CMS Price Transparency Data

Blood test, hemoglobin

Facility: Mercyone Clinton Medical Center

Billing Code: 85018 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 85018
  • Insurance Median: $5
  • Cash Discount Price: $316
  • vs. Medicare Baseline: 2.11x Medicare
The contracted insurance negotiated median rate for a Blood test, hemoglobin at Mercyone Clinton Medical Center is $5. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $316. Compared to the federal Medicare reimbursement reference rate of $2.37, this hospital’s rate is 2.11x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$316

Average discount available for prompt cash payment at this facility.

Insurance Median
$5

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2.37

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2.37 (100%)
Cash / Self-Pay: $316 (13333%)
Insurance Median: $5 (211%)
Cash: $316 (13333% of Medicare)
Ins. Median: $5 (211% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2.37 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 211% of the Medicare baseline (a markup of 111%). 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 $2 - $51 84%
Blue Cross Blue Shield $2 84%
Geha $2 84%
Iowa Total Care $2 84%
Medicaid / KanCare $2 84%
Medicare (plans) $2 84%
UnitedHealthcare $2 - $58 84%
Amish Hospital Aid $3 127%
Oscar $3 127%
Ambetter / Centene $4 169%
Claimdoc $5 211%
Nova $5 211%
Iowa Dept Of Public Health $9 - $58 380%
Health Choices $16 675%
Medical Associates $16 675%
Preferred Health Choice $17 717%
The Alliance $35 1477%
1199 National Benefit Fund $51 2152%
Allied Benefit Systems $51 2152%
Asr Health Benefits $51 2152%
Christian Brother Services $51 2152%
Coventry $51 2152%
First Health $51 2152%
Health Partners $51 2152%
Lucent Health $51 2152%
Luminare Health $51 2152%
Medical Mutual $51 2152%
Meritain $51 2152%
Trustmark Small Business Benefits $51 2152%
Webtpa $51 2152%
Auxiant $52 2194%
Cigna $52 2194%
Medica $52 2194%
Midlands $52 2194%
Midlands Choice $52 2194%
Multiplan $52 2194%
Qualcare $52 2194%
Usa Managed Care $55 2321%
Crime Victim Assistance $58 2447%

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