CMS Price Transparency Data

Blood test, liver function panel

Facility: St Joseph's Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $256
  • Cash Discount Price: $288
  • vs. Medicare Baseline: 31.33x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at St Joseph's Hospital is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 31.33x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$288

Average discount available for prompt cash payment at this facility.

Insurance Median
$256

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: $288 (3525%)
Insurance Median: $256 (3133%)
Cash: $288 (3525% of Medicare)
Ins. Median: $256 (3133% 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 3133% of the Medicare baseline (a markup of 3033%). 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 $15 184%
Molina Healthcare $15 - $80 184%
UnitedHealthcare $16 - $400 196%
Caterpillar, Inc. $16 196%
Cigna $20 245%
Humana $80 979%
Aetna $80 - $280 979%
Clear Spring Health of Illinois $80 979%
Sae Hospice $80 979%
Blue Cross Blue Shield $80 979%
Amish Community $112 1371%
Naphcare $168 2056%
Celtic Insurance Company $176 2154%
Hopetrust $200 2448%
Claim Doc $200 2448%
Wellfirst $256 3133%
First Health $296 3623%
Multiplan/Phcs $340 4162%
Healthlink $340 4162%
Healthcare Finest Network (Hfn) $360 4406%
Provider Network of America $360 4406%
Consociate Group $400 4896%
Current Health Solutions $400 4896%
Interplan $400 4896%
Mental Health Network $400 4896%
Health Alliance Medical Plans $400 4896%
Illinois Breast and Cervical Cancer Program $400 4896%
Healthscope $400 4896%
Qtc Medical Group of Illinois $400 4896%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals