CMS Price Transparency Data

Blood test, liver function panel

Facility: Saint Joseph Regional Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $113
  • Cash Discount Price: $283
  • vs. Medicare Baseline: 13.83x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Saint Joseph Regional Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 13.83x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$283

Average discount available for prompt cash payment at this facility.

Insurance Median
$113

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: $283 (3464%)
Insurance Median: $113 (1383%)
Cash: $283 (3464% of Medicare)
Ins. Median: $113 (1383% 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 1383% of the Medicare baseline (a markup of 1283%). 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
Aetna $5 - $212 61%
Blue Cross Blue Shield $5 - $16 61%
Medicaid / KanCare $5 - $8 61%
UnitedHealthcare $5 - $277 61%
County Coroner $8 98%
Managed Health Services - Indiana $8 98%
Mdwise $8 98%
Medicare (plans) $8 98%
Meridian Complete $8 98%
Pace-Trinity Health $8 98%
Bureau Of Disability $9 110%
Provider Partners Health Plan Of Indiana $9 110%
Auxiant $12 - $361 147%
Physicians Health Plan Northern Indiana Health Insurance $12 - $25 147%
St Joseph County Hlth Dpt $12 147%
Caresource $13 159%
Siho Insurance Services $13 159%
Key Benefit Administrator $15 - $271 184%
Allied Benefit Systems $16 - $283 196%
Blue Benefit Administrators Of Massachusetts $16 196%
Blue Care Network $16 196%
Blue Distinction Transplant $16 196%
Blue Shield - Ca $16 196%
Blue Shield - Id (Regence) $16 196%
Blue Shield - Ny Highmark Northeastern $16 196%
Blue Shield - Ny Highmark Western $16 196%
Blue Shield - Pa (Highmark) $16 196%
Blue Shield - Wa (Regence) $16 196%
Custom Design Benefits $18 220%
Hospice Of Marshall County $113 1383%
Hospice Of St Joseph County $113 1383%
Plain Church Group $117 1432%
Asr Health Benefits $212 2595%
Christian Brother Services $212 2595%
Employee Benefit Management $212 2595%
Medical Mutual $212 2595%
Meritain $212 2595%
Preferred One $212 2595%
Rural Carrier Health Benefit Plan $212 2595%
Webtpa $212 2595%
Notre Dame Athletic Association $239 2925%
Wc Notre Dame $239 2925%
Luminare Health (Detroit) $248 - $261 3035%
Encore Health $258 - $271 3158%
Ameriben $261 3195%
Indiana Criminal Justice Inst $271 3317%
Western & Southern Financial Group $271 3317%
Geha $277 3390%
Healthscope $277 3390%
Student Insurance Cma $277 3390%
Cigna $278 3403%
Group Administrators $278 3403%
Health Partners $278 3403%
Mvp $278 3403%
Prairie States $278 3403%
Priority Health $278 3403%
Professional Benefit Administrators $278 3403%
Sagamore Health Network $278 - $322 3403%
Sisco Benefits $278 3403%
Unified Group Services $278 3403%
Goshen Preferred Network $335 - $374 4100%
Christian Brothers Holy Cross $348 4259%
Signature Care $348 4259%
Bankers Life Casualty $435 5324%
Wc Align Network $435 5324%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals