Blood test, liver function panel
Facility: Morris County Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $80
- Cash Discount Price: $123
- vs. Medicare Baseline: 9.79x 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 979% of the Medicare baseline (a markup of 879%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $8 | 98% |
| Aetna | $9 | 110% |
| Va Ccn-All Plans | $17 | 208% |
| Blue Cross Blue Shield | $30 - $80 | 367% |
| UnitedHealthcare | $80 - $205 | 979% |
| Choice Care Mcr Adv-All Plans | $80 | 979% |
| Coventry Mcr | $80 | 979% |
| Cigna | $148 | 1812% |
| Multiplan-All Plans | $184 | 2252% |
| Coventry Comm-All Other Plans | $184 | 2252% |
Consumer Guidance & Cost Commentary
For this blood test, liver function panel procedure at Morris County Hospital in Council Grove, KS, the cash median price is $123.00, while the median negotiated rate paid by insurance is $80.00. This facility is a Critical Access Hospital with government-local ownership, and its pricing is benchmarked against the Medicare amount of $8.17. While the cash price is higher than the negotiated rate, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective if their insurance allows a rate exceeding the cash price. It is important to note that commercial negotiated rates often include administrative overhead and can be higher than the true cost of care; therefore, patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services are billed separately. If you receive a bill, always request a full itemized CPT-coded statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the costly insurance claims cycle. Given that the facility is located in a specific geographic area, comparing these rates to local state or county averages provides a clearer picture of fair pricing than relying solely on the hospital's published chargemaster list.