CMS Price Transparency Data

Blood test, liver function panel

Facility: UPMC Hamot

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $46
Cash Discount Price: $321
vs. Medicare Baseline: 5.63x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at UPMC Hamot is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 5.63x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$321

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $321 (3929%)

Insurance Median: $46 (563%)

Cash: $321 (3929% of Medicare)

Ins. Median: $46 (563% 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 563% of the Medicare baseline (a markup of 463%). 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
Aetna	$8 - $374	98%
Fidelis	$8	98%
Independent Health	$8	98%
Upmc Health Plan	$8 - $27	98%
Upmc Work Partners	$8	98%
Wellcare	$8	98%
Amerihealth Caritas	$9 - $14	110%
Blue Cross Blue Shield	$9 - $105	110%
Cigna	$9 - $214	110%
Health Partners Plans (Jefferson Health Plan)	$9	110%
Highmark Wholecare (Prev Gateway)	$9 - $13	110%
Pa Health & Wellness	$9 - $15	110%
UnitedHealthcare	$9 - $11	110%
Geisinger	$13	159%
Univera	$80 - $235	979%
Intergroup	$348 - $428	4259%
Multiplan	$374 - $428	4578%

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 $321.
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 Hamot 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.