CMS Price Transparency Data

Blood test, potassium

Facility: Monroe County Hospital

Billing Code: 84132 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84132
Insurance Median: $40
Cash Discount Price: $43
vs. Medicare Baseline: 8.40x Medicare

The contracted insurance negotiated median rate for a Blood test, potassium at Monroe County Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $43. Compared to the federal Medicare reimbursement reference rate of $4.76, this hospital’s rate is 8.40x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$43

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.76

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.76 (100%)

Cash / Self-Pay: $43 (903%)

Insurance Median: $40 (840%)

Cash: $43 (903% of Medicare)

Ins. Median: $40 (840% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.76 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 840% of the Medicare baseline (a markup of 740%). 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	$2 - $5	42%
Wellmark Hmo	$6	126%
Wellmark Ppo - All Other Plans	$7	147%
Aetna	$18 - $96	378%
Amerigroup Mcare	$18 - $43	378%
Humana	$18 - $43	378%
Mahp Mcare - All Plans	$18 - $43	378%
Tricare	$18 - $43	378%
UnitedHealthcare	$18 - $97	378%
Wellmark Mcare	$18 - $43	378%
Iowa Total Care Mcaid - All Plans	$21 - $51	441%
Molina Mcaid - All Plans	$21 - $52	441%
Amerigroup Mcaid - All Other Plans	$22 - $52	462%
Centivo - All Plans	$26 - $64	546%
Midlands Choice - All Plans	$29 - $71	609%
Preferred Hlth - All Plans	$32 - $76	672%
Geha - All Plans	$34 - $82	714%
Multiplan - All Plans	$38 - $92	798%
Integrated Hp - All Plans	$41 - $99	861%

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 $43.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84132.

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 84132.
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.