CMS Price Transparency Data

Blood test, liver function panel

Facility: Modoc Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $168
  • Cash Discount Price: $193
  • vs. Medicare Baseline: 20.56x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Modoc Medical Center is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 20.56x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.
Cash / Self-Pay
$193

Average discount available for prompt cash payment at this facility.

Insurance Median
$168

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: $193 (2362%)
Insurance Median: $168 (2056%)
Cash: $193 (2362% of Medicare)
Ins. Median: $168 (2056% 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 2056% of the Medicare baseline (a markup of 1956%). 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
Integrated Hp Wc $8 98%
Multiplan Wc $8 98%
Ntwrks By Design Wc - All Plans $8 98%
Adv Med Mgmt - All Plans $9 110%
Medi-Cal $9 110%
Medi-Cal 7/1/24 $9 110%
Partnership Hp - All Plans $9 110%
Blue Shield Mcr Adv $105 1285%
Blue Shield Va $105 1285%
UnitedHealthcare $105 - $184 1285%
Tricare $110 1346%
Healthnet Mcr Adv $111 1359%
Blue Cross Blue Shield $159 - $177 1946%
Blue Shield Exch $159 1946%
Blue Shield Comm - All Other Plans $176 2154%
Carelon - All Plans $177 2166%
Corvel - All Plans $182 2228%
Aetna $184 2252%
Coventry/First Health - All Plans $184 2252%
Galaxy Health - All Plans $184 2252%
Healthnet Comm - All Other Plans $184 2252%
Hmn - All Plans $184 2252%
Integrated Hp - All Other Plans $184 2252%
Interplan - All Plans $184 2252%
Multiplan - All Other Plans $184 2252%
Superior Ca Ppo - All Plans $184 2252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 N Nagle Street, Alturas, CA 96101
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals