CMS Price Transparency Data

Blood test, liver function panel

Facility: Nationwide Children's Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $162
Cash Discount Price: $256
vs. Medicare Baseline: 19.83x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Nationwide Children's Hospital is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 19.83x the Medicare baseline. Located in 700 Children's Drive, Columbus, OH.

Cash / Self-Pay

$256

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $256 (3133%)

Insurance Median: $162 (1983%)

Cash: $256 (3133% of Medicare)

Ins. Median: $162 (1983% 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 1983% of the Medicare baseline (a markup of 1883%). 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	$29 - $374	355%
Amerihealth	$30	367%
Bchp	$30	367%
Caresource	$30 - $187	367%
Humana	$30 - $378	367%
Molina	$30	367%
UnitedHealthcare	$30 - $378	367%
Mmo	$146 - $342	1787%
Aetna	$153 - $378	1873%
Ohg	$153 - $358	1873%
Ohio Ppo Connect	$155 - $370	1897%
Osu	$155 - $370	1897%
Ohc	$158 - $370	1934%
Ahpo	$160 - $374	1958%
Cigna	$160 - $374	1958%
Front Path Health Coalition	$160 - $374	1958%
Unicare	$162 - $378	1983%
The Health Plan	$163 - $382	1995%
Emerald Health	$167 - $390	2044%
First Health	$167 - $390	2044%
Phcs	$167 - $390	2044%

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 $256.
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 Nationwide Children's Hospital 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.