Blood test, liver function panel
Facility: Mercy Hospital Columbus
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $84
- Cash Discount Price: $75
- vs. Medicare Baseline: 10.28x 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 1028% of the Medicare baseline (a markup of 928%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $1 | 12% |
| UnitedHealthcare | $7 - $96 | 86% |
| Medicaid / KanCare | $7 - $84 | 86% |
| Humana | $7 - $110 | 86% |
| Blue Cross Blue Shield | $7 - $84 | 86% |
| Medicare (plans) | $8 - $88 | 98% |
| Insurance System Inc Contracted [320465] | $50 | 612% |
| Health Systems Inc Contracted [320174] | $50 | 612% |
| Administrative Payor Contracted [320005] | $52 | 636% |
| Halo Hcr Inc Hospice Contracted [320432] | $84 | 1028% |
| Aetna | $84 - $104 | 1028% |
| Kindful Hospice Contracted [320434] | $84 | 1028% |
| Kindful Hospice [20434] | $84 | 1028% |
| Qual Choice Contracted [320325] | $84 | 1028% |
| Globalhealth Contracted [320145] | $84 | 1028% |
| Home State Health Plan Contracted [320187] | $84 | 1028% |
| Indian Health Service Contracted [320198] | $84 | 1028% |
| Halo Hcr Inc Hospice [20432] | $84 | 1028% |
| Cross Timbers Hospice [20098] | $84 | 1028% |
| Dept Of Veteran Affairs Contracted [320106] | $84 | 1028% |
| Pace Of The Ozarks Contracted [320518] | $84 | 1028% |
| Cigna | $84 | 1028% |
| Novasys Contracted [320285] | $84 | 1028% |
| Mercy Hospice Okc [20252] | $84 | 1028% |
| Cherokee Nation Health Serv Contracted [320066] | $84 | 1028% |
| Ambetter / Centene | $84 | 1028% |
| Medical Associates Health Contracted [320444] | $84 | 1028% |
| Centurion Of Missouri [20459] | $84 | 1028% |
| Tricare | $84 | 1028% |
| Elara Caring Aspire Hospice [20433] | $84 | 1028% |
| Mercy Mgd Behavioral Health Contracted [320259] | $84 | 1028% |
| Provider Partners Health Plans Contracted [320450] | $84 | 1028% |
| Healthscope Contracted [320182] | $89 | 1089% |
| Workers Comp [20426] | $93 - $99 | 1138% |
| United Medical Resources Contracted [320454] | $96 - $110 | 1175% |
| Federal Medical Center Contracted [320127] | $104 | 1273% |
| Healthlink Contracted [320179] | $104 - $110 | 1273% |
| American Healthcare Alliance Contracted [320020] | $104 | 1273% |
| Mercy Benefit Admin Contracted [320251] | $104 - $110 | 1273% |
| Medica Contracted [320239] | $104 | 1273% |
| Preferred Health Plan Contracted [320522] | $104 | 1273% |
| Usa Managed Care Org Contracted [320429] | $104 | 1273% |
| First Health Contracted [320128] | $104 | 1273% |
| Private Health Care Systems Contracted [320320] | $110 | 1346% |
| Edison Health Solutions Contracted [320502] | $110 | 1346% |
| Ebms Contracted [320493] | $110 | 1346% |
| Point C Contracted [320238] | $110 | 1346% |
| 90 Degree Benefits Contracted [320436] | $110 | 1346% |
| Auxiant Contracted [320462] | $110 | 1346% |
| Benefit Management Contracted [320052] | $110 | 1346% |
| Aither Health Contracted [320449] | $110 | 1346% |
| Show-Me Health Administrators Contracted [320483] | $110 | 1346% |
| Imagine 360 Contracted [320494] | $110 | 1346% |
| Yuzu Health Contracted [320521] | $110 | 1346% |
| Ppo Plus Contracted [320310] | $110 | 1346% |
| Reflect Health Contracted [320492] | $110 | 1346% |
Consumer Guidance & Cost Commentary
For the CPT code 80076 (Blood test, liver function panel) at Mercy Hospital Columbus, the facility's cash price of $75.00 is lower than the state average of $84.00. While many insurance plans negotiate rates ranging from $84.00 to $110.00, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $75.00. It is important to note that while the facility is a Critical Access Hospital in Kansas, the negotiated rates for in-network payers often exceed the cash price due to administrative costs and contract structures. Patients should verify their specific plan's allowed amount before scheduling, as some commercial payers like UnitedHealthcare and Humana have negotiated rates that are higher than the cash rate.
The Medicare benchmark for this service is $8.17, which serves as a baseline for evaluating pricing fairness; commercial negotiated rates are significantly higher than this federal rate. Although the data does not provide a specific county average for comparison, the facility's cash price remains competitive relative to the state median. To minimize potential balance billing, patients should request a waiver of insurance submission at registration to ensure the cash price applies, and they should ask about prompt-pay discounts, which can reduce the final bill by 20% to 50% for upfront payment. Additionally, patients should always request an itemized bill to review specific CPT codes and avoid paying for services that were not rendered or were incorrectly bundled.