CMS Price Transparency Data

Blood test, liver function panel

Facility: Essentia Health St Mary's Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $78
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 9.55x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Essentia Health St Mary's Medical Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 9.55x the Medicare baseline. Located in 402 East Second Street, Duluth, MN.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$78

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: $115 (1408%)
Insurance Median: $78 (955%)
Cash: $115 (1408% of Medicare)
Ins. Median: $78 (955% 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 955% of the Medicare baseline (a markup of 855%). 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
Advocare/Security Health $8 98%
Blue Cross Blue Shield $8 - $132 98%
Freedom Blue Ppo $8 98%
Healthpartners Care Msho / Mcr Adv $8 98%
Imcare Msho (Ref Req) $8 98%
Imcare Msho Pcc Prime $8 98%
Imcare Msho Ref Req $8 98%
Itasca Med Care $8 98%
Medica Advantage Solutions $8 98%
Medica Msho/Dual Solutions $8 98%
Medica Prime Solution Group $8 98%
Medicare (plans) $8 98%
Nd Va Administration $8 98%
Platinum Blue / Vantage Blue $8 98%
Primewest $8 98%
Primewest Msho $8 98%
Secure Blue Msho $8 98%
Ubh Cost Plan $8 98%
Ubh Msho $8 98%
Ucare Msho $8 98%
UnitedHealthcare $8 - $127 98%
Sanford Health Plan $26 - $79 318%
Medica Access $58 710%
Healthpartners Care Pmap $69 845%
Blue Plus Pmap Pcc Prime $77 - $87 942%
Medica $96 - $99 1175%
Medica Uplan $96 1175%
Healthpartners $104 - $124 1273%
Medica Choice $106 1297%
Ucare $114 1395%
Cigna $124 1518%
Healthpartners Pcc Prime $124 1518%
Wea $125 - $134 1530%
Security Health $134 1640%
America'S Ppo $135 1652%
Wps $144 - $146 1763%
Aetna $148 1812%
Healthscope Benefits $148 1812%
Healtheos $150 1836%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 East Second Street, Duluth, MN 55805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals