Blood test, liver function panel
Facility: Kiowa County Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $104
- Cash Discount Price: $99
- vs. Medicare Baseline: 12.73x 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 1273% of the Medicare baseline (a markup of 1173%). 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 - $104 | 392% |
| UnitedHealthcare | $94 - $117 | 1151% |
| Health Partners Of Ks-All Plans | $103 | 1261% |
| Aetna | $104 | 1273% |
| Humana | $104 | 1273% |
| Celtic Comml Exchange-All Other Plans | $104 | 1273% |
| Medica Prime Mcare Cost-All Plans | $104 | 1273% |
| Medicaid / KanCare | $117 | 1432% |
| Providrs Care/Wppa-All Plans | $176 | 2154% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a blood test for liver function, Kiowa County Memorial Hospital in Greensburg, KS, has a gross charge of $117.00. While the facility's cash median price is $99.00, which is lower than the negotiated rates paid by most insurers, patients should be aware that commercial payers like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $32.00 to $117.00. It is important to note that cash payments can sometimes be more cost-effective for individuals with high-deductible plans if their insurance negotiated rate exceeds the cash price. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, as paying upfront can often reduce the final amount owed.
When evaluating this cost, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this service is $8.17, and the facility's cash rate of $99.00 represents a significant markup above this federal baseline. While the data does not provide specific state or county average comparisons for this exact code, understanding that commercial negotiated rates often average 200% to 300% of Medicare helps contextualize the $117.00 gross charge. If you receive a bill, you should request an itemized audit to ensure no errors exist, as over 80% of hospital bills contain mistakes such as double-billing or unbundled codes. Furthermore, if you are out-of-network, the No Surprises Act protects you from balance billing for emergency care and non-emergency services at