Blood test, liver function panel
Facility: St Luke Hospital & Living Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $68
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 8.32x 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 832% of the Medicare baseline (a markup of 732%). 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 | $68 | 832% |
| Blue Cross Blue Shield | $68 | 832% |
| Bluestem Pace | $68 | 832% |
| Kansas Department Of Health And Environment | $68 | 832% |
| Humana | $68 | 832% |
| UnitedHealthcare | $68 | 832% |
| Ambetter / Centene | $69 | 845% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at St Luke Hospital & Living Center in Marion, KS, the negotiated rate is $68.00, which aligns exactly with the lowest and highest negotiated rates reported across all seven payers, including major carriers like UnitedHealthcare and Humana. This facility, a Critical Access Hospital owned by a government hospital district, charges $134.00 as its gross list price. While the facility does not offer a specific cash or self-pay discount in this dataset, patients with high-deductible plans should consider that paying cash directly could sometimes be cheaper than the insurance negotiated rate if the patient's plan allows them to bypass the administrative overhead of claims processing. It is always advisable to contact the hospital's billing department directly to inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can significantly reduce out-of-pocket costs.
When evaluating the cost of this service, it is important to compare rates against objective benchmarks rather than the facility's inflated gross charges. The Medicare benchmark for this procedure is $8.17, meaning the negotiated rate of $68.00 represents a significant markup above the federal cost baseline. This pricing structure is typical for commercial insurance, where negotiated rates often exceed Medicare rates by 200% to 300% due to administrative costs and contract dynamics. Patients should be aware of the risk of balance billing if they receive care from out-of-network providers, even at an in-network facility, though the No Surprises Act protects against such surprise bills for emergency and non-emergency services. To ensure accuracy, consumers should request a full itemized bill to verify that