CMS Price Transparency Data

Blood antibody screen

Facility: Monroe County Hospital

Billing Code: 86850 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 86850
  • Insurance Median: $97
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 1.82x Medicare
The contracted insurance negotiated median rate for a Blood antibody screen at Monroe County Hospital is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $53.24, this hospital’s rate is 1.82x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $121 (227%)
Insurance Median: $97 (182%)
Cash: $121 (227% of Medicare)
Ins. Median: $97 (182% 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.

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
Wellmark Hmo $5 9%
Wellmark Ppo - All Other Plans $6 11%
Va Ccn - All Plans $15 - $20 28%
Mahp Mcare - All Plans $63 - $88 118%
Tricare $63 - $88 118%
UnitedHealthcare $63 - $199 118%
Amerigroup Mcare $64 - $89 120%
Humana $64 - $89 120%
Wellmark Mcare $64 - $89 120%
Aetna $65 - $196 122%
Iowa Total Care Mcaid - All Plans $75 - $104 141%
Molina Mcaid - All Plans $77 - $106 145%
Amerigroup Mcaid - All Other Plans $78 - $108 147%
Centivo - All Plans $95 - $132 178%
Midlands Choice - All Plans $106 - $146 199%
Preferred Hlth - All Plans $113 - $157 212%
Geha - All Plans $121 - $167 227%
Multiplan - All Plans $136 - $188 255%
Integrated Hp - All Plans $146 - $203 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6580 165Th Street, Albia, IA 52531
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals