Blood test, liver function panel
Facility: Scott County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $98
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 12.00x 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 1200% of the Medicare baseline (a markup of 1100%). 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 | $8 - $108 | 98% |
| Blue Cross Blue Shield | $32 | 392% |
| Humana | $46 - $48 | 563% |
| Wppa | $65 - $1,200 | 796% |
| Aetna | $98 - $103 | 1200% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Scott County Hospital in Scott City, KS, the facility's negotiated rates range from $8 to $108 across five insurance plans, with a median negotiated amount of $98. This commercial rate is 12% higher than the Medicare benchmark of $8.17, which serves as the objective baseline for fair pricing. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash-pay options may offer significant savings. Although the cash median is not currently listed, hospitals often provide prompt-pay discounts of 20% to 50% for upfront payments, which can bypass administrative overhead and reduce the final cost compared to the insurance negotiated rate.
To maximize savings, patients should verify their specific plan details before scheduling, as the allowed amount varies significantly by carrier, ranging from $32 with Blue Cross Blue Shield to $1,200 with WPPA. It is crucial to request a self-pay classification and a prompt-pay discount prior to check-in, as billing systems may automatically submit claims for active coverage, voiding any cash agreement. Additionally, patients should avoid accepting summary bills and instead demand a full itemized statement to identify any errors or unbundled charges, as over 80% of hospital bills contain inaccuracies. By comparing the facility's rates against the Medicare benchmark and actively negotiating for cash discounts or reviewing itemized statements, consumers can ensure they are not overpaying for essential laboratory services.