CMS Price Transparency Data

Blood test, liver function panel

Facility: North Adams Regional Hospital Corporation

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $57
  • Cash Discount Price: $96
  • vs. Medicare Baseline: 6.98x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at North Adams Regional Hospital Corporation is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.98x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$96

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $96 (1175%)
Insurance Median: $57 (698%)
Cash: $96 (1175% of Medicare)
Ins. Median: $57 (698% 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 698% of the Medicare baseline (a markup of 598%). 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.

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
Mcd Masshealth $7 - $9 86%
Mcd New York $7 - $9 86%
Mcd Out Of State $7 - $9 86%
Mcdmanaged Cdphp $7 - $9 86%
Mcdmanaged Hne Mcdaco $7 - $9 86%
Medicaid / KanCare $7 - $44 86%
Comm Hospice $8 - $23 98%
Mcdmanaged Bmchnp $8 - $9 98%
Mcdmanaged Network $8 - $57 98%
Mcr Miscellaneous $8 - $23 98%
Mcrmanaged Usa Family $8 - $23 98%
Mcrmanaged Va $8 - $23 98%
Medicare (plans) $8 - $23 98%
Oth United Vaccn $8 - $23 98%
Blue Cross Blue Shield $9 - $86 110%
Mcrmanaged Cca One Care $9 - $23 110%
Aetna $10 - $76 122%
Tricare $10 - $38 122%
Comm Fallon Qhp $12 - $57 147%
Comm Unicare $21 - $65 257%
Comm Network Qhpsub $57 - $61 698%
Wc Workers Comp $61 747%
Comm Network Qhpnonsub $64 - $72 783%
Comm Nhp $65 796%
Comm Hne Hmo $66 - $76 808%
Comm Hne $68 - $70 832%
Comm Hne Ppo $71 - $76 869%
Comm Tufts $80 979%
UnitedHealthcare $87 1065%
Cigna $91 - $94 1114%
Comm Cdphp $91 1114%
Comm Mvp $91 1114%
Comm Oxford $91 1114%
Comm First Health $94 - $96 1151%
Comm Connecticare $96 1175%
Comm Consolidated Health $96 1175%
Comm Harvard $96 1175%
Comm Other $96 1175%
Comm Phcs $96 1175%
Comm Self Pay $96 1175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals