CMS Price Transparency Data

Blood antibody screen

Facility: Mercyone Elkader Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $97
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.82x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercyone Elkader Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.82x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$53.24

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $53.24 (100%)
Cash / Self-Pay: $86 (162%)
Insurance Median: $97 (182%)
Cash: $86 (162% of Medicare)
Ins. Median: $97 (182% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $53.24 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
Aetna $10 - $97 19%
Blue Cross Blue Shield $68 128%
Medicare (plans) $69 - $71 130%
UnitedHealthcare $73 - $99 137%
Iowa Total Care $82 154%
Medicaid / KanCare $83 - $84 156%
Amish Hospital Aid $91 171%
1199 National Benefit Fund $97 182%
Allied Benefit Systems $97 182%
Asr Health Benefits $97 182%
Christian Brother Services $97 182%
Coventry $97 182%
First Health $97 182%
Lucent Health $97 182%
Luminare Health $97 182%
Medical Mutual $97 182%
Meritain $97 182%
Trustmark Small Business Benefits $97 182%
Webtpa $97 182%
Geha $99 186%
Centivo $103 193%
Health Choices $106 199%
Medical Associates $106 199%
Ambetter / Centene $115 216%
Health Partners $127 239%
Auxiant $129 242%
Cigna $129 242%
Medica $129 242%
Midlands $129 242%
Midlands Choice $129 242%
Crime Victim Assistance $132 248%
Iowa Dept Of Public Health $132 248%
Claimdoc $138 259%
Nova $138 259%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals