Blood test, liver function panel
Facility: Great Plains Of Sabetha
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $57
- Cash Discount Price: $60
- vs. Medicare Baseline: 6.98x 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 698% of the Medicare baseline (a markup of 598%). 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 |
|---|---|---|
| Celtic Mcr Adv | $31 | 379% |
| Aetna | $32 - $61 | 392% |
| Celtic Comm Exchange-All Other Plans | $39 | 477% |
| Great West Healthcare-All Plans | $51 | 624% |
| UnitedHealthcare | $56 - $60 | 685% |
| Cigna | $57 | 698% |
| Humana | $57 | 698% |
| Century/Wppa/Providers-All Plans | $57 | 698% |
| Multiplan-Phcs-All Plans | $57 | 698% |
| Federated Mutual Ins-All Plans | $58 | 710% |
| Medicaid / KanCare | $60 | 734% |
| Blue Cross Blue Shield | $60 | 734% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Great Plains Of Sabetha in Sabetha, KS, the facility's cash price is $60.00, which matches the gross charge and the median cash rate. This cash price is significantly lower than the negotiated rates paid by most insurance plans, ranging from $51.00 to $60.00, with the median negotiated rate being $57.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that paying cash upfront may be the most cost-effective option if their insurance deductible has not yet been met, as the cash price aligns with the lowest negotiated rates found among payers like Medicaid/KanCare and Celtic Mcr Adv.
When evaluating this cost, it is important to compare the facility's rates against the Medicare benchmark rather than the hospital's gross list price. The Medicare amount for this service is $8.17, and the facility's cash rate of $60.00 represents a 7.0% markup above the Medicare rate, indicating a pricing structure that is relatively close to the federal baseline for this procedure. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, they should still request an itemized bill to ensure no unbundled charges or services not rendered are included. Additionally, asking the billing department about prompt-pay discounts before scheduling can help secure the lowest possible rate, as these discounts are often available for upfront payments and bypass the administrative costs associated with insurance claims processing.