Blood test, liver function panel
Facility: F W Huston Medical Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $76
- Cash Discount Price: $79
- vs. Medicare Baseline: 9.30x 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 930% of the Medicare baseline (a markup of 830%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $32 | 392% |
| Aetna | $74 | 906% |
| Humana | $78 | 955% |
| Cigna | $84 | 1028% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at F W Huston Medical Center in Winchester, KS, the facility's cash median price is $79.00, which is lower than the state average of $99.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield ($32), Aetna ($74), and Humana ($78) are also below the gross charge, they remain higher than the cash price. This pricing structure highlights a common billing dynamic where paying out-of-pocket can be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price. To maximize savings, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
It is important to understand that the $99.00 gross charge listed is not the actual price you will pay; rather, it represents the facility's maximum allowed rate before discounts or insurance negotiations are applied. The Medicare benchmark for this service is $8.17, providing a clear baseline for evaluating the facility's pricing markup. Since the facility is a Critical Access Hospital with voluntary non-profit ownership, its rates are generally regulated to remain competitive. Consumers should avoid accepting summary bills that obscure individual charges and instead request an itemized audit to ensure no errors or unbundled codes are inflating the total. If you receive a balance bill from an out-of-network provider at this in-network facility, you may be entitled to protections under the No Surprises Act, which bans balance billing for emergency and non-emergency services.