CMS Price Transparency Data

Blood test, liver function panel

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $138
  • Cash Discount Price: $183
  • vs. Medicare Baseline: 16.89x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Saint Joseph Regional Medical Center - Plymouth is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 16.89x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$183

Average discount available for prompt cash payment at this facility.

Insurance Median
$138

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: $183 (2240%)
Insurance Median: $138 (1689%)
Cash: $183 (2240% of Medicare)
Ins. Median: $138 (1689% 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 1689% of the Medicare baseline (a markup of 1589%). 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 - $138 61%
Blue Cross Blue Shield $5 - $16 61%
Medicaid / KanCare $5 - $8 61%
UnitedHealthcare $5 - $180 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 - $234 147%
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 - $198 184%
Allied Benefit Systems $16 - $183 196%
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%
Plain Church Group $76 930%
Asr Health Benefits $138 1689%
Christian Brother Services $138 1689%
Employee Benefit Management $138 1689%
Medical Mutual $138 1689%
Meritain $138 1689%
Preferred One $138 1689%
Rural Carrier Health Benefit Plan $138 1689%
Webtpa $138 1689%
Notre Dame Athletic Association $155 1897%
Wc Notre Dame $155 1897%
Luminare Health (Detroit) $161 - $169 1971%
Ameriben $169 2069%
Geha $180 2203%
Healthscope $180 2203%
Student Insurance Cma $180 2203%
Encore Health $198 2424%
Indiana Criminal Justice Inst $198 2424%
Western & Southern Financial Group $198 2424%
Cigna $203 2485%
Group Administrators $203 2485%
Health Partners $203 2485%
Mvp $203 2485%
Prairie States $203 2485%
Priority Health $203 2485%
Professional Benefit Administrators $203 2485%
Sagamore Health Network $203 - $217 2485%
Sisco Benefits $203 2485%
Unified Group Services $203 2485%
Goshen Preferred Network $217 - $243 2656%
Signature Care $234 2864%
Allied National Global Care $254 3109%
Asrm - Reliance Standard Life Insurance $254 3109%
Avmed Health Plan $254 3109%
Christian Care Ministry $254 3109%
Dean Health $254 3109%
Fallon Health $254 3109%
Family Life Insurance Company $254 3109%
Freedom Life Insurance Company $254 3109%
Ghc Scw $254 3109%
International Benefit Administrators $254 3109%
Lifetime Benefit Solutions $254 3109%
Manhattan Life $254 3109%
Medi Share $254 3109%
Multiplan $254 3109%
Pai $254 3109%
Pan-American Life $254 3109%
Paramount Hmo $254 3109%
Phcs $254 3109%
Philadelphia American Life Insurance $254 3109%
Trinity Health Share $254 3109%
Bankers Life Casualty $282 3452%
Wc Align Network $282 3452%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals