CMS Price Transparency Data

Blood test, vitamin B12

Facility: Mercyone Clinton Medical Center

Billing Code: 82607 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82607
  • Insurance Median: $146
  • Cash Discount Price: $109
  • vs. Medicare Baseline: 9.68x Medicare
The contracted insurance negotiated median rate for a Blood test, vitamin B12 at Mercyone Clinton Medical Center is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $15.08, this hospital’s rate is 9.68x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$109

Average discount available for prompt cash payment at this facility.

Insurance Median
$146

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$15.08

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $15.08 (100%)
Cash / Self-Pay: $109 (723%)
Insurance Median: $146 (968%)
Cash: $109 (723% of Medicare)
Ins. Median: $146 (968% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $15.08 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 968% of the Medicare baseline (a markup of 868%). 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 $15 - $146 99%
Blue Cross Blue Shield $15 99%
Geha $15 99%
Iowa Total Care $15 99%
Medicaid / KanCare $15 99%
Medicare (plans) $15 99%
UnitedHealthcare $15 - $167 99%
Amish Hospital Aid $20 133%
Oscar $21 139%
Ambetter / Centene $25 166%
Claimdoc $30 199%
Nova $30 199%
Health Choices $47 312%
Medical Associates $47 312%
Preferred Health Choice $48 318%
The Alliance $101 670%
1199 National Benefit Fund $146 968%
Allied Benefit Systems $146 968%
Asr Health Benefits $146 968%
Christian Brother Services $146 968%
Coventry $146 968%
First Health $146 968%
Health Partners $146 968%
Lucent Health $146 968%
Luminare Health $146 968%
Medical Mutual $146 968%
Meritain $146 968%
Trustmark Small Business Benefits $146 968%
Webtpa $146 968%
Auxiant $150 995%
Cigna $150 995%
Medica $150 995%
Midlands $150 995%
Midlands Choice $150 995%
Multiplan $150 995%
Qualcare $150 995%
Usa Managed Care $159 1054%
Crime Victim Assistance $167 1107%
Iowa Dept Of Public Health $167 1107%

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