CMS Price Transparency Data

Blood test, liver function panel

Facility: Jefferson County Health Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $52
  • Cash Discount Price: $72
  • vs. Medicare Baseline: 6.36x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Jefferson County Health Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.36x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$72

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $72 (881%)
Insurance Median: $52 (636%)
Cash: $72 (881% of Medicare)
Ins. Median: $52 (636% 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 636% of the Medicare baseline (a markup of 536%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $10 - $108 122%
Tricare $47 575%
Amerigroup Mcr Adv $48 588%
Humana $48 588%
Iowa Total Care Comm - All Other Plans $48 588%
Iowa Total Care Mcr $48 588%
Molina Mcr Adv $48 588%
Iowa Total Care Mcaid $50 612%
Molina Mcaid/Chip $50 612%
Medicaid / KanCare $51 624%
Wellmark Hmo $53 649%
Aetna $59 - $108 722%
Medicare (plans) $59 722%
Wellmark Indemnity/Ppo - All Other Plans $59 722%
Midlands New Product $98 1200%
Coventry Commercial Hmo $102 1248%
Coventry Commercial Ppo - All Other Plans $108 1322%
Midlands Choice-All Other Plans $108 1322%
Molina Marketplace - All Other Plans $120 1469%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals