Blood test, liver function panel
Facility: Phillips County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $53
- Cash Discount Price: $50
- vs. Medicare Baseline: 6.49x 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 649% of the Medicare baseline (a markup of 549%). 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 | $32 - $48 | 392% |
| UnitedHealthcare | $47 - $59 | 575% |
| Health Partners-All Plans | $59 | 722% |
| Medicaid / KanCare | $59 | 722% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Phillips County Hospital in Phillipsburg, KS, the facility's cash median price is $50.00, which is lower than the state average of $53.00. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $32 to $59, these amounts often exceed the cash price. For patients with high-deductible plans, paying the $50.00 cash rate directly can be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the negotiated allowed amount surpasses the cash price. Since this facility is a Critical Access Hospital owned by the local government, patients should explicitly ask about self-pay or prompt-pay discounts before scheduling to ensure they receive the lowest possible rate.
The Medicare benchmark for this service is $8.17, highlighting that commercial rates are significantly higher than the federal baseline. Although the facility's negotiated rates are capped by insurance contracts, patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, though unexpected charges can still occur for out-of-network ancillary services like emergency physicians. To avoid errors, consumers should request a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain mistakes such as unbundled codes or charges for services not rendered. If a patient receives a bill that seems incorrect, they should dispute it in writing with the billing supervisor rather than settling verbally, ensuring that any discrepancies are formally corrected before payment.