Blood test, liver function panel
Facility: Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $79
- Cash Discount Price: $143
- vs. Medicare Baseline: 9.67x 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 967% of the Medicare baseline (a markup of 867%). 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 | $22 | 269% |
| Humana | $71 | 869% |
| Tricare | $71 | 869% |
| Medicare (plans) | $72 | 881% |
| Ambetter / Centene | $79 | 967% |
| Coventry - All Other Plans | $129 | 1579% |
| Health Partners Of Kansas - All Plans | $136 | 1665% |
| Preferred Healthcare-All Plans | $136 | 1665% |
| Wppa/Providers Care-All Plans | $200 | 2448% |
Consumer Guidance & Cost Commentary
For this liver function panel test at Memorial Hospital in Abilene, KS, the cash price is $143.00, which matches the facility's median negotiated rate of $79.00 for most major payers. While the facility's negotiated rate of $79.00 is lower than the cash price, patients with high-deductible plans may find paying the full cash price of $143.00 upfront more cost-effective if their insurance allowed amount exceeds this figure. It is important to note that while the facility is in-network for nine payers, including Blue Cross Blue Shield and Humana, the specific allowed amount for your plan could differ from the general median. Patients should always confirm their specific deductible status and allowed amounts with their insurance carrier before scheduling to avoid unexpected out-of-pocket costs.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $8.17 for this procedure. The facility's cash price of $143.00 represents a significant markup compared to the Medicare rate of $8.17, illustrating the difference between government-set costs and commercial pricing. To maximize savings, patients should inquire about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days, effectively bypassing the administrative overhead of insurance claims. Additionally, since over 80% of hospital bills contain errors, requesting a detailed, itemized statement of charges is a critical step to identify any unbundled codes or services not rendered before finalizing payment.