CMS Price Transparency Data

Blood antibody screen

Facility: Mercyone Clinton Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $75
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercyone Clinton Medical Center is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.41x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$75

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: $129 (242%)
Insurance Median: $75 (141%)
Cash: $129 (242% of Medicare)
Ins. Median: $75 (141% 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 - $198 19%
Iowa Total Care $48 90%
Medicaid / KanCare $48 - $49 90%
Bcn Domestic $53 100%
Blue Benefit Administrators Of Massachusetts $53 100%
Blue Care Network $53 100%
Blue Cross Blue Shield $53 - $55 100%
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%
Aetna $54 - $173 101%
Medicare (plans) $54 - $57 101%
Health Choices $56 105%
Medical Associates $56 105%
Preferred Health Choice $57 107%
Amish Hospital Aid $74 139%
Oscar $76 143%
Ambetter / Centene $93 175%
Claimdoc $112 210%
Nova $112 210%
The Alliance $120 225%
1199 National Benefit Fund $173 325%
Allied Benefit Systems $173 325%
Asr Health Benefits $173 325%
Christian Brother Services $173 325%
Coventry $173 325%
First Health $173 325%
Lucent Health $173 325%
Luminare Health $173 325%
Medical Mutual $173 325%
Meritain $173 325%
Trustmark Small Business Benefits $173 325%
Webtpa $173 325%
Health Partners $174 327%
Auxiant $178 334%
Cigna $178 334%
Medica $178 334%
Midlands $178 334%
Midlands Choice $178 334%
Multiplan $178 334%
Qualcare $178 334%
Usa Managed Care $188 353%
Crime Victim Assistance $198 372%
Iowa Dept Of Public Health $198 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals