CMS Price Transparency Data

Blood test, liver function panel

Facility: Adventist Health Clearlake

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $81
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 9.91x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Adventist Health Clearlake is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 9.91x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $84 (1028%)
Insurance Median: $81 (991%)
Cash: $84 (1028% of Medicare)
Ins. Median: $81 (991% 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 991% of the Medicare baseline (a markup of 891%). 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 $1 - $314 12%
Blue Cross Blue Shield $3 - $96 37%
Blue Shield Mcr Adv $3 - $79 37%
Kaiser Mcr Adv $3 - $79 37%
Tricare $3 - $79 37%
Ah Employee Health Plan - All Plans $5 - $158 61%
Aetna $9 - $282 110%
Bc Managed Mcal $9 110%
Medi-Cal $9 110%
Partnership Mcal - All Plans $9 110%
Blue Shield Epn - All Other Plans $10 - $290 122%
Blue Shield Non-Epn $10 - $290 122%
First Health- All Plans $10 - $302 122%
Healthnet- All Plans $10 - $309 122%
Western Growers- All Plans $10 - $283 122%
Cigna $11 - $339 135%
Foundation- All Plans $11 - $320 135%
Health Mgmt Network- All Plans $11 - $320 135%
Humana $11 - $320 135%
Interplan- All Plans $11 - $339 135%
Kaiser- All Other Plans $11 - $339 135%
Phcs- All Plans $11 - $320 135%
Three Rivers Provider Network- All Plans $11 - $339 135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15630 18Th Ave - Hwy 53, Clearlake, CA 95422
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals