CMS Price Transparency Data

Blood test, liver function panel

Facility: Clara Barton Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $131
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 16.03x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Clara Barton Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 16.03x the Medicare baseline. Located in 250 W 9Th Street, Hoisington, KS.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$131

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $102 (1248%)
Insurance Median: $131 (1603%)
Cash: $102 (1248% of Medicare)
Ins. Median: $131 (1603% of 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 1603% of the Medicare baseline (a markup of 1503%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $32 392%
6 Degrees Health - All Plans $102 1248%
Wppa-All Plans $116 1420%
Aetna $130 1591%
UnitedHealthcare $130 1591%
Phcs - All Plans $130 1591%
Hlth Partners Of Ks-All Plans $133 1628%

Consumer Guidance & Cost Commentary

For the blood test, liver function panel (CPT 80076) at Clara Barton Hospital in Hoisington, KS, the facility's negotiated rates range from $32 to $133, with a median negotiated amount of $131. This is notably higher than the cash price of $102, which may be a better option for patients with high-deductible plans or those without insurance, as paying cash directly avoids the administrative markup often found in insurance contracts. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan's allowed amount before scheduling, as commercial rates can vary significantly even within the same network.

The facility's pricing is also compared against Medicare benchmarks, where the Medicare rate for this service is $8.17. The facility's cash price of $102 represents a significant markup over the federal baseline, which is common in commercial billing but worth noting for transparency. To minimize costs, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to ensure no errors, unbundled codes, or services not rendered are included, as over 80% of hospital bills contain discrepancies that can be corrected through formal written disputes.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 W 9Th Street, Hoisington, KS 67544
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals