Blood test, liver function panel
Facility: Saint John Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $9
- Cash Discount Price: $8
- vs. Medicare Baseline: 1.10x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $8 | 98% |
| Midland Care Connection | $8 | 98% |
| Medicare (plans) | $8 | 98% |
| Aetna | $8 - $14 | 98% |
| UnitedHealthcare | $8 - $11 | 98% |
| Cigna | $8 | 98% |
| Medicaid / KanCare | $8 | 98% |
| Kansas Superior Select | $8 | 98% |
| Healthy Blue | $8 - $9 | 98% |
| Celtic | $8 - $98 | 98% |
| Corizon | $11 | 135% |
| Employer Direct Healthcare | $11 | 135% |
| Well Path | $11 | 135% |
| Centurion | $12 | 147% |
| Naphcare | $13 | 159% |
| Blue Cross Blue Shield | $15 - $32 | 184% |
| Comp Alliance Workers Comp | $16 | 196% |
| Oha Networks | $18 | 220% |
| Worker Compensation | $18 | 220% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a blood test and liver function panel, Saint John Hospital in Leavenworth, KS, lists a cash median of $8.00, which is significantly lower than the facility's negotiated median paid rate of $139.00. This substantial difference highlights how commercial insurance contracts often inflate prices due to administrative overhead and multi-layered billing structures, whereas cash-pay rates reflect the base cost of the service. While the facility's cash rate is notably lower than its negotiated amounts, patients should verify if their specific insurance plan's negotiated rate exceeds this cash price, as paying out-of-pocket could result in lower total costs for those with high deductibles. Additionally, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing the costly insurance claims processing cycle.
When evaluating the value of this service, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $8.17, indicating that the cash rate of $8.00 is nearly aligned with the federal government's cost-based reimbursement standard, which serves as an objective baseline for fair pricing. In contrast, the facility's negotiated rate of $139.00 represents a significant markup over the Medicare baseline, illustrating the common practice where commercial rates exceed fair pricing thresholds. To ensure transparency and avoid unexpected costs, patients should request an itemized billing audit to confirm that no unbundled codes or services not rendered are included in the final invoice, as over 80% of hospital bills contain errors that can be corrected