CMS Price Transparency Data

Blood test, liver function panel

Facility: Lmh

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $8
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Lmh is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 0.98x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $66 (808%)
Insurance Median: $8 (98%)
Cash: $66 (808% of Medicare)
Ins. Median: $8 (98% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
UnitedHealthcare $7 - $46 86%
Blue Cross Blue Shield $7 - $172 86%
Cigna $8 - $177 98%
Allwell $8 98%
Medicare (plans) $8 98%
Haskell Indian Health Services $8 98%
Humana $8 98%
Aetna $9 - $220 110%
Ambetter / Centene $13 159%
Non Contracted $212 2595%
First Health $247 3023%

Consumer Guidance & Cost Commentary

For this blood test, liver function panel service, the facility's cash median price of $66.00 is significantly lower than the gross charge of $265.00, offering a substantial potential savings for patients. While the facility is in-network for major payers like UnitedHealthcare, Blue Cross Blue Shield, and Cigna, their negotiated rates range widely from $7 to $247 depending on the specific plan. It is important to note that for patients with high-deductible plans, paying the cash price of $66.00 upfront may be more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate. Additionally, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final balance by offering immediate liquidity incentives.

The facility's pricing is benchmarked against federal standards, with a Medicare amount of $8.17 serving as the baseline for cost evaluation. Although the data does not provide specific state or county average comparisons for this code, the facility's cash rate of $66.00 is notably higher than the Medicare amount, reflecting the complexity of commercial billing structures. To ensure you are receiving the most accurate pricing, we recommend requesting an itemized bill before payment to verify that all charges are correct and that no unnecessary services were billed. If you receive a balance bill from an out-of-network provider, such as a lab or physician, you have the right to dispute it under the No Surprises Act, which protects you from unexpected costs for emergency and non-emergency care at in-network facilities.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals