CMS Price Transparency Data

Blood test, liver function panel

Facility: Hermann Area District Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $67
Cash Discount Price: $69
vs. Medicare Baseline: 8.20x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Hermann Area District Hospital is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 8.20x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$69

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: $69 (845%)

Insurance Median: $67 (820%)

Cash: $69 (845% 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.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Coventry - All Plans	$9	110%
UnitedHealthcare	$12 - $49	147%
Tricare	$46	563%
Cigna	$47	575%
Choicecare Mcr Adv- All Plans	$49	600%
American Hlth Mcr Adv- All Plans	$51	624%
Blue Cross Blue Shield	$51 - $94	624%
Humana	$51	624%
Aetna	$52 - $110	636%
Wellcare Mcr Adv - All Plans	$52	636%
Harmony Hp Mcaid- All Plans	$67	820%
Healthcare Usa Mcaid- All Plans	$75	918%
Healthlink Hmo	$75	918%
Ambetter / Centene	$81	991%
Healthlink Ppo - All Other Plans	$87	1065%
Multiplan/Phcs - All Plans	$87	1065%
Comp Results - All Plans	$104	1273%
Three Rivers - All Plans	$104	1273%
Care Partners Mcaid- All Plans	$116	1420%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $69.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 80076.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hermann Area District Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 80076.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.