied Benefit Systems $280 2713%
Asr Health Benefits $280 2713%
Christian Brother Services $280 2713%
Coventry $280 2713%
First Health $280 2713%
Lucent Health $280 2713%
Luminare Health $280 2713%
Medical Mutual $280 2713%
Meritain $280 2713%
Trustmark Small Business Benefits $280 2713%
Webtpa $280 2713%
Auxiant $302 2926%
Cigna $302 2926%
Medica $302 2926%
Midlands $302 2926%
Multiplan $302 2926%
Unity $302 2926%
Crime Victim Assistance $335 3246%

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