Blood test, liver function panel
Facility: Clay County Medical Center
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $67
- Cash Discount Price: $71
- vs. Medicare Baseline: 8.20x 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 820% of the Medicare baseline (a markup of 720%). 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 | $66 | 808% |
| Wppa/Providrs Care- All Plans | $66 | 808% |
| UnitedHealthcare | $67 | 820% |
| Health Partners - All Plans | $67 | 820% |
| Multiplan- All Plans | $67 | 820% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at Clay County Medical Center in Clay Center, KS, the cash median price is $71.00, which matches the facility's negotiated rate for Aetna, WPPA/Providers Care, UnitedHealthcare, Health Partners, and Multiplan. This cash price is 8.2% higher than the Medicare benchmark of $8.17, reflecting the typical administrative overhead and contract dynamics that inflate commercial rates above the federal baseline. While the facility is a Critical Access Hospital owned by the local government, patients should note that commercial negotiated rates often exceed cash prices due to multi-layered billing structures; however, in this specific case, the cash rate aligns with the negotiated amounts, meaning there is no additional cost savings available by paying out-of-pocket for this service.
Patients should be aware that while in-network insurance prevents balance billing under the No Surprises Act, it does not guarantee the lowest possible price, as some in-network facilities charge significantly more than others. For this procedure, the median negotiated rate of $67.00 is consistent across all five payers listed, but patients with high-deductible plans might still find the cash price more favorable if their insurance allowed amount exceeds $71.00. To ensure you receive the best possible rate, it is essential to request a self-pay or prompt-pay discount before scheduling your visit, as hospitals often offer reductions of 20% to 50% for upfront payments that bypass costly claims processing. Always verify your deductible status and ask for an itemized bill to confirm that no unbundled codes or services not rendered have inflated your final charge.