Blood test, liver function panel
Facility: Smith County Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $47
- Cash Discount Price: $50
- vs. Medicare Baseline: 5.75x 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 575% of the Medicare baseline (a markup of 475%). 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 | $32 | 392% |
| Medicaid / KanCare | $35 - $50 | 428% |
| Multiplan-All Plans | $45 | 551% |
| Wppa-All Plans | $47 | 575% |
| UnitedHealthcare | $48 | 588% |
| Health Partners Of Ks Ppo-All Plans | $48 | 588% |
| Midlands Choice-All Plans | $48 | 588% |
Consumer Guidance & Cost Commentary
For the liver function panel procedure (CPT 80076) at Smith County Memorial Hospital in Smith Center, KS, the facility's cash price of $50.00 is identical to the state average, while the median negotiated rate across seven payers ranges from $32.00 to $50.00. Although the facility is a Critical Access Hospital with government local ownership, patients should be aware that cash payments can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's allowed amount might exceed the cash price. To secure the lowest possible cost, 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, bypassing the administrative overhead and collection fees associated with insurance billing cycles.
When using insurance, the negotiated rates vary significantly by payer, with Blue Cross Blue Shield offering the lowest rate at $32.00 and Medicaid/KanCare plans ranging from $35.00 to $50.00 across three different plans. It is important to note that these negotiated rates often include administrative costs for claims processing and may not reflect the true cost of care, as commercial rates can average 200% to 300% of the Medicare benchmark of $8.17 for this service. If a patient receives a balance bill for services rendered by out-of-network providers, such as emergency physicians or lab services, they may face unexpected charges; however, the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in