CMS Price Transparency Data

Blood test, liver function panel

Facility: Woodlawn Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $50
Cash Discount Price: $172
vs. Medicare Baseline: 6.12x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Woodlawn Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.12x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$172

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $172 (2105%)

Insurance Median: $50 (612%)

Cash: $172 (2105% of Medicare)

Ins. Median: $50 (612% 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 612% of the Medicare baseline (a markup of 512%). 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
Blue Cross Blue Shield	$3 - $174	37%
Caresource Mcaid Hww	$8	98%
Mdwise Excel Hhw & Hcc	$8	98%
Mhs Mcaid Hcc	$8	98%
Mhs Mcaid Hhw	$8	98%
UnitedHealthcare	$8 - $174	98%
Partners Direct Health-All Plans	$19	233%
Aetna	$50 - $218	612%
Caresource Mcaid Hip	$50	612%
Caresource Mcr Adv	$50	612%
Humana	$50 - $178	612%
Mdwise Mcaid Excel Hip	$50	612%
Mhs Exch Mrktplce-All Other Plans	$50	612%
Mhs Mcaid Hip	$50	612%
Mhs Mcr Adv	$51	624%
Caresource Exch - All Other Plans	$65	796%
Ambetter / Centene	$67	820%
Cigna	$164 - $195	2007%
Parkview Health Plans-All Plans	$172	2105%
Sagamore All Other Grps - All Other Plans	$192	2350%
Encore Comm-All Plans	$195	2387%
Phcs/Multiplan-All Plans	$213	2607%
Community Health Alliance-All Plans	$218	2668%

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 $172.
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 Woodlawn 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.