CMS Price Transparency Data

Blood test, liver function panel

Facility: Hamilton Memorial Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $260
  • Cash Discount Price: $276
  • vs. Medicare Baseline: 31.82x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Hamilton Memorial Hospital is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 31.82x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$276

Average discount available for prompt cash payment at this facility.

Insurance Median
$260

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: $276 (3378%)
Insurance Median: $260 (3182%)
Cash: $276 (3378% of Medicare)
Ins. Median: $260 (3182% 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 3182% of the Medicare baseline (a markup of 3082%). 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
Medicaid / KanCare $121 - $130 1481%
Blue Cross Blue Shield $123 - $295 1506%
Aetna $130 - $292 1591%
Health Alliance $130 - $260 1591%
Humana $130 1591%
Medicare (plans) $130 1591%
UnitedHealthcare $130 - $232 1591%
Wellcare $130 1591%
Alliance Coal $227 2778%
Healthscope $227 2778%
Wellfirst (Ssmhic) $227 2778%
Hope Trust $243 2974%
Cigna $255 3121%
Hfn, Inc $260 - $292 3182%
Healthlink $276 - $292 3378%
Multiplan $276 3378%
Siho $292 3574%
Three Rivers Provider $292 3574%
Healthsmart $308 3770%
Stratose $308 3770%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals