Blood test, liver function panel
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $16
- Cash Discount Price: $183
- vs. Medicare Baseline: 1.96x 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.
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 |
|---|---|---|
| Aetna | $7 - $8 | 86% |
| UnitedHealthcare | $7 - $261 | 86% |
| United Medical Resources Contracted [320454] | $7 - $22 | 86% |
| Medicaid / KanCare | $7 - $12 | 86% |
| Humana | $7 - $8 | 86% |
| Blue Cross Blue Shield | $7 - $23 | 86% |
| First Health Contracted [320128] | $7 | 86% |
| Halo Hcr Inc Hospice Contracted [320432] | $8 | 98% |
| Medical Associates Health Contracted [320444] | $8 | 98% |
| Pace Of The Ozarks Contracted [320518] | $8 | 98% |
| Cross Timbers Hospice [20098] | $8 | 98% |
| Elara Caring Aspire Hospice [20433] | $8 | 98% |
| Qual Choice Contracted [320325] | $8 | 98% |
| Tricare | $8 | 98% |
| Kindful Hospice Contracted [320434] | $8 | 98% |
| Mercy Hospice Okc [20252] | $8 | 98% |
| Kindful Hospice [20434] | $8 | 98% |
| Medica Contracted [320239] | $8 | 98% |
| Cigna | $8 - $46 | 98% |
| Mercy Mgd Behavioral Health Contracted [320259] | $8 | 98% |
| Dept Of Veteran Affairs Contracted [320106] | $8 | 98% |
| Medicare (plans) | $8 | 98% |
| Cherokee Nation Health Serv Contracted [320066] | $8 | 98% |
| Globalhealth Contracted [320145] | $8 | 98% |
| Halo Hcr Inc Hospice [20432] | $8 | 98% |
| Provider Partners Health Plans Contracted [320450] | $9 | 110% |
| Centivo Contracted [320505] | $13 | 159% |
| Providrs Care Network Contracted [320484] | $16 | 196% |
| Benefit Management Contracted [320052] | $22 | 269% |
| Point C Contracted [320238] | $22 - $212 | 269% |
| Healthscope Contracted [320182] | $22 - $212 | 269% |
| Insurance System Inc Contracted [320465] | $22 | 269% |
| Health Systems Inc Contracted [320174] | $22 | 269% |
| Show-Me Health Administrators Contracted [320483] | $50 | 612% |
| Mercy Benefit Admin Contracted [320251] | $50 - $197 | 612% |
| Aither Health Contracted [320449] | $197 | 2411% |
| Imagine 360 Contracted [320494] | $197 | 2411% |
| American Healthcare Alliance Contracted [320020] | $197 | 2411% |
| Reflect Health Contracted [320492] | $197 | 2411% |
| Edison Health Solutions Contracted [320502] | $197 | 2411% |
| Ebms Contracted [320493] | $197 | 2411% |
| Yuzu Health Contracted [320521] | $197 | 2411% |
| Auxiant Contracted [320462] | $197 - $212 | 2411% |
| Federal Medical Center Contracted [320127] | $212 | 2595% |
| Healthlink Contracted [320179] | $212 | 2595% |
| Preferred Health Plan Contracted [320522] | $212 | 2595% |
| Compcare Of The Ozarks Contracted [320437] | $223 | 2729% |
| Workers Comp [20426] | $226 | 2766% |
| Private Health Care Systems Contracted [320320] | $261 | 3195% |
| Multiplan [20270] | $268 | 3280% |
| Multiplan Contracted [320270] | $268 | 3280% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a blood test and liver function panel, the facility's cash median price is $183.00, which is significantly lower than the gross charge of $282.00. This cash rate is notably lower than the Medicare benchmark of $8.17 when adjusted for the facility's specific pricing context, highlighting that commercial negotiated rates often exceed the base Medicare amount due to administrative overhead and contract structures. While the facility offers a median negotiated rate of $16.00 for certain payers, patients should be aware that insurance plans may pay amounts ranging from $7 to $261 depending on the specific contract, meaning the negotiated rate does not always represent the lowest possible cost. For individuals with high-deductible plans, paying the cash price of $183.00 upfront could be more financially advantageous than relying on insurance, as the insurer's allowed amount might exceed the cash price, leaving the patient responsible for the difference.
To ensure you are receiving the most favorable rate, it is essential to request an itemized billing audit before finalizing payment, as summary bills can obscure individual line items and potential errors. If you choose to pay out-of-pocket, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if settled within a short window, effectively bypassing the administrative costs associated with insurance claims. Additionally, while the facility is located in Galena, KS, and serves the broader state, understanding that commercial rates can vary widely across different payer contracts is crucial; for instance, some contracted payers have negotiated rates as high as $268, whereas