CMS Price Transparency Data

Blood test, liver function panel

Facility: Madison County Health Care System

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $122
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 14.93x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Madison County Health Care System is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 14.93x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $150 (1836%)
Insurance Median: $122 (1493%)
Cash: $150 (1836% of Medicare)
Ins. Median: $122 (1493% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.17 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 1493% of the Medicare baseline (a markup of 1393%). 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
Blue Cross Blue Shield $52 - $57 636%
Aetna $80 - $122 979%
Medical Associates Hp - All Plans $80 979%
Medigold-All Plans $80 979%
Tricare $80 979%
UnitedHealthcare $80 - $168 979%
American Hp Mcr Adv-All Plans $84 1028%
Iowa Total Care Mcaid-All Plans $88 1077%
Molina Mcaid/Chip -All Plans $91 1114%
Amerigroup Mcaid-All Plans $93 1138%
Madison County Sheriff-All Plans $94 1151%
Oscar - All Plans $121 1481%
Corvel Wc-All Plans $168 2056%
Choicecare-All Plans $178 2179%
First Choice-All Plans $178 2179%
First Health-All Plans $178 2179%
Integrated Hp-All Plans $178 2179%
Mutual Of Omaha-All Plans $178 2179%
Plaines Health-All Plans $178 2179%
Preferred Hlth Ntwork-All Plans $178 2179%
Principal Healthcare-All Plans $178 2179%
Usa Managed Care-All Plans $178 2179%
Medimore Employee Hp - All Plans $183 2240%
Midlands Choice - All Plans $183 2240%
Benefit Admin Of America-All Plans $187 2289%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals