CMS Price Transparency Data

Blood test, comprehensive metabolic panel

Facility: Mercyone Oelwein Medical Center

Billing Code: 80053 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80053
  • Insurance Median: $178
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 16.86x Medicare
The contracted insurance negotiated median rate for a Blood test, comprehensive metabolic panel at Mercyone Oelwein Medical Center is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $10.56, this hospital’s rate is 16.86x the Medicare baseline. Located in 201 Eighth Avenue Se, Oelwein, IA.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$178

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$10.56

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $10.56 (100%)
Cash / Self-Pay: $407 (3854%)
Insurance Median: $178 (1686%)
Cash: $407 (3854% of Medicare)
Ins. Median: $178 (1686% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $10.56 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 1686% of the Medicare baseline (a markup of 1586%). 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 - $194 85%
Medicare (plans) $74 - $83 701%
Iowa Total Care $75 710%
Medicaid / KanCare $76 - $77 720%
Blue Cross Blue Shield $79 748%
UnitedHealthcare $84 - $138 795%
Aetna $91 - $178 862%
Amish Hospital Aid $106 1004%
Centivo $119 1127%
Ambetter / Centene $134 1269%
Geha $138 1307%
Health Choices $143 1354%
Medical Associates $143 1354%
Claimdoc $160 1515%
Nova $160 1515%
1199 National Benefit Fund $178 1686%
Allied Benefit Systems $178 1686%
Asr Health Benefits $178 1686%
Christian Brother Services $178 1686%
Coventry $178 1686%
First Health $178 1686%
Lucent Health $178 1686%
Luminare Health $178 1686%
Medical Mutual $178 1686%
Meritain $178 1686%
Trustmark Small Business Benefits $178 1686%
Webtpa $178 1686%
Health Partners $187 1771%
Multiplan $188 1780%
Auxiant $190 1799%
Cigna $190 1799%
Medica $190 1799%
Midlands $190 1799%
Midlands Choice $190 1799%
Crime Victim Assistance $194 1837%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Eighth Avenue Se, Oelwein, IA 50662
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals