CMS Price Transparency Data

Blood test, liver function panel

Facility: Adena Fayette Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $22
Cash Discount Price: $17
vs. Medicare Baseline: 2.69x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Adena Fayette Medical Center is $22. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 2.69x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$17

Average discount available for prompt cash payment at this facility.

Insurance Median

$22

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: $17 (208%)

Insurance Median: $22 (269%)

Cash: $17 (208% of Medicare)

Ins. Median: $22 (269% 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 269% of the Medicare baseline (a markup of 169%). 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	$3 - $23	37%
Aetna	$14 - $59	171%
Buckeye Community Health Plan	$14	171%
Care Source	$14	171%
Humana	$14	171%
Medical Mutual Of Ohio	$14 - $26	171%
Medigold	$14	171%
Molina	$14	171%
Molina Marketplace	$16	196%
United Medical Resources Ohcp	$22	269%
UnitedHealthcare	$22	269%
Cigna	$24	294%
Ohio Ppo Connect	$24	294%
The Health Plan	$24	294%
Care Source Just4Me	$26	318%
Medical Mutual Of Ohio Supermed	$26	318%
First Health	$27 - $59	330%
Ohio Health Choice	$28	343%
Multiplan/Private Healthcare Systems	$33	404%
Sidecar Health	$39	477%

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 $17.
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 Adena Fayette 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.