Blood test, liver function panel
Facility: Amberwell Atchison Association
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $42
- Cash Discount Price: $82
- vs. Medicare Baseline: 5.14x 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 514% of the Medicare baseline (a markup of 414%). 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 |
|---|---|---|
| Superior Select Mcr Adv - All Plans | $27 | 330% |
| Humana | $27 - $37 | 330% |
| UnitedHealthcare | $27 - $147 | 330% |
| Triwest - All Plans | $27 | 330% |
| Va Ccn - All Plans | $27 | 330% |
| Blue Cross Blue Shield | $30 - $32 | 367% |
| Ambetter / Centene | $42 | 514% |
| Aetna | $45 | 551% |
| Cigna | $45 | 551% |
| Oscar - All Plans | $62 | 759% |
| Centrus Health Direct - All Plans | $62 | 759% |
| Multiplan - All Plans | $64 | 783% |
| Wppa Providrs Care - All Plans | $74 | 906% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a blood test for liver function, the Amberwell Atchison Association in Atchison, KS, lists a gross charge of $82.00. While the facility's cash median rate is $82.00, the actual amount commercial payers negotiate to pay ranges from $27 to $147 depending on the insurance plan. It is important to note that for patients with high-deductible plans, paying the cash price of $82.00 upfront may be more cost-effective than using insurance, as the negotiated rates for many in-network plans exceed the cash amount. Additionally, patients should inquire directly with the hospital about potential self-pay or prompt-pay discounts, which can further reduce the final balance before any insurance processing occurs.
When evaluating the cost against federal benchmarks, the facility's cash rate of $82.00 is 5.1 times higher than the Medicare amount of $8.17 for this service. This significant markup highlights the difference between the government's cost-based reimbursement and commercial pricing structures. While the median negotiated rate across payers is $42.00, which is lower than the cash price, patients must be aware that this rate is a contractual ceiling set by insurers and does not guarantee the lowest possible price. To ensure transparency, consumers should request an itemized billing audit to verify that all charges are accurate and that no unbundled codes or services not rendered have inflated the total bill.