CMS Price Transparency Data

Blood test, liver function panel

Facility: Golden Valley Memorial Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $8
  • Cash Discount Price: $127
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Golden Valley Memorial Hospital is $8. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 0.98x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$127

Average discount available for prompt cash payment at this facility.

Insurance Median
$8

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: $127 (1554%)
Insurance Median: $8 (98%)
Cash: $127 (1554% of Medicare)
Ins. Median: $8 (98% 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.

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
Aetna $8 98%
Home State Health $8 98%
Humana $8 98%
UnitedHealthcare $8 - $14 98%
Ambetter / Centene $10 122%

Consumer Guidance & Cost Commentary

Golden Valley Memorial Hospital in Clinton, Missouri, offers a blood test, liver function panel with a cash median price of $127. This cash rate is significantly lower than the facility's gross charge of $211 and the state average of $127. While the hospital's negotiated rates with major insurers like Aetna, Home State Health, and Humana are set at $8, the UnitedHealthcare plan allows up to $14, and the Ambetter / Centene plan allows $10. These commercial rates are notably higher than the cash price, which may be beneficial for patients with high-deductible plans if their insurance negotiated rate exceeds the cash amount.

For patients seeking the lowest cost, it is important to note that the facility's cash price of $127 aligns with the state average, whereas the Medicare benchmark for this service is $8.17. Although the cash rate is higher than the Medicare amount, the negotiated rates of $8 to $14 are close to the Medicare benchmark, suggesting the facility is pricing competitively against federal standards. Patients should verify their specific plan's allowed amount before scheduling and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can provide additional savings by bypassing the administrative costs associated with insurance billing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals