CMS Price Transparency Data
Blood test, liver function panel
Facility: Mercy Health Lakeshore Campus
Billing Code: 80076 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 80076
- Insurance Median: $74
- Cash Discount Price: $56
- vs. Medicare Baseline: 9.06x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Mercy Health Lakeshore Campus is $74. 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 9.06x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$56
Average discount available for prompt cash payment at this facility.
Insurance Median
$74
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: $74 (906%)
Cash: $56 (685% of Medicare)
Ins. Median: $74 (906% 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 906% of the Medicare baseline (a markup of 806%). 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 | $6 - $74 | 73% |
| Medicaid / KanCare | $6 | 73% |
| Blue Care Network Advantage | $8 | 98% |
| Medicare (plans) | $8 - $21 | 98% |
| U Of M Health Plan | $12 - $77 | 147% |
| Wellpath | $13 | 159% |
| Access Health | $15 | 184% |
| Aetna | $22 - $68 | 269% |
| Align Senior Care | $22 | 269% |
| Correctional Recovery | $22 | 269% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $24 | 294% |
| Oscar | $26 | 318% |
| Vitalcore | $29 | 355% |
| UnitedHealthcare | $30 - $77 | 367% |
| Molina Marketplace | $36 | 441% |
| Hospice Of Michigan | $47 | 575% |
| Nomi Health | $48 | 588% |
| Hap | $64 - $79 | 783% |
| Geha | $68 - $77 | 832% |
| Meritain | $68 | 832% |
| Wc Accident Fund | $68 | 832% |
| Wc Advantage | $68 | 832% |
| Wc Aig | $68 | 832% |
| Wc Allied | $68 | 832% |
| Wc Amerisure | $68 | 832% |
| Wc Amtrust | $68 | 832% |
| Wc Asu Risk Mgt | $68 | 832% |
| Wc Berkley Admin | $68 | 832% |
| Wc Broadspire | $68 | 832% |
| Wc Bunch & Associates | $68 | 832% |
| Wc Ccmsi | $68 | 832% |
| Wc Emc Insurance Company | $68 | 832% |
| Wc Esis | $68 | 832% |
| Wc Fcci | $68 | 832% |
| Wc Federated | $68 | 832% |
| Wc Gallagher Bassett | $68 | 832% |
| Wc Genex Care For Ohio | $68 | 832% |
| Wc Guard Insurance Company | $68 | 832% |
| Wc Hartford | $68 | 832% |
| Wc Liberty Mutual | $68 | 832% |
| Wc Meijers | $68 | 832% |
| Wc Michigan | $68 | 832% |
| Wc Mitchell Frankenmuth | $68 | 832% |
| Wc Pma | $68 | 832% |
| Wc Sedgwick | $68 | 832% |
| Wc Sentry | $68 | 832% |
| Wc Travelers | $68 | 832% |
| Wc Tristar | $68 | 832% |
| Wc Walmart | $68 | 832% |
| Wc Zurich | $68 | 832% |
| Asr Health Benefits | $72 | 881% |
| 1199 National Benefit Fund | $74 | 906% |
| Allied National Global Care | $74 | 906% |
| Asrm - Reliance Standard Life Insurance | $74 | 906% |
| Bcn Domestic | $74 | 906% |
| Blue Benefit Administrators Of Massachusetts | $74 | 906% |
| Blue Care Network | $74 | 906% |
| Blue Distinction Transplant | $74 | 906% |
| Blue Shield - Ca | $74 | 906% |
| Blue Shield - Id (Regence) | $74 | 906% |
| Blue Shield - Ny Highmark Northeastern | $74 | 906% |
| Blue Shield - Ny Highmark Western | $74 | 906% |
| Blue Shield - Pa (Highmark) | $74 | 906% |
| Blue Shield - Wa (Regence) | $74 | 906% |
| Christian Care Ministry | $74 | 906% |
| Dean Health | $74 | 906% |
| Fallon Health | $74 | 906% |
| Family Life Insurance Company | $74 | 906% |
| Ghc Scw | $74 | 906% |
| Group Pension Administrators | $74 | 906% |
| Health Choices | $74 - $77 | 906% |
| International Benefit Administrators | $74 | 906% |
| Kaiser Domestic | $74 | 906% |
| Lifetime Benefit Solutions | $74 | 906% |
| Manhattan Life | $74 | 906% |
| Medi Share | $74 | 906% |
| Multiplan | $74 | 906% |
| Mvp | $74 | 906% |
| Pai | $74 | 906% |
| Pan-American Life | $74 | 906% |
| Paramount Hmo | $74 | 906% |
| Phcs | $74 | 906% |
| Trinity Health Share | $74 | 906% |
| Cigna | $75 | 918% |
| Acclaim | $77 | 942% |
| Administrative Concepts | $77 | 942% |
| Allegeant | $77 | 942% |
| Allied Benefit Systems | $77 | 942% |
| Ameriben | $77 | 942% |
| American Family | $77 | 942% |
| American Healthcare Alliance | $77 | 942% |
| American Republic | $77 | 942% |
| Amerihealth | $77 | 942% |
| Aultcare | $77 | 942% |
| Automated Benefit Services | $77 | 942% |
| Auxiant | $77 | 942% |
| Benefit Administrative Systems,Llc | $77 | 942% |
| Boon Chapman | $77 | 942% |
| Cam Administrative Services | $77 | 942% |
| Caresource | $77 | 942% |
| Christian Brother Services | $77 | 942% |
| Christian Brothers Holy Cross | $77 | 942% |
| Claimchoice Adminstrators | $77 | 942% |
| Comprehensive Benefits | $77 | 942% |
| Consociate | $77 | 942% |
| Continental Life Insurance | $77 | 942% |
| Custom Benefit Administrators | $77 | 942% |
| Cypress Benefit Administrators | $77 | 942% |
| Employee Benefit Concepts | $77 | 942% |
| Employee Benefit Management | $77 | 942% |
| Enterprise Group Planning | $77 | 942% |
| Forest County Potawatomi | $77 | 942% |
| Freedom Life Insurance Company | $77 | 942% |
| Group Administrators | $77 | 942% |
| Group Marketing Services | $77 | 942% |
| Guardian | $77 | 942% |
| Health America | $77 | 942% |
| Health Smart | $77 | 942% |
| Healthez | $77 | 942% |
| Healthgram | $77 | 942% |
| Healthscope | $77 | 942% |
| Humana | $77 | 942% |
| Insight | $77 | 942% |
| Intercare | $77 | 942% |
| Jfp Benefit Management | $77 | 942% |
| Jp Farley Corporation | $77 | 942% |
| Key Benefit Administrator | $77 | 942% |
| Liberty Union Life Assurance Co | $77 | 942% |
| Lucent Health | $77 | 942% |
| Luminare Health | $77 | 942% |
| Luminare Health (Detroit) | $77 | 942% |
| Medben | $77 | 942% |
| Medcost | $77 | 942% |
| Medical Mutual | $77 | 942% |
| Mutual Health Services | $77 | 942% |
| Mutual Of Omaha | $77 | 942% |
| Ncas | $77 | 942% |
| Nippon Life Ins | $77 | 942% |
| Nova | $77 | 942% |
| Painters Union Insurance Fund | $77 | 942% |
| Physicians Mutual | $77 | 942% |
| Plumbers Local 98 Insurance Fund | $77 | 942% |
| Prairie States | $77 | 942% |
| Primary Physician Care | $77 | 942% |
| Professional Benefit Administrators | $77 | 942% |
| Secureone Preferred United Plans | $77 | 942% |
| The Loomis Company | $77 | 942% |
| Trustmark Small Business Benefits | $77 | 942% |
| Unicare | $77 | 942% |
| Unified Group Services | $77 | 942% |
| Us Health And Life | $77 | 942% |
| Valenz | $77 | 942% |
| Varipro | $77 - $79 | 942% |
| Western & Southern Financial Group | $77 | 942% |
| Wps | $77 | 942% |
| First Health | $78 | 955% |
| Priority Health | $78 | 955% |