CMS Price Transparency Data
Blood test, liver function panel
Facility: Trinity Health Muskegon Hospital
Billing Code: 80076 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80076
- Insurance Median: $65
- Cash Discount Price: $56
- vs. Medicare Baseline: 7.96x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Trinity Health Muskegon Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 7.96x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$56
Average discount available for prompt cash payment at this facility.
Insurance Median
$65
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: $56 (685%)
Insurance Median: $65 (796%)
Cash: $56 (685% of Medicare)
Ins. Median: $65 (796% 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 796% of the Medicare baseline (a markup of 696%). 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 | $4 - $13 | 49% |
| Medicaid / KanCare | $4 - $5 | 49% |
| Access Health | $6 | 73% |
| Aetna | $8 - $36 | 98% |
| Align Senior Care | $8 | 98% |
| Blue Care Network Advantage | $8 | 98% |
| Correctional Recovery | $8 | 98% |
| Heartland Hospice | $8 | 98% |
| Hospice Harbor Hospice | $8 | 98% |
| Medicare (plans) | $8 | 98% |
| Oscar | $8 | 98% |
| UnitedHealthcare | $8 - $76 | 98% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $9 | 110% |
| Molina Marketplace | $11 | 135% |
| Geha | $12 - $76 | 147% |
| Meritain | $12 | 147% |
| U Of M Health Plan | $12 - $68 | 147% |
| Bcn Domestic | $13 | 159% |
| Blue Benefit Administrators Of Massachusetts | $13 | 159% |
| Blue Care Network | $13 | 159% |
| Blue Distinction Transplant | $13 | 159% |
| Blue Shield - Ca | $13 | 159% |
| Blue Shield - Id (Regence) | $13 | 159% |
| Blue Shield - Ny Highmark Northeastern | $13 | 159% |
| Blue Shield - Ny Highmark Western | $13 | 159% |
| Blue Shield - Pa (Highmark) | $13 | 159% |
| Blue Shield - Wa (Regence) | $13 | 159% |
| Health Choices | $13 - $68 | 159% |
| Kaiser Domestic | $13 | 159% |
| Vitalcore | $13 | 159% |
| Wellpath | $13 | 159% |
| Acs Benefit Services | $45 | 551% |
| Allied Benefit Systems | $45 | 551% |
| Claimchoice Adminstrators | $45 | 551% |
| Consociate | $45 | 551% |
| Cypress Benefit Administrators | $45 | 551% |
| Forest County Potawatomi | $45 | 551% |
| Health Smart | $45 | 551% |
| Healthgram | $45 | 551% |
| Healthscope | $45 | 551% |
| Preferred One | $45 | 551% |
| Secureone Preferred United Plans | $45 | 551% |
| Sisco Benefits | $45 | 551% |
| The Health Plan | $45 | 551% |
| Trustmark Small Business Benefits | $45 | 551% |
| Unified Group Services | $45 | 551% |
| Webtpa | $45 | 551% |
| Asr Health Benefits | $46 | 563% |
| Hap | $46 - $68 | 563% |
| Wc Accident Fund | $46 | 563% |
| Wc Advantage | $46 | 563% |
| Wc Aig | $46 | 563% |
| Wc Allied | $46 | 563% |
| Wc Amerisure | $46 | 563% |
| Wc Amtrust | $46 | 563% |
| Wc Asu Risk Mgt | $46 | 563% |
| Wc Berkley Admin | $46 | 563% |
| Wc Broadspire | $46 | 563% |
| Wc Bunch & Associates | $46 | 563% |
| Wc Ccmsi | $46 | 563% |
| Wc Emc Insurance Company | $46 | 563% |
| Wc Esis | $46 | 563% |
| Wc Fcci | $46 | 563% |
| Wc Federated | $46 | 563% |
| Wc Gallagher Bassett | $46 | 563% |
| Wc Genex Care For Ohio | $46 | 563% |
| Wc Guard Insurance Company | $46 | 563% |
| Wc Hartford | $46 | 563% |
| Wc Liberty Mutual | $46 | 563% |
| Wc Meijers | $46 | 563% |
| Wc Michigan | $46 | 563% |
| Wc Mitchell Frankenmuth | $46 | 563% |
| Wc Pma | $46 | 563% |
| Wc Sedgwick | $46 | 563% |
| Wc Sentry | $46 | 563% |
| Wc Travelers | $46 | 563% |
| Wc Tristar | $46 | 563% |
| Wc Walmart | $46 | 563% |
| Wc Zurich | $46 | 563% |
| Hospice Of Michigan | $47 | 575% |
| Nomi Health | $48 | 588% |
| Varipro | $50 | 612% |
| Caresource | $54 | 661% |
| Cigna | $54 | 661% |
| Priority Health | $62 - $70 | 759% |
| 1199 National Benefit Fund | $64 | 783% |
| Allied National Global Care | $64 | 783% |
| Asrm - Reliance Standard Life Insurance | $64 | 783% |
| Christian Care Ministry | $64 | 783% |
| Dean Health | $64 | 783% |
| Fallon Health | $64 | 783% |
| Family Life Insurance Company | $64 | 783% |
| Ghc Scw | $64 | 783% |
| Group Pension Administrators | $64 | 783% |
| International Benefit Administrators | $64 | 783% |
| Lifetime Benefit Solutions | $64 | 783% |
| Manhattan Life | $64 | 783% |
| Medi Share | $64 | 783% |
| Multiplan | $64 | 783% |
| Mvp | $64 | 783% |
| Pai | $64 | 783% |
| Pan-American Life | $64 | 783% |
| Paramount Hmo | $64 | 783% |
| Phcs | $64 | 783% |
| Trinity Health Share | $64 | 783% |
| Acclaim | $68 | 832% |
| Administrative Concepts | $68 | 832% |
| Allegeant | $68 | 832% |
| Ameriben | $68 | 832% |
| American Family | $68 | 832% |
| American Healthcare Alliance | $68 | 832% |
| American Republic | $68 | 832% |
| Amerihealth | $68 | 832% |
| Aultcare | $68 | 832% |
| Automated Benefit Services | $68 | 832% |
| Auxiant | $68 | 832% |
| Benefit Administrative Systems,Llc | $68 | 832% |
| Boon Chapman | $68 | 832% |
| Cam Administrative Services | $68 | 832% |
| Christian Brother Services | $68 | 832% |
| Christian Brothers Holy Cross | $68 | 832% |
| Comprehensive Benefits | $68 | 832% |
| Continental Life Insurance | $68 | 832% |
| Custom Benefit Administrators | $68 | 832% |
| Employee Benefit Concepts | $68 | 832% |
| Employee Benefit Management | $68 | 832% |
| Enterprise Group Planning | $68 | 832% |
| Freedom Life Insurance Company | $68 | 832% |
| Group Administrators | $68 | 832% |
| Group Marketing Services | $68 | 832% |
| Guardian | $68 | 832% |
| Health America | $68 | 832% |
| Healthez | $68 | 832% |
| Humana | $68 | 832% |
| Insight | $68 | 832% |
| Intercare | $68 | 832% |
| Jfp Benefit Management | $68 | 832% |
| Jp Farley Corporation | $68 | 832% |
| Key Benefit Administrator | $68 | 832% |
| Liberty Union Life Assurance Co | $68 | 832% |
| Lucent Health | $68 | 832% |
| Luminare Health | $68 | 832% |
| Luminare Health (Detroit) | $68 | 832% |
| Medben | $68 | 832% |
| Medcost | $68 | 832% |
| Medical Mutual | $68 | 832% |
| Mutual Health Services | $68 | 832% |
| Mutual Of Omaha | $68 | 832% |
| Ncas | $68 | 832% |
| Nippon Life Ins | $68 | 832% |
| Nova | $68 | 832% |
| Painters Union Insurance Fund | $68 | 832% |
| Physicians Mutual | $68 | 832% |
| Plumbers Local 98 Insurance Fund | $68 | 832% |
| Prairie States | $68 | 832% |
| Primary Physician Care | $68 | 832% |
| Professional Benefit Administrators | $68 | 832% |
| The Loomis Company | $68 | 832% |
| Unicare | $68 | 832% |
| Us Health And Life | $68 | 832% |
| Valenz | $68 | 832% |
| Western & Southern Financial Group | $68 | 832% |
| Wps | $68 | 832% |
| First Health | $71 | 869% |
| Barinet | $86 | 1053% |
| Cmh Allegan County | $86 | 1053% |
| Cmh Barry County | $86 | 1053% |
| Cmh Berrien County | $86 | 1053% |
| Cmh Cass County | $86 | 1053% |
| Cmh Kalamazoo | $86 | 1053% |
| Cmh Kent County | $86 | 1053% |
| Cmh Misc | $86 | 1053% |
| Cmh Muskegon County | $86 | 1053% |
| Cmh North Country | $86 | 1053% |
| Cmh Northern Lakes County | $86 | 1053% |
| Cmh Ottawa County | $86 | 1053% |
| Cmh Van Buren County | $86 | 1053% |
| Cmh West Mi County | $86 | 1053% |