CMS Price Transparency Data

Blood test, liver function panel

Facility: Decatur Memorial Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $143
Cash Discount Price: $308
vs. Medicare Baseline: 17.50x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Decatur Memorial Hospital is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $308. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 17.50x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$308

Average discount available for prompt cash payment at this facility.

Insurance Median

$143

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: $308 (3770%)

Insurance Median: $143 (1750%)

Cash: $308 (3770% of Medicare)

Ins. Median: $143 (1750% 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 1750% of the Medicare baseline (a markup of 1650%). 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
Blue Cross Blue Shield	$7 - $308	86%
Aetna	$8 - $207	98%
Coventry	$8 - $156	98%
Health Alliance	$8 - $205	98%
Humana	$8 - $200	98%
Medicare (plans)	$8	98%
Tricare	$8	98%
UnitedHealthcare	$8 - $308	98%
Veterans Administration	$8	98%
Wellcare	$8	98%
Medicaid / KanCare	$9	110%
Caterpillar	$10	122%
Plain Church Medical Group	$11 - $139	135%
Illinois Workers Compensation	$48 - $126	588%
Mennonite Churches	$108	1322%
Hfn	$118 - $231	1444%
Commercial Workers Compensation	$119	1457%
Health Alliance Mh Employee Plan	$142	1738%
Cigna	$144	1763%
6 Degrees Health	$185	2264%
Hopetrust	$185	2264%
Hst	$185	2264%
Phcs Savility	$200	2448%
Phcs Multiplan Ppo	$209	2558%
Healthlink	$211	2583%
Corvel	$222	2717%
Consociate	$228	2791%
Liability	$308	3770%

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 $308.
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 Decatur Memorial 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.