CMS Price Transparency Data

Blood test, liver function panel

Facility: Montefiore Mount Vernon Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $9
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Montefiore Mount Vernon Hospital is $9. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 1.10x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$9

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: $68 (832%)
Insurance Median: $9 (110%)
Cash: $68 (832% of Medicare)
Ins. Median: $9 (110% 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.

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
Wellcare $5 - $7 61%
Blue Cross Blue Shield $7 - $83 86%
Emblem $7 - $83 86%
Fidelis $7 - $13 86%
Healthfirst $7 - $12 86%
Medicaid / KanCare $7 86%
Point Comfort $7 86%
UnitedHealthcare $7 - $16 86%
Villagecaremax $7 86%
Vnsny Choice $7 - $8 86%
Amidacare $8 98%
Centerlight $8 98%
Humana $8 98%
Longevity $8 98%
Vnsny Select Health $8 98%
Metroplus $10 122%
Oscar $10 122%
Mvp $15 184%
American Postal Workers $16 196%
Aetna $36 - $41 441%
Cigna $62 - $69 759%
Centivo $66 808%
Elderplan $83 1016%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12 North 7Th Avenue, Mount Vernon, NY 10550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals