Blood test, liver function panel
Facility: Bob Wilson Memorial Hospital
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $79
- Cash Discount Price: $39
- 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 |
|---|---|---|
| Centura Employee Plan | $10 | 122% |
| Aetna | $31 - $77 | 379% |
| UnitedHealthcare | $31 - $80 | 379% |
| Medicare (plans) | $31 | 379% |
| Humana | $31 | 379% |
| Kansas Health | $31 | 379% |
| Blue Cross Blue Shield | $43 | 526% |
| Multiplan | $87 - $90 | 1065% |
| Health Partners Of Kansas | $91 | 1114% |
| Wppa | $92 | 1126% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Bob Wilson Memorial Hospital in Ulysses, KS, the cash median price is $39.00, which is significantly lower than the facility's gross charge of $96.00. While the hospital's negotiated rates range from $10 to $92 across ten payers, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $39.00. It is important to note that the facility's cash rate is notably higher than the state average for this service, suggesting that while self-pay offers a clear baseline, commercial insurance contracts may still result in higher out-of-pocket costs depending on the specific plan.
The Medicare benchmark for this procedure is $8.17, providing a clear cost baseline against which commercial rates can be evaluated. Although the facility's negotiated rates average $79.00, which is higher than the Medicare amount, the cash option remains the most affordable direct payment method at $39.00. To minimize costs, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed. Additionally, patients should request a full itemized bill to ensure no unbundled charges or services not rendered are included, as summary bills often obscure the true cost of specific laboratory components.