CMS Price Transparency Data

Blood test, liver function panel

Facility: Lexington Memorial Hospital Inc

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $77
Cash Discount Price: $87
vs. Medicare Baseline: 9.42x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Lexington Memorial Hospital Inc is $77. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 9.42x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$87

Average discount available for prompt cash payment at this facility.

Insurance Median

$77

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: $87 (1065%)

Insurance Median: $77 (942%)

Cash: $87 (1065% of Medicare)

Ins. Median: $77 (942% 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 942% of the Medicare baseline (a markup of 842%). 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
Alliance	$15	184%
Amerihealth	$15 - $26	184%
Carolina Complete	$15	184%
Healthy Blue	$15	184%
Partners	$15	184%
Trillium	$15	184%
UnitedHealthcare	$15 - $78	184%
Vaya	$15	184%
Wellcare	$15	184%
Blue Cross Blue Shield	$25 - $41	306%
Ambetter / Centene	$27	330%
Medcost	$38 - $116	465%
Aetna	$49 - $161	600%
Oscar	$56 - $77	685%
Cigna	$76 - $77	930%
Directnet	$103	1261%
Healthgram Lexington Home Brands	$125	1530%
Healthgram	$139	1701%
Private Healthcare Systems	$143	1750%
Beechstreet	$153	1873%
Humana	$153	1873%
Multiplan	$157	1922%
National Provider Network	$157	1922%

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 $87.
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 Lexington Memorial Hospital Inc 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.