CMS Price Transparency Data

Blood test, liver function panel

Facility: Down East Community Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $81
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 9.91x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Down East Community Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 9.91x the Medicare baseline. Located in 11 Hospital Drive, Machias, ME.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

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: $73 (894%)
Insurance Median: $81 (991%)
Cash: $73 (894% of Medicare)
Ins. Median: $81 (991% 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 991% of the Medicare baseline (a markup of 891%). 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
Blue Cross Blue Shield $43 - $78 526%
Humana $43 526%
Wellcare $43 526%
Partners Direct Health $49 600%
Community Health Options $80 979%
Aetna $81 991%
UnitedHealthcare $83 1016%
Cigna $87 1065%
Martins Point $87 1065%
Patients Advocates $87 1065%
Harvard Pilgrim $89 1089%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 11 Hospital Drive, Machias, ME 04654
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals