Blood test, liver function panel
Facility: Hodgeman County Health Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $112
- Cash Discount Price: $127
- vs. Medicare Baseline: 13.71x 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 1371% of the Medicare baseline (a markup of 1271%). 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 | $30 - $32 | 367% |
| Humana | $102 | 1248% |
| Medicaid / KanCare | $102 - $159 | 1248% |
| Triwest - All Plans | $102 | 1248% |
| UnitedHealthcare | $102 - $151 | 1248% |
| Aetna | $127 | 1554% |
| First Health - All Plans | $143 | 1750% |
| Health Partners - All Plans | $151 | 1848% |
| Wppa (Provdrscare) - All Plans | $151 | 1848% |
Consumer Guidance & Cost Commentary
For CPT code 80076, a liver function panel, Hodgeman County Health Center in Jetmore, Kansas, lists a cash median price of $127.00, which is notably lower than the facility's gross charge of $159.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare and Medicaid/KanCare have negotiated ranges extending up to $151 and $159 respectively, meaning paying cash upfront could result in significant savings for those with high-deductible plans or those without insurance. It is advisable to contact the facility directly to confirm "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating costs, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this service is $8.17, and the facility's cash rate of $127.00 represents a 13.7% increase over the Medicare rate, which falls within the typical range for fair pricing. Commercial negotiated rates, however, often average 200% to 300% of Medicare, so relying on the gross charge to determine savings can be misleading. To ensure you are not overcharged, request a detailed, itemized bill to verify that no unbundled codes or services not rendered are included, and dispute any balance billing immediately if you receive a surprise invoice, as federal protections may apply depending on your network status.