Blood test, liver function panel
Facility: William Newton Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $26
- Cash Discount Price: $60
- vs. Medicare Baseline: 3.18x 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 318% of the Medicare baseline (a markup of 218%). 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 |
|---|---|---|
| UnitedHealthcare | $5 - $54 | 61% |
| Blue Cross Blue Shield | $21 - $30 | 257% |
| Ambetter / Centene | $21 - $60 | 257% |
| Triwest- All Plans | $21 | 257% |
| Providrs Care Nexus | $36 | 441% |
| Providrs Care - All Other Plans | $42 | 514% |
Consumer Guidance & Cost Commentary
For the blood test, liver function panel (CPT 80076) at William Newton Hospital in Winfield, KS, the cash price is $60.00, which matches the facility's median negotiated rate of $26.00 and the state average. While the hospital is a Critical Access Hospital with a government-local ownership structure, patients should note that commercial insurance rates for this service range widely, with UnitedHealthcare plans negotiating between $5 and $54, and Blue Cross Blue Shield plans between $21 and $30. Because the cash price of $60.00 is significantly higher than the median negotiated rate of $26.00, patients with high-deductible plans might find paying out-of-pocket cheaper if their insurance allowed amount exceeds the cash price, though this depends on their specific plan's deductible status.
When evaluating costs, it is important to compare these rates against the Medicare benchmark of $8.17, which serves as the federal baseline for healthcare delivery costs. The facility's cash rate of $60.00 represents a substantial markup over the Medicare amount, illustrating how commercial rates can differ significantly from the true cost of care. To potentially lower your bill, you should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final amount by 20% to 50% if paid upfront. Additionally, since the facility is in-network for several major payers, ensure you verify your specific plan's allowed amount before scheduling to avoid unexpected balance billing, as the No Surprises Act protects patients from being billed the difference between the chargemaster and the insurance allowed amount for out-of-network services at in