Blood test, liver function panel
Facility: Wamego Health Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $9
- Cash Discount Price: $106
- vs. Medicare Baseline: 1.10x 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.
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 |
|---|---|---|
| Medicaid / KanCare | $8 - $9 | 98% |
| Aetna | $8 | 98% |
| UnitedHealthcare | $8 | 98% |
| Providrs Care | $8 | 98% |
| Blue Cross Blue Shield | $224 - $238 | 2742% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Wamego Health Center in Wamego, KS, the cash median price is $106.00, which is significantly lower than the facility's gross charge of $264.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the negotiated rates for in-network payers like Medicaid/KanCare, Aetna, and UnitedHealthcare range from $8.00 to $238.00, with a median negotiated rate of $9.00. This data highlights a common pricing dynamic where commercial insurance contracts can sometimes result in higher out-of-pocket costs for patients than paying cash directly, particularly if the patient has a high deductible and the insurance allowed amount exceeds the cash price.
To ensure you are not overcharged, it is important to understand that commercial rates are often inflated by administrative costs and contract structures, whereas Medicare rates serve as a more reliable benchmark for fair pricing. In this case, the Medicare amount of $8.17 provides a clear baseline, showing that the facility's cash rate is roughly 13 times the Medicare benchmark, while the median negotiated rate is only slightly higher. Patients should be aware of balance billing risks if receiving out-of-network care, though the No Surprises Act protects against unexpected bills for emergency services at in-network facilities. Additionally, since hospitals often offer prompt-pay discounts for upfront cash payments, you should explicitly ask the billing department about self-pay or prompt-pay rates before scheduling your visit to potentially lower your total cost.