CMS Price Transparency Data

Blood test, calcium

Facility: Shenandoah Medical Center

Billing Code: 82310 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 82310
Insurance Median: $22
Cash Discount Price: $42
vs. Medicare Baseline: 4.26x Medicare

The contracted insurance negotiated median rate for a Blood test, calcium at Shenandoah Medical Center is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $5.16, this hospital’s rate is 4.26x the Medicare baseline. Located in 300 Pershing Avenue, Shenandoah, IA.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $42 (814%)

Insurance Median: $22 (426%)

Cash: $42 (814% of Medicare)

Ins. Median: $22 (426% 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 426% of the Medicare baseline (a markup of 326%). 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
UnitedHealthcare	$5 - $64	97%
Blue Cross Blue Shield	$7	136%
Home State Health Plan Mcaid-All Plans	$21	407%
Molina Mcd	$21	407%
Nebraska Total Care Mcaid-All Plans	$21	407%
Aetna	$22 - $62	426%
Amerigroup Mcaid-All Plans	$22	426%
Iowa Total Care Mcaid-All Plans	$22	426%
Molina Mcr - All Other Plans	$22	426%
Tricare	$22	426%
Triwest Wellmark - All Plans	$22	426%
Wellcare Mcr Adv - All Plans	$22	426%
Midlands Choice-All Plans	$60	1163%

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 $42.
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 Shenandoah Medical Center 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.