CMS Price Transparency Data

Blood test, liver function panel

Facility: Northwest Health - Porter

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $20
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Northwest Health - Porter is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 2.45x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $164 (2007%)
Insurance Median: $20 (245%)
Cash: $164 (2007% of Medicare)
Ins. Median: $20 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Blue Cross Blue Shield $3 - $12 37%
UnitedHealthcare $7 - $39 86%
Aetna $8 - $265 98%
Care Improvement Plus $8 98%
Caresource $8 98%
Healthy Indiana Plan $8 98%
Humana $8 98%
In Dept Of Correction $8 98%
Managed Health Services $8 - $16 98%
Medicaid / KanCare $8 98%
Medicare (plans) $8 - $9 98%
Mhs $8 98%
Node Devoted Health Mcr Adv $8 98%
Node Hospice Non Par Agree $8 98%
Node Mhs Mcr Adv $8 98%
Node Va $8 98%
Tricare $8 98%
Veterans Eval Services $8 98%
Node Us Dept Of Labor $10 122%
Align Network $13 159%
One Call Work Comp $13 159%
Encore Health $15 - $418 184%
Prime Health $15 - $392 184%
Indiana Work Comp $16 196%
Lutheran Preferred $16 - $313 196%
Node Encore Kba Epo $20 245%
Porter County $20 245%
Preferred Network Access $20 245%
Magnacare Ma $21 257%
Lutheran Preferred Chs Employees $125 1530%
Self Pay $141 - $188 1726%
Cigna $145 1775%
Physicians Health Plan $200 2448%
Php Freedom $216 2644%
Sagamore Health Network $231 - $309 2827%
First Health Coventry $256 3133%
Encore Ppo $261 3195%
Southeastem Indiana Health Operations $365 - $392 4468%
Network Synergy Group $392 4798%
Multiplan/Phcs $438 5361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals