Blood test, liver function panel
Facility: Pratt Regional Medical Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $68
- Cash Discount Price: $55
- vs. Medicare Baseline: 8.32x 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 832% of the Medicare baseline (a markup of 732%). 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 |
|---|---|---|
| Christian Health Aid | $59 | 722% |
| UnitedHealthcare | $65 - $80 | 796% |
| Health Partners Of Kansas | $66 | 808% |
| Aetna | $70 | 857% |
| Choicecare | $78 | 955% |
Consumer Guidance & Cost Commentary
For the blood test liver function panel at Pratt Regional Medical Center, the cash median price of $55.00 is notably lower than the facility's gross charge of $78.00 and the Medicare benchmark of $8.17. While the facility's negotiated rates range from $59.00 to $80.00 depending on the insurance carrier, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $55.00. It is important to note that commercial rates often include administrative overhead and contract dynamics that can inflate the baseline price, so comparing the cash option directly to the Medicare rate provides a clearer picture of the facility's true cost structure.
Before scheduling, patients should explicitly request self-pay or prompt-pay discounts, which can offer significant fee reductions for upfront payment. Since over 80% of hospital bills contain errors, consumers are advised to demand a full itemized CPT-coded statement rather than accepting summary bills, ensuring no unbundled codes or services not rendered are charged. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should remain vigilant regarding ancillary services and avoid signing consent waivers that may inadvertently waive their rights to dispute out-of-network charges.