CMS Price Transparency Data

Blood test, sodium

Facility: Monroe County Hospital

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 84295
Insurance Median: $51
Cash Discount Price: $62
vs. Medicare Baseline: 10.60x Medicare

The contracted insurance negotiated median rate for a Blood test, sodium at Monroe County Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 10.60x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)

Cash / Self-Pay: $62 (1289%)

Insurance Median: $51 (1060%)

Cash: $62 (1289% of Medicare)

Ins. Median: $51 (1060% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 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 1060% of the Medicare baseline (a markup of 960%). 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	$5	104%
Wellmark Hmo	$6	125%
Wellmark Ppo - All Other Plans	$7	146%
Amerigroup Mcare	$44	915%
Humana	$44	915%
Mahp Mcare - All Plans	$44	915%
Tricare	$44	915%
UnitedHealthcare	$44 - $99	915%
Wellmark Mcare	$44	915%
Aetna	$45 - $98	936%
Iowa Total Care Mcaid - All Plans	$52	1081%
Molina Mcaid - All Plans	$53	1102%
Amerigroup Mcaid - All Other Plans	$54	1123%
Centivo - All Plans	$66	1372%
Midlands Choice - All Plans	$73	1518%
Preferred Hlth - All Plans	$78	1622%
Geha - All Plans	$83	1726%
Multiplan - All Plans	$94	1954%
Integrated Hp - All Plans	$101	2100%

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 $62.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 84295.

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 84295.
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.