Blood test, liver function panel
Facility: Osborne County Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $89
- Cash Discount Price: $83
- vs. Medicare Baseline: 10.89x 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 1089% of the Medicare baseline (a markup of 989%). 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 |
|---|---|---|
| UnitedHealthcare | $74 | 906% |
| Health Partners Of Kansas | $84 | 1028% |
| Wppa | $93 | 1138% |
| Blue Cross Blue Shield | $96 | 1175% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Osborne County Memorial Hospital in Osborne, KS, the cash median price is $83.00, which is lower than the facility's gross charge of $98.00. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly by payer, ranging from $74.00 with UnitedHealthcare to $96.00 with Blue Cross Blue Shield. It is important to note that these negotiated rates often exceed the cash price due to administrative overhead and contract dynamics; therefore, patients with high-deductible plans may find paying the cash median of $83.00 upfront more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not been met.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $8.17. The cash price of $83.00 represents a substantial markup relative to this baseline, illustrating how commercial rates can differ significantly from the CMS cost basis used for Medicare reimbursement. Although the data does not provide specific state or county average comparisons for this exact code, patients should be aware that commercial negotiated rates frequently average between 200% and 300% of Medicare rates, whereas fair pricing is typically defined as 120% to 150%. To ensure you are receiving the best possible rate, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill before any insurance claims are processed.