CMS Price Transparency Data

Blood test, liver function panel

Facility: Mt Sinai Hospital Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $27
  • Cash Discount Price: $183
  • vs. Medicare Baseline: 3.30x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Mt Sinai Hospital Medical Center is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 3.30x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$183

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $183 (2240%)
Insurance Median: $27 (330%)
Cash: $183 (2240% of Medicare)
Ins. Median: $27 (330% 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 330% of the Medicare baseline (a markup of 230%). 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
Advocate Physician Prtnrs Mcr $8 98%
Blue Cross Blue Shield $8 - $305 98%
Cenpatico Illinicare Dual $8 98%
Cenpatico Illinicare Mcr - All Other Plans $8 98%
Cigna $8 - $593 98%
Harmony Behavioral Htlh - All Plans $8 98%
Humana $8 - $1,508 98%
Lawndale Christian - All Plans $8 - $96 98%
Meridian/Harmony D-Snp - All Plans $8 98%
Nextlevel Hlth Icp Fhp Aca - All Plans $8 98%
Tricare $8 98%
UnitedHealthcare $8 98%
Va Healthnet - All Plans $8 98%
Zing Mcr Adv - All Plans $8 98%
Advocate Physician Prtnrs - All Other Plans $9 110%
Ambetter / Centene $9 - $504 110%
Molina Mcr - All Other Plans $9 110%
Aetna $12 - $1,085 147%
Family Health Network Mcaid - All Plans $12 147%
Molina Mcaid $13 159%
Partners In Hlth - All Plans $18 - $192 220%
Healthlink Hmo $22 - $240 269%
Healthlink Ppo - All Other Plans $22 - $240 269%
Compsych Ip/Op Only - All Plans $26 - $288 318%
Hfn Platinum $29 - $312 355%
Multiplan Primary Ntwrk/Phcs - All Other Plans $31 - $336 379%
Hfn Epo $35 - $384 428%
Multiplan Complementary Ntwrk $35 - $384 428%
Hfn Ppo - All Other Plans $39 - $422 477%
Oscar - All Plans $39 - $48 477%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals