Blood test, liver function panel
Facility: Hospital District #6 Patterson Health Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $50
- Cash Discount Price: $44
- vs. Medicare Baseline: 6.12x 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 612% of the Medicare baseline (a markup of 512%). 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 | $30 - $32 | 367% |
| UnitedHealthcare | $50 - $55 | 612% |
| Providers Care (Wppa)-All Plans | $96 | 1175% |
Consumer Guidance & Cost Commentary
For the CPT code 80076 (Blood test, liver function panel) at Hospital District #6 Patterson Health Center in Anthony, KS, the facility's cash median price is $44.00, which is lower than the state average of $50.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $30 to $55, patients with high-deductible plans may find paying the cash price of $44.00 upfront more cost-effective than relying on insurance, which often results in higher out-of-pocket costs once deductibles are met. It is important to note that this facility is a Critical Access Hospital owned by the Government, and patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the best possible rate, as these discounts can significantly reduce the final bill.
The facility's Medicare benchmark amount for this service is $8.17, which serves as a baseline for evaluating pricing fairness. Although the commercial negotiated rates are higher than the Medicare amount, the cash price remains competitive compared to the broader market. Patients should be aware that hospitals often issue summary bills that obscure individual charges, so requesting a full itemized CPT-coded statement is essential to identify any errors or unbundled codes before payment. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, but they must verify their coverage status and avoid signing away rights to dispute potential surprise bills during registration.