CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercyone Clinton Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $21
  • Cash Discount Price: $281
  • vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercyone Clinton Medical Center is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 1.99x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$281

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.56 (100%)
Cash / Self-Pay: $281 (2661%)
Insurance Median: $21 (199%)
Cash: $281 (2661% of Medicare)
Ins. Median: $21 (199% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.56 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
Iowa Dept Of Public Health $9 - $131 85%
Aetna $10 - $115 95%
Blue Cross Blue Shield $10 95%
Iowa Total Care $10 95%
Medicaid / KanCare $10 95%
Medicare (plans) $10 - $11 95%
Geha $11 104%
UnitedHealthcare $11 - $131 104%
Amish Hospital Aid $14 133%
Oscar $14 133%
Ambetter / Centene $18 170%
Claimdoc $21 199%
Nova $21 199%
Health Choices $37 350%
Medical Associates $37 350%
Preferred Health Choice $38 360%
The Alliance $79 748%
1199 National Benefit Fund $115 1089%
Allied Benefit Systems $115 1089%
Asr Health Benefits $115 1089%
Christian Brother Services $115 1089%
Coventry $115 1089%
First Health $115 1089%
Health Partners $115 1089%
Lucent Health $115 1089%
Luminare Health $115 1089%
Medical Mutual $115 1089%
Meritain $115 1089%
Trustmark Small Business Benefits $115 1089%
Webtpa $115 1089%
Auxiant $118 1117%
Cigna $118 1117%
Medica $118 1117%
Midlands $118 1117%
Midlands Choice $118 1117%
Multiplan $118 1117%
Qualcare $118 1117%
Usa Managed Care $124 1174%
Crime Victim Assistance $131 1241%

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