CMS Price Transparency Data

Blood test, liver function panel

Facility: Capital Health Medical Center - Hopewell

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $30
  • Cash Discount Price: $481
  • vs. Medicare Baseline: 3.67x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Capital Health Medical Center - Hopewell is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $481. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 3.67x the Medicare baseline. Located in One Capital Way, Pennington, NJ.
Cash / Self-Pay
$481

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $481 (5887%)
Insurance Median: $30 (367%)
Cash: $481 (5887% of Medicare)
Ins. Median: $30 (367% 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 367% of the Medicare baseline (a markup of 267%). 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
Medicaid / KanCare $2 - $39 24%
Wellpoint $2 - $39 24%
Aetna $3 - $324 37%
Blue Cross Blue Shield $5 - $109 61%
Horizon Nj Health $7 86%
UnitedHealthcare $7 - $8 86%
Clover $8 98%
Humana $8 98%
Medicare (plans) $8 98%
Oxford Benefit Plan $8 98%
Fidelis $13 159%
Cigna $30 - $686 367%
Multiplan $41 - $777 502%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Capital Way, Pennington, NJ 08534
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals