CMS Price Transparency Data

Blood antibody screen

Facility: Mercy Medical Center-New Hampton

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $125
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 2.35x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Mercy Medical Center-New Hampton is $125. 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 2.35x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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: $125 (235%)
Cash: $86 (162% of Medicare)
Ins. Median: $125 (235% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 235% of the Medicare baseline (a markup of 135%). 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
Blue Cross Blue Shield $52 98%
Aetna $53 - $125 100%
Medicare (plans) $53 - $59 100%
UnitedHealthcare $56 - $79 105%
Health Choices $67 126%
Medical Associates $67 126%
Amish Hospital Aid $70 131%
Oscar $78 147%
Geha $79 148%
Ambetter / Centene $89 167%
Iowa Total Care $90 169%
Medicaid / KanCare $92 173%
Claimdoc $106 199%
Nova $106 199%
1199 National Benefit Fund $125 235%
Allied Benefit Systems $125 235%
Asr Health Benefits $125 235%
Coventry $125 235%
First Choice Health $125 235%
First Health $125 235%
Lucent Health $125 235%
Luminare Health $125 235%
Medical Mutual $125 235%
Meritain $125 235%
Trustmark Small Business Benefits $125 235%
Webtpa $125 235%
Health Partners $127 239%
Auxiant $128 240%
Cigna $128 240%
Medica $128 240%
Midlands $128 240%
Midlands Choice $128 240%
Crime Victim Assistance $132 248%
Iowa Dept Of Public Health $132 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 308 North Maple Avenue, New Hampton, IA 50659
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals