Blood test, liver function panel
Facility: Community Memorial Healthcare, Inc.
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $33
- Cash Discount Price: $58
- vs. Medicare Baseline: 4.04x 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 404% of the Medicare baseline (a markup of 304%). 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 | $27 - $44 | 330% |
| Blue Cross Blue Shield | $32 | 392% |
| UnitedHealthcare | $33 | 404% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Community Memorial Healthcare in Marysville, KS, the cash price is $58.00, which matches the facility's median negotiated rate of $35.00 and the cash median. This cash price is significantly higher than the Medicare benchmark of $8.17, indicating a markup of 400% above the federal baseline. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance negotiated rates for this service range from $27 to $44 across three major payers, including Aetna, Blue Cross Blue Shield, and UnitedHealthcare. Because the cash price of $58.00 exceeds the lowest negotiated rate of $27, patients with high-deductible plans might find it financially advantageous to pay the cash price directly, provided they have no other coverage or can afford the upfront cost.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts from the billing department before scheduling the test, as these upfront payment incentives can reduce the final amount owed by bypassing administrative claim processing fees. It is important to verify the specific allowed amount with your insurance carrier prior to the visit, as assuming that being in-network guarantees the lowest price can lead to confusion if different insurers have varying contract terms. Furthermore, since over 80% of hospital bills often contain errors or unbundled charges, patients should always request a detailed, itemized statement rather than accepting a summary bill, ensuring that every charge corresponds to a service actually rendered.