CMS Price Transparency Data

Blood test, liver function panel

Facility: UPMC Carlisle

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $35
Cash Discount Price: $54
vs. Medicare Baseline: 4.28x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at UPMC Carlisle is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 4.28x the Medicare baseline. Located in 361 Alexander Spring Road, Carlisle, PA.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $54 (661%)

Insurance Median: $35 (428%)

Cash: $54 (661% of Medicare)

Ins. Median: $35 (428% 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 428% of the Medicare baseline (a markup of 328%). 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	$8 - $49	98%
Humana	$8	98%
Upmc Work Partners	$8	98%
Aetna	$9 - $44	110%
Amerihealth Caritas	$9	110%
Cigna	$9 - $21	110%
Geisinger	$9 - $65	110%
Pa Health & Wellness	$9 - $15	110%
UnitedHealthcare	$9 - $71	110%
Highmark Wholecare (Prev Gateway)	$11	135%
Health Partners Plans (Jefferson Health Plan)	$12	147%
Prime Net	$12 - $68	147%
Upmc Health Plan	$12 - $63	147%
Keystone Autism Services	$13	159%
Keystone Health Plan	$18 - $49	220%
Wellspan Population Health	$58 - $72	710%
Multiplan	$76	930%

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 $54.
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 UPMC Carlisle 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.