CMS Price Transparency Data

Blood test, liver function panel

Facility: Carolina East Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $52
Cash Discount Price: $77
vs. Medicare Baseline: 6.36x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Carolina East Medical Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 6.36x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $77 (942%)

Insurance Median: $52 (636%)

Cash: $77 (942% of Medicare)

Ins. Median: $52 (636% 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 636% of the Medicare baseline (a markup of 536%). 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
Humana	$8	98%
Inclusive Health (Nchirp)-All Plans	$8	98%
Tricare	$8 - $201	98%
Pamlico Co Jail-All Plans	$15 - $53	184%
Craven Co. Jail Systems - All Plans	$20 - $68	245%
UnitedHealthcare	$20 - $143	245%
Medcost Ppo Employees And Retirees	$37 - $132	453%
Medcost Ppo Ultra (Employees)	$37 - $126	453%
Blue Cross Blue Shield	$40 - $138	490%
Medcost Ppo City Employees	$42 - $146	514%
Medcost Ppo County Employee	$43 - $152	526%
Benefit Mgmt, Svcs-All Plans	$48 - $171	588%
Aetna	$50 - $178	612%
Medcost Benefit Svc-All Other Plans	$50 - $178	612%
Acs Consult Svc Inc-All Plans	$51 - $182	624%
Medcost Ppo Standard	$51 - $182	624%
Cigna	$52 - $183	636%

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 $77.
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 Carolina East Medical Center 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.