CMS Price Transparency Data

Blood test, liver function panel

Facility: Southcoast Hospitals Group

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $10
Cash Discount Price: $197
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Southcoast Hospitals Group is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 1.22x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$197

Average discount available for prompt cash payment at this facility.

Insurance Median

$10

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: $197 (2411%)

Insurance Median: $10 (122%)

Cash: $197 (2411% of Medicare)

Ins. Median: $10 (122% 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.

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
Aetna	$8 - $300	98%
Blue Cross Blue Shield	$8 - $16	98%
Commonwealth Care Alliance [1080501]	$8	98%
Evercare [1010304]	$8	98%
Medicare (plans)	$8 - $97	98%
Tufts Senior Care Options [1010315]	$8	98%
UnitedHealthcare	$8 - $10	98%
Wellsense Health Plan Senior Care Options [1020208	$8	98%
Eternal Health [1010322]	$9	110%
Tufts Health Public Plans [1010213]	$10	122%
Fallon [1000114]	$11	135%
Harvard Pilgrim [1010602]	$17	208%
Cigna	$19	233%
Wellpoint [1000102]	$26	318%
Wellsense Health Plan Clarity Connectorcare & Meta	$84	1028%
Tufts [1010701]	$165	2020%
Mass General Brigham Health Plan Commercial [10122	$222	2717%
Mass General Brigham Health Plan Connectorcare [10	$222	2717%
Group Insurance Service Center [1013001]	$236	2889%
Innovative Health Plan [1025001]	$236	2889%
Priority Health [1015001]	$236	2889%
PHCS [1000125]	$256	3133%
First Health [1000130]	$300	3672%

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 $197.
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 Southcoast Hospitals Group 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.