CMS Price Transparency Data

Blood test, liver function panel

Facility: North Carolina Baptist Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $55
Cash Discount Price: $83
vs. Medicare Baseline: 6.73x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at North Carolina Baptist Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.73x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

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: $83 (1016%)

Insurance Median: $55 (673%)

Cash: $83 (1016% of Medicare)

Ins. Median: $55 (673% 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 673% of the Medicare baseline (a markup of 573%). 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
Aetna	$8 - $144	98%
Apex	$8	98%
Blue Cross Blue Shield	$8 - $63	98%
Cigna	$8 - $102	98%
Devoted	$8	98%
Healthteam	$8	98%
Humana	$8 - $93	98%
Medicare (plans)	$8	98%
UnitedHealthcare	$8 - $59	98%
Wellcare	$8 - $15	98%
Liberty	$9	110%
Alliance	$15	184%
Amerihealth	$15 - $40	184%
Carolina Complete	$15	184%
Health Blue	$15	184%
Partners	$15	184%
Trillium	$15	184%
Vaya	$15	184%
Medcost	$18 - $113	220%
Ambetter / Centene	$36 - $38	441%
Oscar	$48 - $61	588%
Directnet	$95 - $100	1163%
Cone Health	$113 - $119	1383%
Healthgram	$113 - $119	1383%
First Carolina Care	$129 - $136	1579%
Private Healthcare Systems	$132 - $139	1616%
Multiplan	$145 - $153	1775%

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 $83.
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 North Carolina Baptist 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.