CMS Price Transparency Data

Blood test, liver function panel

Facility: Sanford Hillsboro

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $116
Cash Discount Price: $113
vs. Medicare Baseline: 14.20x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Sanford Hillsboro is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 14.20x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $113 (1383%)

Insurance Median: $116 (1420%)

Cash: $113 (1383% of Medicare)

Ins. Median: $116 (1420% 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 1420% of the Medicare baseline (a markup of 1320%). 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
Blue Cross Blue Shield	$34 - $130	416%
Sanford Health Plan Align	$64	783%
Ucare	$69 - $124	845%
Aetna	$70 - $123	857%
Health Partners	$70 - $110	857%
Medicare (plans)	$70	857%
UnitedHealthcare	$70 - $118	857%
Primewest	$71	869%
Security Health Plan	$78	955%
Sanford Health Plan	$111 - $131	1359%
Medica	$116 - $124	1420%
First Choice Health Network	$127	1554%
Healthez	$127	1554%
Multiplan	$127	1554%

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 $113.
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 Sanford Hillsboro 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.