Blood test, liver function panel
Facility: Norton County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $45
- Cash Discount Price: $93
- vs. Medicare Baseline: 5.51x 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 551% of the Medicare baseline (a markup of 451%). 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 | $45 | 551% |
Consumer Guidance & Cost Commentary
For this liver function panel test at Norton County Hospital, the cash price of $93.00 is significantly lower than the facility's negotiated rate of $45.00 paid by Blue Cross Blue Shield. While the negotiated rate is the amount your insurance will pay, the cash price is often more affordable for patients with high-deductible plans who may not yet have met their out-of-pocket limits. If your insurance allows a rate higher than $93.00, paying cash directly could result in substantial savings. To secure this lower rate, you should explicitly request a "self-pay" classification and ask about "prompt-pay" discounts, which can further reduce the final amount owed if you settle the bill in full upfront.
This service is benchmarked against federal standards to ensure transparency. The Medicare reimbursement rate for this procedure is $8.17, and the facility's cash price of $93.00 represents a markup of 5.5 times the Medicare amount. It is important to note that comparing your discount to the hospital's gross charge list is misleading, as those figures are inflated to make discounts appear larger. Instead, the most accurate way to evaluate pricing is to compare your negotiated or cash rate directly to the Medicare benchmark. Additionally, since this facility is a Critical Access Hospital in Norton, KS, you should verify that no unexpected balance billing will occur, as federal protections generally prevent surprise charges for services rendered at in-network facilities.