CMS Price Transparency Data

Blood test, liver function panel

Facility: Southwest General Health Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $64
Cash Discount Price: $94
vs. Medicare Baseline: 7.83x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Southwest General Health Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 7.83x the Medicare baseline. Located in 18697 Bagley Road, Middleburg Heights, OH.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $94 (1151%)

Insurance Median: $64 (783%)

Cash: $94 (1151% of Medicare)

Ins. Median: $64 (783% 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 783% of the Medicare baseline (a markup of 683%). 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
Medical Mutual	$4	49%
Medical Mutual-Ohio	$4	49%
Buckeye	$11 - $64	135%
Molina	$11 - $64	135%
Cigna	$19	233%
Healthsmart	$40	490%
Health Design Plus	$46	563%
Humana	$49 - $64	600%
Clarity Health	$50	612%
Healthspan	$50	612%
Healthsmart Preferred	$56	685%
Ohio Health Choice Plus	$60	734%
Amerihealth Caritas	$64	783%
Blue Cross Blue Shield	$64	783%
Caresource	$64	783%
UnitedHealthcare	$64 - $68	783%
Aetna	$68	832%
Summacare	$68	832%
Coventry	$86	1053%
First Health	$86	1053%
Ohio Health Choice	$97	1187%
Private Healthare Systems	$100	1224%

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 $94.
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 Southwest General Health 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.