Blood test, liver function panel
Facility: Mcpherson Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $43
- Cash Discount Price: $39
- vs. Medicare Baseline: 5.26x 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 526% of the Medicare baseline (a markup of 426%). 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 |
|---|---|---|
| Tricare | $7 | 86% |
| Healthy Blue Mcr Adv | $8 | 98% |
| Wellcare Mcr Adv - All Plans | $8 | 98% |
| Blue Cross Blue Shield | $8 | 98% |
| UnitedHealthcare | $8 - $171 | 98% |
| Va Ccn - All Plans | $8 | 98% |
| Humana | $8 | 98% |
| Ambetter / Centene | $9 | 110% |
| Wppa - All Plans | $30 - $120 | 367% |
| Medical Associates - All Plans | $32 - $128 | 392% |
| Central Plains - All Plans | $32 - $128 | 392% |
| Christian Health Aid - All Plans | $34 - $137 | 416% |
| Aetna | $35 - $171 | 428% |
| Multiplan - All Plans | $39 - $154 | 477% |
| Health Partners - All Plans | $41 - $162 | 502% |
| Cigna | $41 - $162 | 502% |
| First Health - All Plans | $41 - $162 | 502% |
| Medicaid / KanCare | $43 - $171 | 526% |
| Health Blue Mcaid - All Other Plans | $44 - $174 | 539% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a blood test for liver function, McPherson Hospital in McPherson, KS, has a cash median price of $39.00, which is lower than the facility's negotiated median paid rate of $42.00. While the facility's negotiated rate of $43.00 is higher than the cash price, patients with high-deductible plans may find the cash option more cost-effective if their insurance negotiated rate exceeds $39.00. It is important to note that commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $8 to $171 and $35 to $171 respectively, which can significantly exceed the cash price. To minimize costs, patients should verify their specific plan's allowed amount and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront.
When evaluating this charge against broader benchmarks, the Medicare amount for this service is $8.17, and the facility's rate is 5.3 times the Medicare amount. While commercial negotiated rates often average 200% to 300% of Medicare, fair pricing is typically defined as 120% to 150% of the Medicare rate. Patients should avoid using the hospital's inflated chargemaster list as a benchmark, as discounts are often calculated against these high list prices rather than the actual cost of care. If you receive an itemized bill, review it for errors such as double-billing or unbundled codes, as over