Blood test, liver function panel
Facility: Kansas City Orthopaedic Institute
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $26
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.18x 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 318% of the Medicare baseline (a markup of 218%). 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 |
|---|---|---|
| Cigna | $8 - $38 | 98% |
| Aetna | $8 | 98% |
| UnitedHealthcare | $8 - $44 | 98% |
| Blue Cross Blue Shield | $15 - $49 | 184% |
| Medica | $40 - $42 | 490% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Kansas City Orthopaedic Institute in Leawood, KS, the Medicare benchmark rate is $8.17. The facility's cash median is not available, but the median negotiated rate for in-network payers is $26.00. This negotiated rate is significantly higher than the Medicare baseline, reflecting the administrative costs and contract structures typical of commercial insurance. While the facility is owned by a physician group, patients should be aware that cash-pay options may offer a lower total cost if the insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans. It is important to verify the specific "self-pay" or "prompt-pay" discount rates directly with the hospital before scheduling, as these upfront payment incentives can bypass standard insurance billing cycles and reduce overall out-of-pocket expenses.
When evaluating costs, it is crucial to compare rates against the Medicare benchmark rather than the facility's gross chargemaster list, which often inflates the perceived savings of discounts. The data provided includes specific negotiated ranges for major payers such as Cigna, Aetna, UnitedHealthcare, Blue Cross Blue Shield, and Medica, with allowed amounts ranging from $8 to $49 depending on the plan. However, without explicit county or state average data included in this specific record, direct regional comparisons cannot be made at this time. Patients should request a full itemized bill to ensure no errors, double-billing, or unbundled codes are present, as over 80% of hospital bills contain discrepancies. If a balance bill arises from out-of-network ancillary services, the No Surprises Act may provide protections against unexpected