CMS Price Transparency Data

Blood test, liver function panel

Facility: City of Hope National Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $99
Cash Discount Price: $141
vs. Medicare Baseline: 12.12x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at City of Hope National Medical Center is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 12.12x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$141

Average discount available for prompt cash payment at this facility.

Insurance Median

$99

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: $141 (1726%)

Insurance Median: $99 (1212%)

Cash: $141 (1726% of Medicare)

Ins. Median: $99 (1212% 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 1212% of the Medicare baseline (a markup of 1112%). 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
Health Net	$5 - $137	61%
Cal Optima	$7 - $9	86%
Heritage Provider Network	$8 - $99	98%
Inland Empire	$10 - $113	122%
Facey	$11	135%
Prime Healthcare Keenan	$14 - $135	171%
UnitedHealthcare	$25 - $79	306%
Blue Cross Blue Shield	$70 - $99	857%
Blue Shield	$83 - $182	1016%
Blue Shield Covca	$86	1053%
Blue Shield Promise	$99	1212%
Cencal	$113	1383%
La Care Health	$113	1383%
Kaiser	$127	1554%
Aetna	$141	1726%
Gold Coast	$141	1726%
Molina	$141 - $183	1726%
Cigna	$151	1848%
Healthcare Partners	$163	1995%
St. Joseph Heritage	$169	2069%
Primecare Medical Network	$183	2240%
First Health	$217	2656%
Phcs Multiplan	$253	3097%

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 $141.
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 City of Hope National Medical Center 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.