Blood test, liver function panel
Facility: Ellinwood District Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $44
- Cash Discount Price: $53
- vs. Medicare Baseline: 5.39x 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 539% of the Medicare baseline (a markup of 439%). 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 | $44 | 539% |
| Aetna | $44 | 539% |
| Blue Cross Blue Shield | $44 | 539% |
| UnitedHealthcare | $44 | 539% |
| Humana | $44 | 539% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Ellinwood District Hospital in Ellinwood, KS, the facility's cash median price is $53.00, which is $5.40 higher than the Medicare benchmark of $8.17. While the hospital is a Critical Access Hospital owned by the Government - Hospital District or Authority, the negotiated rate for in-network payers like Cigna, Aetna, and Blue Cross Blue Shield is $44.00. This negotiated amount is significantly lower than the cash price, meaning patients with high-deductible plans or those without insurance may find paying out-of-pocket $53.00 more expensive than using their insurance, which caps the cost at $44.00. However, patients should verify their specific plan details, as some commercial contracts include administrative overhead that can inflate the final allowed amount beyond the base negotiated rate.
To maximize savings, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling the test, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is also important to request a full itemized bill to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes that could be corrected. While the facility is located in Ellinwood (ZIP 67526), the provided data does not include specific county or state average comparisons for this procedure, so the most reliable benchmark for evaluating the facility's pricing remains the federal Medicare rate of $8.17.