CMS Price Transparency Data

Blood test, liver function panel

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $21
Cash Discount Price: $134
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at UMass Memorial Health - Harrington Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 2.57x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$134

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$8.17

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $8.17 (100%)

Cash / Self-Pay: $134 (1640%)

Insurance Median: $21 (257%)

Cash: $134 (1640% of Medicare)

Ins. Median: $21 (257% of 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 257% of the Medicare baseline (a markup of 157%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$7 - $8	86%
Blue Cross Blue Shield	$8 - $21	98%
Cigna	$8 - $95	98%
Institution [10406]	$8	98%
Mgb Mcr [10124]	$8	98%
Tufts Us Family [11203]	$8	98%
Aetna	$9 - $134	110%
Commonwealth Care Alliance [10103]	$9	110%
Fallon Mcr Supp [20202]	$9	110%
Fallon Mcr [10105]	$9	110%
Senior Whole Health [10110]	$9	110%
Tufts Mcr [10112]	$9	110%
UnitedHealthcare	$9 - $134	110%
Champva [11001]	$10	122%
Workers Compensation [20501]	$11	135%
Tufts Connectorcare [10507]	$14	171%
Wellpoint [11112]	$21	257%
Harvard Pilgrim [10701]	$30 - $37	367%
Fallon Connectorcare [10503]	$81	991%
Hne [11108]	$87	1065%
Tufts [11201]	$95	1163%
First Health Network [11120]	$100	1224%
Evernorth Behavioral Health [27]	$107	1310%
Connecticare [11105]	$134	1640%
Fallon Carelon Hlth [28]	$134	1640%
Fallon Mcaid Carelon Hlth [29]	$134	1640%
Grants [20507]	$134	1640%
Masshealth Mcd Mbhp [38]	$134	1640%
Wellsense Mcaid Carelon Hlth [21]	$134	1640%
Hsno/Free Care [10801]	$681	8335%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $134.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80076.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UMass Memorial Health - Harrington Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80076.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.