CMS Price Transparency Data

Blood antibody screen

Facility: Mercyone Dyersville Medical Center

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 86850
Insurance Median: $109
Cash Discount Price: $86
vs. Medicare Baseline: 2.05x Medicare

The contracted insurance negotiated median rate for a Blood antibody screen at Mercyone Dyersville Medical Center is $109. 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 2.05x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.

Cash / Self-Pay

$86

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $109 (205%)

Cash: $86 (162% of Medicare)

Ins. Median: $109 (205% 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 205% of the Medicare baseline (a markup of 105%). 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
Health Choices	$50	94%
Blue Cross Blue Shield	$73	137%
Medicare (plans)	$75 - $82	141%
UnitedHealthcare	$78 - $92	147%
The Alliance	$80	150%
Geha	$92	173%
Iowa Total Care	$92	173%
Medicaid / KanCare	$93	175%
Amish Hospital Aid	$98	184%
1199 National Benefit Fund	$109	205%
Aetna	$109	205%
Allied Benefit Systems	$109	205%
Asr Health Benefits	$109	205%
Christian Brother Services	$109	205%
Coventry	$109	205%
First Health	$109	205%
Luminare Health	$109	205%
Medical Mutual	$109	205%
Meritain	$109	205%
Trustmark Small Business Benefits	$109	205%
Webtpa	$109	205%
Auxiant	$119	224%
Cigna	$119	224%
Medica	$119	224%
Midlands	$119	224%
Midlands Choice	$119	224%
Multiplan	$119	224%
Ambetter / Centene	$124	233%
Crime Victim Assistance	$132	248%
Iowa Dept Of Public Health	$132	248%
Claimdoc	$149	280%
Nova	$149	280%

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 $86.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 86850.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercyone Dyersville Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 86850.
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.