CMS Price Transparency Data

Blood test, liver function panel

Facility: Wilkes Regional Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $51
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 6.24x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Wilkes Regional Medical Center is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.24x the Medicare baseline. Located in 1370 West D St, North Wilkesboro, NC.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $50 (612%)
Insurance Median: $51 (624%)
Cash: $50 (612% of Medicare)
Ins. Median: $51 (624% 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 624% of the Medicare baseline (a markup of 524%). 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
Healthteam $8 98%
Alliance $15 184%
Amerihealth $15 - $58 184%
Carolina Complete $15 184%
Healthblue $15 184%
Partners $15 184%
Trillium $15 184%
UnitedHealthcare $15 - $53 184%
Vaya $15 184%
Wellcare $15 184%
Medcost $29 - $71 355%
Aetna $38 - $69 465%
Blue Cross Blue Shield $39 - $58 477%
Ambetter / Centene $47 - $61 575%
Cigna $52 - $54 636%
Oscar $55 - $65 673%
Directnet $59 722%
Private Healthcare Systems $90 1102%
Multiplan $92 1126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1370 West D St, North Wilkesboro, NC 28659
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals