Blood test, liver function panel
Facility: Children'S Mercy South
Billing Code: 80076 (CPT)
- CPT Billing Code: 80076
- Insurance Median: $63
- Cash Discount Price: $46
- vs. Medicare Baseline: 7.71x 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 771% of the Medicare baseline (a markup of 671%). 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 | $7 - $65 | 86% |
| Healthy Blue | $9 - $22 | 110% |
| Medicaid / KanCare | $10 | 122% |
| Home State Health | $20 | 245% |
| Blue Cross Blue Shield | $39 - $71 | 477% |
| Cigna | $46 - $67 | 563% |
| Medica | $56 | 685% |
| Aetna | $58 - $65 | 710% |
| Orscheln | $62 | 759% |
| Wppa Providrs Care | $62 | 759% |
| Quiktrip | $62 | 759% |
| Centivo | $62 | 759% |
| Nebraska Furniture Mart | $62 | 759% |
| Health Midwest Comprehensive Care | $62 | 759% |
| Wellfit/Centrus | $62 | 759% |
| Humana | $64 | 783% |
| Coventry Health Care Of Kansas | $71 | 869% |
| Coxhealth Network | $71 | 869% |
| Mercy Health | $72 | 881% |
| Multiplan | $73 | 894% |
| American Healthcare Alliance | $82 | 1004% |
| Healthlink | $84 | 1028% |
| National Preferred Provider Network | $86 | 1053% |
Consumer Guidance & Cost Commentary
For the CPT code 80076, representing a liver function panel at Children's Mercy South in Overland Park, KS, the facility's cash price of $46.00 is notably lower than the state average of $63.00. While the facility's negotiated rates for commercial payers range from $7 to $86, depending on the insurance plan, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $46.00. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to direct cash payments.
To maximize savings, patients should verify their specific plan's allowed amount before scheduling and consider requesting a "self-pay" or "prompt-pay" discount, which can reduce the bill by 20% to 50% for upfront payment. Although the facility's cash rate is below the state average, patients must be aware that balance billing could occur if ancillary services are out-of-network, though the No Surprises Act protects against surprise billing for emergency care and non-emergency services at in-network facilities. Finally, since the facility's cash price is significantly lower than the Medicare benchmark of $8.17 for this service, patients should avoid comparing discounts to the hospital's gross chargemaster list, as this can create a misleading impression of savings; instead, comparing rates to the Medicare rate provides a more accurate view of fair pricing.