CMS Price Transparency Data

Blood test, liver function panel

Facility: Nemours Children's Hospital, Delaware

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $188
  • Cash Discount Price: $336
  • vs. Medicare Baseline: 23.01x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Nemours Children's Hospital, Delaware is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $336. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 23.01x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$336

Average discount available for prompt cash payment at this facility.

Insurance Median
$188

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: $336 (4113%)
Insurance Median: $188 (2301%)
Cash: $336 (4113% of Medicare)
Ins. Median: $188 (2301% 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 2301% of the Medicare baseline (a markup of 2201%). 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
Priority Partners John Hopkins $8 - $165 98%
Tricare $8 98%
Us Family Health Plan $10 122%
Celtic Transplant $14 - $336 171%
Keystone First Hlth Plan $67 - $149 820%
Amerihealth Caritas Delaware $103 - $192 1261%
Blue Cross Blue Shield $104 - $297 1273%
Celtic Transplant For De First Health $118 1444%
Delaware First Health $121 1481%
UnitedHealthcare $123 - $210 1506%
Wellpoint Maryland $124 1518%
Kidz Partners $127 1554%
Health Partners $130 1591%
Upmc $133 1628%
Fidelis $134 1640%
Aetna $143 - $195 1750%
Six Degrees Health Transplant $168 2056%
Cigna $185 - $212 2264%
Great West-One Health Plan $185 - $212 2264%
Ambetter / Centene $192 2350%
Geisinger Health Plan $202 2472%
Integra Administrative Group $202 2472%
National Transplant Network (Ntn) $218 2668%
Six Degrees Health $218 2668%
Star Healthcare Network $218 2668%
Life Trac Solid Organ And Bmt Transplant $235 2876%
First Health Network $319 3905%
Insurance Administrators Of America $319 3905%
Interlink Transplant Network $319 3905%
Multiplan $319 3905%
Preferred Healthcare $319 3905%
Private Healthcare Systems $319 3905%
Three Rivers Provider Network $319 3905%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens