CMS Price Transparency Data
Blood test, liver function panel
Facility: Trinity Health Oakland Hospital
Billing Code: 80076 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80076
- Insurance Median: $67
- Cash Discount Price: $64
- vs. Medicare Baseline: 8.20x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Trinity Health Oakland Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 8.20x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$64
Average discount available for prompt cash payment at this facility.
Insurance Median
$67
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: $64 (783%)
Insurance Median: $67 (820%)
Cash: $64 (783% of Medicare)
Ins. Median: $67 (820% 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 820% of the Medicare baseline (a markup of 720%). 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.
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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 | $4 - $11 | 49% |
| Medicaid / KanCare | $4 - $5 | 49% |
| Priority Health | $7 - $8 | 86% |
| Aetna | $8 - $44 | 98% |
| Align Senior Care | $8 | 98% |
| Blue Care Network Advantage | $8 | 98% |
| Hospice Advantage | $8 | 98% |
| Medicare (plans) | $8 | 98% |
| UnitedHealthcare | $8 - $74 | 98% |
| Cca - Zing Health | $9 | 110% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $9 | 110% |
| Bcn Domestic | $11 | 135% |
| Blue Benefit Administrators Of Massachusetts | $11 | 135% |
| Blue Care Network | $11 | 135% |
| Blue Distinction Transplant | $11 | 135% |
| Blue Shield - Ca | $11 | 135% |
| Blue Shield - Id (Regence) | $11 | 135% |
| Blue Shield - Ny Highmark Northeastern | $11 | 135% |
| Blue Shield - Ny Highmark Western | $11 | 135% |
| Blue Shield - Pa (Highmark) | $11 | 135% |
| Blue Shield - Wa (Regence) | $11 | 135% |
| Health Choices | $11 - $72 | 135% |
| Kaiser Domestic | $11 | 135% |
| Molina Marketplace | $11 | 135% |
| Geha | $12 - $74 | 147% |
| Medical Mutual | $12 | 147% |
| Meritain | $12 | 147% |
| U Of M Health Plan | $12 | 147% |
| Health Cost Solutions | $13 | 159% |
| Vitalcore | $13 | 159% |
| Wellpath | $13 | 159% |
| Asr Health Benefits | $15 | 184% |
| Caresource | $15 | 184% |
| Hap | $15 - $71 | 184% |
| Varipro | $15 | 184% |
| Employee Benefit Logistic | $18 | 220% |
| Wc Accident Fund | $30 | 367% |
| Wc Advantage | $30 | 367% |
| Wc Aig | $30 | 367% |
| Wc Allied | $30 | 367% |
| Wc Amerisure | $30 | 367% |
| Wc Amtrust | $30 | 367% |
| Wc Asu Risk Mgt | $30 | 367% |
| Wc Berkley Admin | $30 | 367% |
| Wc Broadspire | $30 | 367% |
| Wc Bunch & Associates | $30 | 367% |
| Wc Ccmsi | $30 | 367% |
| Wc Emc Insurance Company | $30 | 367% |
| Wc Esis | $30 | 367% |
| Wc Fcci | $30 | 367% |
| Wc Federated | $30 | 367% |
| Wc Gallagher Bassett | $30 | 367% |
| Wc Genex Care For Ohio | $30 | 367% |
| Wc Guard Insurance Company | $30 | 367% |
| Wc Hartford | $30 | 367% |
| Wc Liberty Mutual | $30 | 367% |
| Wc Meijers | $30 | 367% |
| Wc Michigan | $30 | 367% |
| Wc Mitchell Frankenmuth | $30 | 367% |
| Wc Pma | $30 | 367% |
| Wc Sedgwick | $30 | 367% |
| Wc Sentry | $30 | 367% |
| Wc Travelers | $30 | 367% |
| Wc Tristar | $30 | 367% |
| Wc Walmart | $30 | 367% |
| Wc Zurich | $30 | 367% |
| Acs Benefit Services | $43 | 526% |
| Allied Benefit Systems | $43 | 526% |
| Claimchoice Adminstrators | $43 | 526% |
| Consociate | $43 | 526% |
| Cypress Benefit Administrators | $43 | 526% |
| Forest County Potawatomi | $43 | 526% |
| Health Smart | $43 | 526% |
| Healthgram | $43 | 526% |
| Healthscope | $43 | 526% |
| Secureone Preferred United Plans | $43 | 526% |
| Sisco Benefits | $43 | 526% |
| The Health Plan | $43 | 526% |
| Trustmark Small Business Benefits | $43 | 526% |
| Unified Group Services | $43 | 526% |
| Webtpa | $43 | 526% |
| Mclaren Health | $47 - $51 | 575% |
| Carelon Behavioral Health | $49 | 600% |
| Magellan Behavioral Health | $59 | 722% |
| 1199 National Benefit Fund | $67 | 820% |
| Allied National Global Care | $67 | 820% |
| Asrm - Reliance Standard Life Insurance | $67 | 820% |
| Christian Care Ministry | $67 | 820% |
| Dean Health | $67 | 820% |
| Fallon Health | $67 | 820% |
| Family Life Insurance Company | $67 | 820% |
| Ghc Scw | $67 | 820% |
| Group Pension Administrators | $67 | 820% |
| International Benefit Administrators | $67 | 820% |
| Lifetime Benefit Solutions | $67 | 820% |
| Manhattan Life | $67 | 820% |
| Medi Share | $67 | 820% |
| Multiplan | $67 | 820% |
| Mvp | $67 | 820% |
| Pai | $67 | 820% |
| Pan-American Life | $67 | 820% |
| Paramount Hmo | $67 | 820% |
| Phcs | $67 | 820% |
| Trinity Health Share | $67 | 820% |
| Health Partners | $71 | 869% |
| Tufts Health Plan | $71 | 869% |
| Access Health | $72 | 881% |
| Acclaim | $72 | 881% |
| Administrative Concepts | $72 | 881% |
| Allegeant | $72 | 881% |
| Ameriben | $72 | 881% |
| American Family | $72 | 881% |
| American Healthcare Alliance | $72 | 881% |
| American National | $72 | 881% |
| American Republic | $72 | 881% |
| Amerihealth | $72 | 881% |
| Aultcare | $72 | 881% |
| Automated Benefit Services | $72 | 881% |
| Auxiant | $72 | 881% |
| Benefit Administrative Systems,Llc | $72 | 881% |
| Boon Chapman | $72 | 881% |
| Cam Administrative Services | $72 | 881% |
| Christian Brother Services | $72 | 881% |
| Christian Brothers Holy Cross | $72 | 881% |
| Comprehensive Benefits | $72 | 881% |
| Continental Life Insurance | $72 | 881% |
| Custom Benefit Administrators | $72 | 881% |
| Employee Benefit Concepts | $72 | 881% |
| Employee Benefit Management | $72 | 881% |
| Enterprise Group Planning | $72 | 881% |
| Freedom Life Insurance Company | $72 | 881% |
| Group Administrators | $72 | 881% |
| Group Marketing Services | $72 | 881% |
| Guardian | $72 | 881% |
| Health America | $72 | 881% |
| Healthcare Management Admin | $72 | 881% |
| Healthez | $72 | 881% |
| Humana | $72 | 881% |
| Insight | $72 | 881% |
| Intercare | $72 | 881% |
| Jfp Benefit Management | $72 | 881% |
| Jp Farley Corporation | $72 | 881% |
| Key Benefit Administrator | $72 | 881% |
| Liberty Union Life Assurance Co | $72 | 881% |
| Lucent Health | $72 | 881% |
| Luminare Health | $72 | 881% |
| Luminare Health (Detroit) | $72 | 881% |
| Magnacare | $72 | 881% |
| Medben | $72 | 881% |
| Medcost | $72 | 881% |
| Mutual Health Services | $72 | 881% |
| Mutual Of Omaha | $72 | 881% |
| Ncas | $72 | 881% |
| Nippon Life Ins | $72 | 881% |
| Nova | $72 | 881% |
| Painters Union Insurance Fund | $72 | 881% |
| Physicians Mutual | $72 | 881% |
| Plumbers Local 98 Insurance Fund | $72 | 881% |
| Prairie States | $72 | 881% |
| Preferred One | $72 | 881% |
| Primary Physician Care | $72 | 881% |
| Professional Benefit Administrators | $72 | 881% |
| Siho Insurance Services | $72 | 881% |
| The Loomis Company | $72 | 881% |
| Unicare | $72 | 881% |
| Us Health And Life | $72 | 881% |
| Valenz | $72 | 881% |
| Western & Southern Financial Group | $72 | 881% |
| Wps | $72 | 881% |
| Cigna | $73 | 894% |
| Coventry | $74 | 906% |
| First Health | $74 | 906% |
| Prime Health Services | $78 | 955% |
| Three Rivers Provider Network | $88 | 1077% |
| Cmh Detroit Wayne Integrated Health Network | $98 | 1200% |
| Cmh Lenawee County | $98 | 1200% |
| Cmh Livingston County | $98 | 1200% |
| Cmh Misc | $98 | 1200% |
| Cmh Monroe County | $98 | 1200% |
| Cmh Oakland County | $98 | 1200% |
| Cmh Washtenaw County | $98 | 1200% |