CMS Price Transparency Data

Blood test, basic metabolic panel

Facility: Monroe County Hospital

Billing Code: 80048 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80048
Insurance Median: $74
Cash Discount Price: $89
vs. Medicare Baseline: 8.75x Medicare

The contracted insurance negotiated median rate for a Blood test, basic metabolic panel at Monroe County Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $8.46, this hospital’s rate is 8.75x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.46

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.46 (100%)

Cash / Self-Pay: $89 (1052%)

Insurance Median: $74 (875%)

Cash: $89 (1052% of Medicare)

Ins. Median: $74 (875% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $8.46 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 875% of the Medicare baseline (a markup of 775%). 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
Wellmark Hmo	$10	118%
Wellmark Ppo - All Other Plans	$11	130%
Va Ccn - All Plans	$12 - $13	142%
Amerigroup Mcare	$62 - $64	733%
Humana	$62 - $64	733%
Mahp Mcare - All Plans	$62 - $63	733%
Tricare	$62 - $63	733%
UnitedHealthcare	$62 - $143	733%
Wellmark Mcare	$62 - $64	733%
Aetna	$63 - $142	745%
Iowa Total Care Mcaid - All Plans	$73 - $75	863%
Molina Mcaid - All Plans	$75 - $77	887%
Amerigroup Mcaid - All Other Plans	$76 - $78	898%
Centivo - All Plans	$93 - $95	1099%
Midlands Choice - All Plans	$103 - $106	1217%
Preferred Hlth - All Plans	$110 - $113	1300%
Geha - All Plans	$118 - $121	1395%
Multiplan - All Plans	$132 - $136	1560%
Integrated Hp - All Plans	$143 - $146	1690%

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 $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80048.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Monroe County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80048.
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.