Blood test, liver function panel
Facility: Sheridan County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $44
- Cash Discount Price: $67
- vs. Medicare Baseline: 5.39x 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 539% of the Medicare baseline (a markup of 439%). 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 Insurance | $41 | 502% |
| Blue Cross Blue Shield | $44 | 539% |
| UnitedHealthcare | $64 | 783% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Sheridan County Hospital in Hoxie, Kansas, the cash price is $67.00, which matches the facility's median negotiated rate of $44.00 and the state average of $67.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash payments can sometimes be more cost-effective than insurance claims if the negotiated rate exceeds the cash price. Since the cash price here equals the state average, patients with high-deductible plans or those without insurance may find paying out-of-pocket directly to the hospital offers a predictable cost, provided they confirm the facility offers a "self-pay" or "prompt-pay" discount for upfront billing.
It is important to distinguish between the facility's gross charge of $67.00 and the actual amounts billed to insurers. The Medicare benchmark for this service is $8.17, which serves as a baseline for evaluating pricing fairness, as commercial rates often exceed this significantly. Although the data shows specific negotiated rates for Celtic Insurance ($41), Blue Cross Blue Shield ($44), and UnitedHealthcare ($64), patients should avoid assuming that being in-network guarantees the lowest possible price, as administrative costs and contract dynamics can inflate these amounts. If you receive a bill, request a full itemized statement to verify that no unbundled codes or services not rendered have been charged, and do not sign away your rights to dispute balance billing without reviewing the terms carefully.