CMS Price Transparency Data

Blood test, liver function panel

Facility: Adena Pike Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $26
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 3.18x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Adena Pike Medical Center is $26. 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 3.18x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$26

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: $26 (318%)
Cash: $17 (208% of Medicare)
Ins. Median: $26 (318% 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 318% of the Medicare baseline (a markup of 218%). 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
Aetna $8 - $59 98%
Blue Cross Blue Shield $8 - $30 98%
Buckeye Community Health Plan $8 98%
Care Source $8 98%
Humana $8 - $33 98%
Medical Mutual Of Ohio $8 - $22 98%
Medigold $8 98%
Molina $8 98%
Gateway Health $11 135%
Molina Marketplace $14 171%
Care Source Just4Me $15 184%
Sidecar Health $23 282%
Ohio Ppo Connect $24 294%
The Health Plan $24 294%
Cigna $25 306%
Medical Mutual Of Ohio Supermed $26 318%
First Health $27 - $59 330%
Ohio Health Choice $28 343%
Healthsmart $33 404%
Integrated Health Plan $33 404%
Multiplan/Private Healthcare Systems $33 404%
Three Rivers Network $33 404%
UnitedHealthcare $80 979%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals