CMS Price Transparency Data

Culture, blood

Facility: Mercy Medical Center-New Hampton

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 87040
  • Insurance Median: $173
  • Cash Discount Price: $646
  • vs. Medicare Baseline: 16.76x Medicare
The contracted insurance negotiated median rate for a Culture, blood at Mercy Medical Center-New Hampton is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $646. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 16.76x the Medicare baseline. Located in 308 North Maple Avenue, New Hampton, IA.
Cash / Self-Pay
$646

Average discount available for prompt cash payment at this facility.

Insurance Median
$173

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.32

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.32 (100%)
Cash / Self-Pay: $646 (6260%)
Insurance Median: $173 (1676%)
Cash: $646 (6260% of Medicare)
Ins. Median: $173 (1676% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.32 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 1676% of the Medicare baseline (a markup of 1576%). 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
Iowa Dept Of Public Health $9 - $183 87%
Blue Cross Blue Shield $72 698%
Aetna $73 - $173 707%
Medicare (plans) $74 - $82 717%
UnitedHealthcare $78 - $110 756%
Health Choices $92 891%
Medical Associates $92 891%
Amish Hospital Aid $97 940%
Oscar $108 1047%
Geha $110 1066%
Ambetter / Centene $123 1192%
Iowa Total Care $125 1211%
Medicaid / KanCare $127 - $128 1231%
Claimdoc $147 1424%
Nova $147 1424%
1199 National Benefit Fund $173 1676%
Allied Benefit Systems $173 1676%
Asr Health Benefits $173 1676%
Coventry $173 1676%
First Health $173 1676%
Lucent Health $173 1676%
Luminare Health $173 1676%
Medical Mutual $173 1676%
Meritain $173 1676%
Trustmark Small Business Benefits $173 1676%
Webtpa $173 1676%
First Choice Health $174 1686%
Health Partners $176 1705%
Auxiant $178 1725%
Cigna $178 1725%
Medica $178 1725%
Midlands $178 1725%
Midlands Choice $178 1725%
Crime Victim Assistance $183 1773%

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