CMS Price Transparency Data

Blood test, calcium

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 82310 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82310
Insurance Median: $55
Cash Discount Price: $46
vs. Medicare Baseline: 10.66x Medicare

The contracted insurance negotiated median rate for a Blood test, calcium at Iowa Specialty Hospital - Clarion is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $5.16, this hospital’s rate is 10.66x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$5.16

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.16 (100%)

Cash / Self-Pay: $46 (891%)

Insurance Median: $55 (1066%)

Cash: $46 (891% of Medicare)

Ins. Median: $55 (1066% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.16 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 1066% of the Medicare baseline (a markup of 966%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Tricare	$22 - $25	426%
Triwest Va - All Plans	$22 - $25	426%
Wellmark Hmo	$32	620%
Wellmark Ppo - All Other Plans	$35	678%
Healthscope Stellar-All Plans	$37 - $43	717%
Auxiant Clarion Schools-All Plans	$46 - $53	891%
Health Partners Prestage	$53 - $61	1027%
Health Partners Ish-All Other Plans	$57 - $65	1105%
Aetna	$60 - $69	1163%
UnitedHealthcare	$67 - $77	1298%
Cigna	$69 - $79	1337%
Midlands Choice-All Plans	$69 - $79	1337%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $46.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 82310.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Iowa Specialty Hospital - Clarion is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 82310.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.