CMS Price Transparency Data

Blood test, cholesterol (lipid panel)

Facility: Monroe County Hospital

Billing Code: 80061 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80061
Insurance Median: $49
Cash Discount Price: $88
vs. Medicare Baseline: 3.66x Medicare

The contracted insurance negotiated median rate for a Blood test, cholesterol (lipid panel) at Monroe County Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $88. Compared to the federal Medicare reimbursement reference rate of $13.39, this hospital’s rate is 3.66x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$88

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$13.39

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $13.39 (100%)

Cash / Self-Pay: $88 (657%)

Insurance Median: $49 (366%)

Cash: $88 (657% of Medicare)

Ins. Median: $49 (366% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $13.39 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 366% of the Medicare baseline (a markup of 266%). 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
Va Ccn - All Plans	$7 - $32	52%
Wellmark Hmo	$10	75%
Wellmark Ppo - All Other Plans	$11	82%
Aetna	$22 - $226	164%
Amerigroup Mcare	$22 - $102	164%
Humana	$22 - $102	164%
Mahp Mcare - All Plans	$22 - $101	164%
Tricare	$22 - $101	164%
UnitedHealthcare	$22 - $228	164%
Wellmark Mcare	$22 - $102	164%
Iowa Total Care Mcaid - All Plans	$26 - $120	194%
Molina Mcaid - All Plans	$26 - $122	194%
Amerigroup Mcaid - All Other Plans	$27 - $123	202%
Centivo - All Plans	$33 - $151	246%
Midlands Choice - All Plans	$36 - $168	269%
Preferred Hlth - All Plans	$39 - $180	291%
Geha - All Plans	$42 - $192	314%
Multiplan - All Plans	$47 - $216	351%
Integrated Hp - All Plans	$50 - $233	373%

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 $88.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80061.

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 80061.
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.