Blood test, liver function panel
Facility: Kiowa District Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $73
- Cash Discount Price: $62
- vs. Medicare Baseline: 8.94x 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 894% of the Medicare baseline (a markup of 794%). 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 |
|---|---|---|
| Healthchoice-All Plans | $12 | 147% |
| Tricare | $30 | 367% |
| Blue Cross Blue Shield | $32 | 392% |
| UnitedHealthcare | $62 - $77 | 759% |
| Health Partners Of Ks-All Plans | $68 | 832% |
| Humana | $69 | 845% |
| Gbs Insurance - All Plans | $72 | 881% |
| Multiplan-All Plans | $72 | 881% |
| Medicare (plans) | $73 | 894% |
| Triwest-All Plans | $73 | 894% |
| Aetna | $73 | 894% |
| Medicaid / KanCare | $77 | 942% |
| Providers Care (Wppa)-All Plans | $116 | 1420% |
| Liberty Healthshare-All Plans | $124 | 1518% |
Consumer Guidance & Cost Commentary
For the CPT code 80076 (Blood test, liver function panel) at Kiowa District Hospital in Kiowa, KS, the facility's cash median price is $62.00, which is lower than the state average of $77.00. While the hospital's negotiated rates with insurance payers range from $12 to $124, the cash price remains the lowest option available for this service. Patients with high-deductible plans or those without insurance may find the cash price most beneficial, as it avoids the administrative layers and higher negotiated rates often seen with commercial payers. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, the cash rate does not necessarily reflect the lowest possible cost if specific self-pay or prompt-pay discounts are available upon direct inquiry.
The Medicare benchmark for this procedure is $8.17, which serves as the objective baseline for evaluating pricing markup. The facility's cash rate of $62.00 represents a significant increase over the Medicare rate, consistent with typical commercial pricing structures that often range from 200% to 300% of Medicare amounts. However, the negotiated rates paid by various insurers, such as UnitedHealthcare and Providers Care, vary widely, with some plans paying up to $124.00. To ensure the best financial outcome, patients should verify their specific plan's allowed amount before scheduling and consider requesting a prompt-pay discount if paying out-of-pocket, as hospitals often offer fee reductions for upfront payments to bypass costly claims processing.