CMS Price Transparency Data

Blood test, complete blood count (CBC)

Facility: Mercyone Clinton Medical Center

Billing Code: 85025 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85025
  • Insurance Median: $16
  • Cash Discount Price: $267
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Blood test, complete blood count (CBC) at Mercyone Clinton Medical Center is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $267. Compared to the federal Medicare reimbursement reference rate of $7.77, this hospital’s rate is 2.06x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$267

Average discount available for prompt cash payment at this facility.

Insurance Median
$16

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$7.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $7.77 (100%)
Cash / Self-Pay: $267 (3436%)
Insurance Median: $16 (206%)
Cash: $267 (3436% of Medicare)
Ins. Median: $16 (206% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $7.77 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 206% of the Medicare baseline (a markup of 106%). 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 - $83 103%
Blue Cross Blue Shield $8 103%
Geha $8 103%
Iowa Total Care $8 103%
Medicaid / KanCare $8 103%
Medicare (plans) $8 103%
UnitedHealthcare $8 - $95 103%
Iowa Dept Of Public Health $9 - $95 116%
Amish Hospital Aid $10 129%
Oscar $11 142%
Ambetter / Centene $13 167%
Claimdoc $16 206%
Nova $16 206%
Health Choices $27 347%
Medical Associates $27 347%
Preferred Health Choice $27 347%
The Alliance $58 746%
1199 National Benefit Fund $83 1068%
Allied Benefit Systems $83 1068%
Asr Health Benefits $83 1068%
Christian Brother Services $83 1068%
Coventry $83 1068%
First Health $83 1068%
Health Partners $83 1068%
Lucent Health $83 1068%
Luminare Health $83 1068%
Medical Mutual $83 1068%
Meritain $83 1068%
Trustmark Small Business Benefits $83 1068%
Webtpa $83 1068%
Auxiant $86 1107%
Cigna $86 1107%
Medica $86 1107%
Midlands $86 1107%
Midlands Choice $86 1107%
Multiplan $86 1107%
Qualcare $86 1107%
Usa Managed Care $90 1158%
Crime Victim Assistance $95 1223%

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