Blood test, liver function panel
Facility: Lane County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $80
- Cash Discount Price: $80
- vs. Medicare Baseline: 9.79x 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 979% of the Medicare baseline (a markup of 879%). 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 |
|---|---|---|
| Aetna | $72 - $76 | 881% |
| UnitedHealthcare | $72 - $80 | 881% |
| Healthy Blue Mcaid | $80 | 979% |
| Medicaid / KanCare | $80 - $88 | 979% |
| Healthy Blue Mcr Adv - All Other Plans | $80 | 979% |
| Wppa Providers-All Plans | $120 | 1469% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a blood test for liver function, Lane County Hospital in Dighton, KS, lists a cash price of $80.00. This cash rate is notably higher than the state average of $8.17, which is the Medicare benchmark for this service. While commercial insurance payers negotiate rates that typically cap between $72 and $88 depending on the plan, patients should be aware that cash-pay options can sometimes be more cost-effective if their insurance negotiated rate exceeds the cash price. Given that the facility is a Critical Access Hospital owned by a Government Hospital District, it is advisable to contact the billing department directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can significantly reduce the final amount owed.
When reviewing your insurance coverage, it is important to distinguish between the negotiated rate your plan pays and the amount you may owe. Although the facility's negotiated rates for this test range from $72 to $88, patients must verify their specific deductible status, as high negotiated rates may not apply if the deductible has not yet been met. Furthermore, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services like specific lab components are billed separately. To ensure accuracy, request a full itemized bill before paying, as summary bills often obscure individual line items that could be disputed. Comparing the facility's rates to the Medicare benchmark of $8.17 highlights the significant markup involved, making it essential to understand your specific plan's allowed amount rather than relying on the hospital's gross charges.