CMS Price Transparency Data

Blood test, liver function panel

Facility: Adventist Health Reedley

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $12
Cash Discount Price: $54
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Adventist Health Reedley is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 1.47x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$12

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: $54 (661%)

Insurance Median: $12 (147%)

Cash: $54 (661% of Medicare)

Ins. Median: $12 (147% 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.

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
Healthnet Medi-Cal	$2 - $58	24%
Bc Mcal	$3	37%
UnitedHealthcare	$5 - $162	61%
Blue Shield Epn - All Other Plans	$6 - $170	73%
Blue Shield Non Epn	$6 - $197	73%
Healthnet- All Other Plans	$6 - $167	73%
Kaiser - All Other Plans	$6 - $192	73%
Western Growers/Pinnacle- All Plans	$6 - $177	73%
Blue Shield Mcare	$8	98%
Cigna	$8 - $250	98%
Dignity Mcr Adv Op/Profee Only	$8	98%
Fhcn Pace Mcr Adv-All Plans	$8	98%
Healthnet- Mcr Adv	$8	98%
Kaiser Mcr Adv	$8	98%
Phs Prime Health Srvcs	$8	98%
Tricare	$8	98%
Cal Viva Hlth Mcal - All Plans	$9	110%
Kern Health Systems Mcal-All Plans	$9	110%
Medi-Cal	$9	110%
Dignity Mcal Op/Profee Only-All Other Plans	$10	122%
Physicians Med Group Op/Profee Only- All Plans	$10 - $308	122%
Community Care Ipa Mcal-All Plans	$12	147%
Aetna	$13 - $47	159%
Bright Health Mcr Adv - All Plans	$13	159%
Ah Employee Health Plan - All Plans	$15	184%
Blue Cross Blue Shield	$36 - $105	441%

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 $54.
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 Adventist Health Reedley 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.