CMS Price Transparency Data

Blood test, liver function panel

Facility: Monroe County Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $73
Cash Discount Price: $89
vs. Medicare Baseline: 8.94x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Monroe County Hospital is $73. 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 $8.17, this hospital’s rate is 8.94x 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

$73

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: $89 (1089%)

Insurance Median: $73 (894%)

Cash: $89 (1089% of Medicare)

Ins. Median: $73 (894% 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 894% of the Medicare baseline (a markup of 794%). 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	122%
Wellmark Ppo - All Other Plans	$11	135%
Va Ccn - All Plans	$12	147%
Mahp Mcare - All Plans	$62	759%
Tricare	$62	759%
UnitedHealthcare	$62 - $141	759%
Aetna	$63 - $139	771%
Amerigroup Mcare	$63	771%
Humana	$63	771%
Wellmark Mcare	$63	771%
Iowa Total Care Mcaid - All Plans	$74	906%
Molina Mcaid - All Plans	$75	918%
Amerigroup Mcaid - All Other Plans	$76	930%
Centivo - All Plans	$93	1138%
Midlands Choice - All Plans	$104	1273%
Preferred Hlth - All Plans	$111	1359%
Geha - All Plans	$118	1444%
Multiplan - All Plans	$133	1628%
Integrated Hp - All Plans	$144	1763%

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: 80076.

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 80076.
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.