CMS Price Transparency Data

Culture, blood

Facility: Mercyone Dyersville Medical Center

Billing Code: 87040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 87040
Insurance Median: $151
Cash Discount Price: $119
vs. Medicare Baseline: 14.63x Medicare

The contracted insurance negotiated median rate for a Culture, blood at Mercyone Dyersville Medical Center is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $10.32, this hospital’s rate is 14.63x the Medicare baseline. Located in 1111 3Rd Street Sw, Dyersville, IA.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $119 (1153%)

Insurance Median: $151 (1463%)

Cash: $119 (1153% of Medicare)

Ins. Median: $151 (1463% 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 1463% of the Medicare baseline (a markup of 1363%). 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	$69	669%
Blue Cross Blue Shield	$101	979%
Medicare (plans)	$104 - $113	1008%
UnitedHealthcare	$109 - $128	1056%
The Alliance	$111	1076%
Iowa Total Care	$127	1231%
Geha	$128	1240%
Medicaid / KanCare	$129	1250%
Amish Hospital Aid	$136	1318%
1199 National Benefit Fund	$151	1463%
Aetna	$151	1463%
Allied Benefit Systems	$151	1463%
Asr Health Benefits	$151	1463%
Christian Brother Services	$151	1463%
Coventry	$151	1463%
First Health	$151	1463%
Luminare Health	$151	1463%
Medical Mutual	$151	1463%
Meritain	$151	1463%
Trustmark Small Business Benefits	$151	1463%
Webtpa	$151	1463%
Auxiant	$165	1599%
Cigna	$165	1599%
Medica	$165	1599%
Midlands	$165	1599%
Midlands Choice	$165	1599%
Multiplan	$165	1599%
Ambetter / Centene	$172	1667%
Crime Victim Assistance	$183	1773%
Iowa Dept Of Public Health	$183	1773%
Claimdoc	$206	1996%
Nova	$206	1996%

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 $119.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 87040.

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 87040.
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.