Blood test, liver function panel
Facility: Susan B Allen Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $554
- Cash Discount Price: $18
- vs. Medicare Baseline: 67.81x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 6781% of the Medicare baseline (a markup of 6681%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 4284% |
| Providrs Care | $757 | 9266% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel procedure at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $18.00, which is significantly lower than the facility's negotiated rates of $554.00. While the hospital's negotiated rates for UnitedHealthcare and Providrs Care are set at $350 and $757 respectively, these figures represent the maximum amounts insurers may pay under contract and do not reflect the actual cost to a self-pay patient. Patients with high-deductible plans may find it financially advantageous to pay the $18.00 cash price directly, as this amount is substantially lower than the insurer's allowed amounts, potentially saving hundreds of dollars on this specific service.
To ensure you are not overcharged, it is important to distinguish between the hospital's gross charges and the actual rates you will pay. The Medicare benchmark for this service is $8.17, which serves as a scientifically validated baseline for the true cost of care; commercial negotiated rates often exceed this by a wide margin due to administrative overhead and contract dynamics. Since the cash price of $18.00 is already higher than the Medicare rate, patients should verify if the facility offers additional "self-pay" or "prompt-pay" discounts that could further reduce the final bill. Always request an itemized CPT-coded statement before paying to confirm that no unbundled charges or services not rendered are included in the total.