CMS Price Transparency Data

Blood test, liver function panel

Facility: HSHS St Elizabeth's Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $185
  • Cash Discount Price: $168
  • vs. Medicare Baseline: 22.64x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at HSHS St Elizabeth's Hospital is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 22.64x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$168

Average discount available for prompt cash payment at this facility.

Insurance Median
$185

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: $168 (2056%)
Insurance Median: $185 (2264%)
Cash: $168 (2056% of Medicare)
Ins. Median: $185 (2264% 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 2264% of the Medicare baseline (a markup of 2164%). 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
Meridian Health Plan $7 86%
Molina Healthcare $7 - $9 86%
Aetna $8 - $164 98%
Blue Cross Blue Shield $8 - $233 98%
Clear Spring Health Of Illinois $8 98%
Health Alliance Medical Plans $8 - $198 98%
Health Partners $8 98%
Humana $8 98%
Sae Hospice $8 98%
UnitedHealthcare $8 - $233 98%
Celtic Insurance Company $17 208%
Naphcare $18 220%
Claim Doc $20 245%
Hopetrust $20 245%
Amish Community $65 796%
Wellfirst $150 1836%
First Health $173 2118%
Cigna $184 - $233 2252%
Healthlink $185 - $233 2264%
Caterpillar, Inc. $187 2289%
Consociate Group $205 2509%
Choicecare $210 2570%
Healthcare Finest Network (Hfn) $210 2570%
Multiplan/Phcs $210 2570%
Provider Network Of America $210 2570%
City Of Springfield $233 2852%
Current Health Solutions $233 2852%
Healthscope $233 2852%
Illinois Breast And Cervical Cancer Program $233 2852%
Interplan $233 2852%
Live360 $233 2852%
Wexford $233 2852%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals