CMS Price Transparency Data

Blood test, liver function panel

Facility: Penn Presbyterian Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $97
  • Cash Discount Price: $277
  • vs. Medicare Baseline: 11.87x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Penn Presbyterian Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $277. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 11.87x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$277

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $277 (3390%)
Insurance Median: $97 (1187%)
Cash: $277 (3390% of Medicare)
Ins. Median: $97 (1187% 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 1187% of the Medicare baseline (a markup of 1087%). 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
Cigna $5 - $88 61%
Blue Cross Blue Shield $8 - $277 98%
Geisinger Health Plan $8 - $26 98%
Health Partners $8 - $277 98%
Humana $8 - $222 98%
Ibc $8 98%
Medicare (plans) $8 98%
Philadelphia Va Medical Center $8 98%
Upmc $8 - $277 98%
Aetna $9 - $277 110%
Clover Health Plan $9 110%
Keystone First $9 110%
Medicaid / KanCare $9 - $277 110%
Pa Health And Wellness $9 - $13 110%
Pa Medical Assistance $9 110%
Penn Life (Living Independently For Elders) $9 110%
Tricare $9 110%
UnitedHealthcare $9 - $277 110%
Us Family Health Plan $9 110%
Gateway Health Plan $10 122%
Elap $12 147%
Keystone Mercy Health Plan $12 - $277 147%
Claims Watcher $13 - $15 159%
Ibc Commercial Hpn $13 159%
Keystone Hmo Proactive $13 159%
Oscar Health Plan $14 171%
Centivo $15 184%
Elap Services $15 184%
Highmark $17 208%
Penn Global Medicine $22 269%
Horizon Nj Health $47 - $49 575%
Pgm - Regie De L'Assurance Maladie Quebec $64 783%
Preferred Health Care Eliance $69 845%
Pgm - Kuwait Defense $97 - $125 1187%
Devon $105 - $125 1285%
Qualcare $105 1285%
Coventry $111 - $141 1359%
Pgm - Chop $111 1359%
Wissahickon Hospice $111 1359%
Healthamerica/Coventry $125 - $136 1530%
Olympus $131 1603%
First Health Global $138 1689%
Urn-Cancer Resource Services $138 1689%
Health Net $166 2032%
Pgm - Royal Embassy Of Saudi Arabia $166 2032%
Pgm - Embassy Of Qatar $180 2203%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $180 2203%
Pgm - Embassy Of The United Emirates/Ipc $194 2375%
Devon Health Services Inc $222 2717%
Health America/Ccn $222 2717%
Intergroup $222 2717%
Pgm - Kuwait Health Division $222 2717%
Pgm - Kuwait Oil $222 2717%
Preferred Care $222 2717%
Commercial Other $277 3390%
International Pfs $277 3390%
Magellan $277 3390%
Quest Behavioral Health $277 3390%
United Behavioral Health $277 3390%
Workers Compensation $277 3390%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals