CMS Price Transparency Data

Blood test, liver function panel

Facility: Mc Donough District Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $55
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 6.73x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Mc Donough District Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.73x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $40 (490%)
Insurance Median: $55 (673%)
Cash: $40 (490% of Medicare)
Ins. Median: $55 (673% 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 673% of the Medicare baseline (a markup of 573%). 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
Health Alliance $5 - $60 61%
Hfn $7 - $60 86%
UnitedHealthcare $7 - $60 86%
Aetna $8 - $67 98%
Humana $8 - $60 98%
Medicaid / KanCare $8 - $67 98%
Medicare (plans) $8 98%
Meridian $8 98%
Molina $8 - $67 98%
Mutual Medical $8 - $67 98%
Tricare $8 98%
Veteran Affairs $8 98%
Blue Cross Blue Shield $9 - $67 110%
Springfield Health $55 673%
Consociate $57 698%
Trilogy $57 698%
Blue Choice $60 734%
Current Health $60 734%
Healthlink $60 - $63 734%
Preferred Plan $64 783%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals