CMS Price Transparency Data

Blood test, sodium

Facility: Mercyone Clinton Medical Center

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $10
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Mercyone Clinton Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 2.08x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$10

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $42 (873%)
Insurance Median: $10 (208%)
Cash: $42 (873% of Medicare)
Ins. Median: $10 (208% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 208% of the Medicare baseline (a markup of 108%). 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 $5 - $40 104%
Blue Cross Blue Shield $5 104%
Geha $5 104%
Iowa Total Care $5 104%
Medicaid / KanCare $5 104%
Medicare (plans) $5 104%
UnitedHealthcare $5 - $46 104%
Amish Hospital Aid $6 125%
Oscar $7 146%
Ambetter / Centene $8 166%
Iowa Dept Of Public Health $9 - $46 187%
Claimdoc $10 208%
Nova $10 208%
Health Choices $13 270%
Medical Associates $13 270%
Preferred Health Choice $13 270%
The Alliance $28 582%
1199 National Benefit Fund $40 832%
Allied Benefit Systems $40 832%
Asr Health Benefits $40 832%
Christian Brother Services $40 832%
Coventry $40 832%
First Health $40 832%
Health Partners $40 832%
Lucent Health $40 832%
Luminare Health $40 832%
Medical Mutual $40 832%
Meritain $40 832%
Trustmark Small Business Benefits $40 832%
Webtpa $40 832%
Auxiant $41 852%
Cigna $41 852%
Medica $41 852%
Midlands $41 852%
Midlands Choice $41 852%
Multiplan $41 852%
Qualcare $41 852%
Usa Managed Care $44 915%
Crime Victim Assistance $46 956%

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