Blood test, liver function panel

For the CPT code 80076 (Blood test, liver function panel) at Satanta District Hospital, the cash price is $58.00, which is lower than the facility's negotiated rates with most insurance carriers. While the median negotiated rate across 38 payers is $46.00, many plans have allowed amounts ranging from $15 to $64, meaning patients with high-deductible plans might save money by paying the cash price of $58.00 upfront rather than relying on insurance reimbursement, which could result in higher out-of-pocket costs if the deductible is not met. It is important to note that this facility is a Critical Access Hospital in Kansas (Zip 67870), and patients should explicitly ask for self-pay or prompt-pay discounts before scheduling to ensure they receive the lowest possible rate.

The Medicare benchmark for this service is $8.17, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $58.00 is significantly higher than the Medicare amount, reflecting the costs associated with specialized laboratory services and local wage indexes. However, the median negotiated rate of $46.00 is also well above the Medicare benchmark, indicating that commercial insurance contracts often include administrative overhead and risk adjustments that increase the final price. Consumers should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still advisable to request an itemized bill to verify that all charges align with the negotiated or cash rates before payment.