Blood test, liver function panel
Facility: Ellsworth County Medical Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $65
- Cash Discount Price: $72
- vs. Medicare Baseline: 7.96x 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 796% of the Medicare baseline (a markup of 696%). 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 | $30 - $32 | 367% |
| Humana | $34 - $68 | 416% |
| Triwest -All Plans | $34 | 416% |
| Va Ccn-All Plans | $34 | 416% |
| Healthy Blue Mcr Adv | $34 | 416% |
| UnitedHealthcare | $47 - $72 | 575% |
| First Health - All Plans | $65 | 796% |
| Aetna | $65 | 796% |
| Cigna | $68 | 832% |
| Medicaid / KanCare | $72 | 881% |
| Coventry Mcaid-All Plans | $72 | 881% |
| Healthy Blue Mcaid- All Other Plans | $72 | 881% |
| Providers Care-Wppa-All Plans | $108 | 1322% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Ellsworth County Medical Center in Ellsworth, Kansas, the cash price is $72.00, which matches the facility's gross charge and the Medicare amount of $8.17 adjusted for local factors. While the facility is a Critical Access Hospital with a proprietary ownership structure, the cash rate is notably higher than the state average for this service, which typically ranges between $30 and $32 for Blue Cross Blue Shield plans and $34 to $68 for Humana. Patients with high-deductible plans or those without insurance may find the cash price more favorable than the negotiated rates, which average $65.00 across various payers and can reach up to $108 for Providers Care-Wppa-All Plans. It is important to note that while the cash price is fixed, commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and contract dynamics, meaning the cash rate can sometimes represent the most economical option for self-pay patients.
To minimize potential costs, patients should actively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these programs often offer significant reductions for upfront payment and bypass costly insurance billing cycles. If you are billed by an out-of-network provider or receive unexpected charges, you may be subject to balance billing, where the provider charges the difference between their full rate and your insurance allowed amount; however, the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. Additionally, since over 80% of hospital bills contain errors, you should request a detailed, itemized