CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Mercyone Clinton Medical Center

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80048
  • Insurance Median: $17
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 2.01x Medicare
The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Mercyone Clinton Medical Center is $17. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 2.01x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$174

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: $174 (2057%)
Insurance Median: $17 (201%)
Cash: $174 (2057% 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 - $99 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 - $113 95%
Iowa Dept Of Public Health $9 - $113 106%
Amish Hospital Aid $11 130%
Oscar $12 142%
Ambetter / Centene $14 165%
Claimdoc $17 201%
Nova $17 201%
Health Choices $32 378%
Medical Associates $32 378%
Preferred Health Choice $33 390%
The Alliance $69 816%
1199 National Benefit Fund $99 1170%
Allied Benefit Systems $99 1170%
Asr Health Benefits $99 1170%
Christian Brother Services $99 1170%
Coventry $99 1170%
First Health $99 1170%
Health Partners $99 1170%
Lucent Health $99 1170%
Luminare Health $99 1170%
Medical Mutual $99 1170%
Meritain $99 1170%
Trustmark Small Business Benefits $99 1170%
Webtpa $99 1170%
Auxiant $102 1206%
Cigna $102 1206%
Medica $102 1206%
Midlands $102 1206%
Midlands Choice $102 1206%
Multiplan $102 1206%
Qualcare $102 1206%
Usa Managed Care $107 1265%
Crime Victim Assistance $113 1336%

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