CMS Price Transparency Data

Blood test, liver function panel

Facility: South Miami Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $224
Cash Discount Price: $325
vs. Medicare Baseline: 27.42x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at South Miami Hospital is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $325. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 27.42x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.

Cash / Self-Pay

$325

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $325 (3978%)

Insurance Median: $224 (2742%)

Cash: $325 (3978% of Medicare)

Ins. Median: $224 (2742% 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 2742% of the Medicare baseline (a markup of 2642%). 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
Aetna	$5 - $472	61%
Amerigroup	$5	61%
Medicaid / KanCare	$5	61%
Sunshine State	$5	61%
UnitedHealthcare	$5 - $590	61%
Vista	$5	61%
Wellcare	$5	61%
Blue Cross Blue Shield	$8 - $382	98%
Medicare (plans)	$8 - $11	98%
Avmed	$9 - $292	110%
Cigna	$9 - $472	110%
Humana	$9	110%
Leon Medical	$9	110%
Medica Health Plan	$9	110%
Non Contracted	$150 - $217	1836%
Amerihealth	$184 - $266	2252%
International	$266 - $384	3256%
Dimension Health Plan	$307 - $531	3758%
Affordable	$348 - $502	4259%
Phcs	$368 - $531	4504%
Quality Health	$368 - $531	4504%

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 $325.
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 South Miami Hospital 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.