Blood test, liver function panel
Facility: Holton Community Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $48
- Cash Discount Price: $43
- vs. Medicare Baseline: 5.88x 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 588% of the Medicare baseline (a markup of 488%). 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 | $30 - $57 | 367% |
| UnitedHealthcare | $30 - $57 | 367% |
| Humana | $31 | 379% |
| Kansas Superior Select - All Plans | $31 | 379% |
| Blue Cross Blue Shield | $32 | 392% |
| Preferred Health Fn Select - All Other Plans | $48 | 588% |
| Preferred Health Freedom | $48 | 588% |
| Preferred Health Professionals | $48 | 588% |
| Wppa Providers - All Plans | $54 | 661% |
| Medicaid / KanCare | $57 | 698% |
Consumer Guidance & Cost Commentary
For this blood test, liver function panel procedure at Holton Community Hospital, the negotiated rates range from $30 to $57 depending on your insurance plan, with the median negotiated amount being $48.00. While the facility's cash price is $43.00, which is lower than the median negotiated rate, patients with high-deductible plans may find paying out-of-pocket initially more cost-effective if their insurance allows a higher allowed amount than the cash price. It is important to note that the facility is a Critical Access Hospital in Kansas, and while specific county or state average data was not provided in this report, the cash price of $43.00 serves as a baseline for self-pay patients who can potentially save money by paying directly rather than relying on insurance processing.
Patients should be aware that commercial insurance rates often include administrative overhead and contract dynamics that can result in higher costs than the direct cash price. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is still advisable to verify your specific plan's allowed amount before scheduling. Additionally, since the cash price is available, you should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill. Always request a full itemized statement before paying to ensure all charges are accurate and to avoid unexpected fees.