Blood test, liver function panel
Facility: Cloud County Health Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $136
- Cash Discount Price: $100
- vs. Medicare Baseline: 16.65x 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 1665% of the Medicare baseline (a markup of 1565%). 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 |
|---|---|---|
| Aetna | $129 - $133 | 1579% |
| Mpi-All Plans | $136 | 1665% |
| Pponext-All Plans | $136 | 1665% |
| Health Partners - All Plans | $136 | 1665% |
Consumer Guidance & Cost Commentary
For the CPT code 80076 (Blood test, liver function panel) at Cloud County Health Center in Concordia, KS, the facility's cash median price is $100.00, which is lower than the negotiated rates of $136.00 paid by major payers like Aetna, Mpi-All Plans, and Health Partners. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the cash price is significantly lower than the gross chargemaster of $143.00, and patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the best possible rate.
The facility's pricing is also notable when compared to federal benchmarks; the Medicare amount for this service is $8.17, meaning the cash price of $100.00 represents a substantial markup relative to the government's cost-based standard. Although specific county or state average data was not provided in the source material, the $100.00 cash rate serves as a clear baseline for patients to evaluate potential balance billing risks. If a patient receives care from an out-of-network provider at this facility, they could be billed the difference between the full chargemaster and their insurance allowed amount, a practice known as balance billing. To avoid unexpected costs, patients should request an itemized bill to verify that no unbundled codes or services not rendered are included, and they should dispute any surprise charges in writing rather than accepting summary invoices or verbal