Blood test, liver function panel
Facility: Rooks County Health Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $59
- Cash Discount Price: $49
- vs. Medicare Baseline: 7.22x 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 722% of the Medicare baseline (a markup of 622%). 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 |
|---|---|---|
| Veterans Admin - All Plans | $5 | 61% |
| Celtic Mcr Adv | $31 | 379% |
| Tricare | $31 | 379% |
| Blue Cross Blue Shield | $32 | 392% |
| Celtic Comm - All Other Plans | $34 | 416% |
| Aetna | $59 | 722% |
| Preferred Benefits Admin | $59 | 722% |
| UnitedHealthcare | $59 | 722% |
| Health Partners - All Plans | $62 | 759% |
| Preferred Hlthcare - All Other Plans | $62 | 759% |
| Healthy Blue Mcaid - All Plans | $66 | 808% |
Consumer Guidance & Cost Commentary
For the liver function panel (CPT 80076) at Rooks County Health Center in Plainville, KS, the facility's cash price of $49.00 is lower than the state average of $66.00 and aligns closely with the median negotiated rate of $59.00 seen across 11 payers. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rates exceed this amount. It is important to note that cash-pay rates can sometimes be cheaper for uninsured or self-pay patients, but hospitals often offer prompt-pay discounts for upfront payment, which can further reduce the final bill.
The Medicare benchmark for this service is $8.17, which serves as a baseline for evaluating the facility's pricing structure; the gross charge of $66.00 represents a significant markup over this federal rate. Although the facility is located in a rural area (ZIP 67663) and does not have a published rating, the data indicates that the cash price is competitive relative to the state average. Consumers are encouraged to request a detailed, itemized bill before paying to ensure no errors exist, as over 80% of hospital bills contain discrepancies. Additionally, patients should verify their deductible status and ask specifically about self-pay or prompt-pay discounts prior to scheduling to avoid unexpected costs.