CMS Price Transparency Data

Blood test, liver function panel

Facility: Girard Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $88
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 10.77x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Girard Medical Center is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 10.77x the Medicare baseline. Located in 302 North Hospital Drive, Girard, KS.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)
Cash / Self-Pay: $150 (1836%)
Insurance Median: $88 (1077%)
Cash: $150 (1836% of Medicare)
Ins. Median: $88 (1077% of 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 1077% of the Medicare baseline (a markup of 977%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $32 - $88 392%
Kansas Superior Select-All Plans $88 1077%
Aetna $88 - $438 1077%
Humana $88 1077%
UnitedHealthcare $88 - $238 1077%
Ambetter / Centene $88 1077%
Medicare (plans) $88 1077%
Multiplan-All Plans $231 2827%
Uhhis-All Plans $238 2913%

Consumer Guidance & Cost Commentary

For the CPT code 80076, representing a blood test for liver function at Girard Medical Center in Girard, KS, the facility's cash median rate is $150.00, which is notably higher than the state average of $88.00. While commercial insurance plans like Blue Cross Blue Shield and Kansas Superior Select-All Plans negotiate rates starting at $88.00, other carriers such as Aetna and UnitedHealthcare have negotiated ranges extending up to $438.00 and $238.00 respectively. Patients should be aware that despite these negotiated rates, paying cash directly can sometimes be more cost-effective if the insurance plan's deductible has not yet been met, as the facility offers a cash median of $150.00 which may be lower than the full negotiated amount for certain high-tier plans. Additionally, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid in full upfront.

When reviewing your bill, it is crucial to request an itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing this service to the Medicare benchmark provides a clear baseline for fair pricing; the Medicare amount for this code is $8.17, and the facility's median negotiated rate of $88.00 represents a significant markup relative to this federal standard. If you receive a bill that appears inflated, you should dispute any errors in writing to the billing supervisor rather than settling verbally

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 302 North Hospital Drive, Girard, KS 66743
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals