Blood test, liver function panel
Facility: Trego County Lemke Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $43
- Cash Discount Price: $43
- vs. Medicare Baseline: 5.26x 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 526% of the Medicare baseline (a markup of 426%). 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 |
|---|---|---|
| Va Ccn - All Plans | $4 | 49% |
| Humana | $24 | 294% |
| Tricare | $26 | 318% |
| UnitedHealthcare | $31 - $50 | 379% |
| Aetna | $31 - $45 | 379% |
| Medicaid / KanCare | $31 - $50 | 379% |
| Ambetter / Centene | $34 | 416% |
| Blue Cross Blue Shield | $44 | 539% |
| Health Partners - All Plans | $48 | 588% |
| Healthy Blue Mcaid - All Plans | $50 | 612% |
Consumer Guidance & Cost Commentary
For the liver function panel (CPT 80076) at Trego County Lemke Memorial Hospital in Wakeeney, KS, the cash median price is $43.00, which is 5.3% higher than the state average. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $31 to $50, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. The facility, a Critical Access Hospital owned by the local government, lists a cash median of $43.00 and a median paid amount of $31.00, suggesting that direct payment can be more cost-effective than relying on insurance reimbursement for this specific service.
To ensure you receive the best possible rate, it is important to understand that hospitals frequently offer prompt-pay discounts for self-pay patients who settle their bill upfront, potentially reducing the cost by 20% to 50%. Since commercial rates can sometimes be inflated by administrative overhead and contract dynamics, you should contact the hospital directly before scheduling to confirm their self-pay or prompt-pay pricing. Additionally, if you are covered by insurance, be aware that while the No Surprises Act protects you from balance billing for emergency care at in-network facilities, it is still wise to request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.