CMS Price Transparency Data

Blood test, liver function panel

Facility: Elkhart General Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $31
Cash Discount Price: $34
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Elkhart General Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 3.79x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $34 (416%)

Insurance Median: $31 (379%)

Cash: $34 (416% of Medicare)

Ins. Median: $31 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Mclaren (Mi	$4	49%
UnitedHealthcare	$4 - $35	49%
Blue Cross Blue Shield	$7 - $16	86%
Aetna	$8 - $35	98%
Caresource	$8 - $68	98%
Humana	$8 - $36	98%
Mdwise	$8 - $68	98%
Mhs	$8 - $68	98%
Pace	$8	98%
Devoted Healthcare	$9 - $10	110%
Plain Church	$12 - $42	147%
Cha	$31 - $41	379%
Immergrun	$31 - $42	379%
Php	$34 - $36	416%
Cigna	$37 - $40	453%
Multiplan	$37	453%
Encore	$38	465%
Signature	$38	465%
Heartland	$52	636%

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 $34.
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 Elkhart General 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.