Blood test, liver function panel
Facility: Medicine Lodge Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $41
- Cash Discount Price: $43
- vs. Medicare Baseline: 5.02x 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 502% of the Medicare baseline (a markup of 402%). 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 |
|---|---|---|
| Tricare | $34 | 416% |
| Humana | $39 | 477% |
| Aetna | $40 - $43 | 490% |
| UnitedHealthcare | $41 | 502% |
| Hpk-All Plans | $41 | 502% |
| Medicaid / KanCare | $43 | 526% |
Consumer Guidance & Cost Commentary
At Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the negotiated rate for a liver function panel (CPT 80076) is $41.00, which aligns with the median negotiated amount across all six payers including Tricare, Humana, and Aetna. This rate is notably higher than the cash price of $43.00, meaning patients with high-deductible plans or those paying out-of-pocket may find the cash rate more favorable if their insurance negotiated rate exceeds the cash price. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific county or state average for comparison; however, the facility's gross charge of $43.00 is only 5.0% above the Medicare benchmark of $8.17, indicating a pricing structure that adheres closely to federal cost baselines rather than inflated chargemaster lists.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is still advisable to request a self-pay or prompt-pay discount before scheduling to avoid unexpected costs. Since hospitals often issue summary bills that obscure individual line items, consumers should demand a full itemized CPT-coded statement to verify that no unbundled codes or services not rendered have been charged. If a balance bill arises despite federal protections, patients should dispute the claim with their insurer and request a No Surprises Act audit rather than paying immediately, and any verbal disputes should be followed up with a formal written audit request sent via certified mail to ensure the corrections are properly recorded.