CMS Price Transparency Data

Blood test, liver function panel

Facility: Pennsylvania Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $142
  • Cash Discount Price: $412
  • vs. Medicare Baseline: 17.38x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Pennsylvania Hospital is $142. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $412. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 17.38x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$412

Average discount available for prompt cash payment at this facility.

Insurance Median
$142

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: $412 (5043%)
Insurance Median: $142 (1738%)
Cash: $412 (5043% of Medicare)
Ins. Median: $142 (1738% 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 1738% of the Medicare baseline (a markup of 1638%). 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 - $140 61%
Blue Cross Blue Shield $8 - $412 98%
Geisinger Health Plan $8 - $26 98%
Health Partners $8 - $412 98%
Humana $8 - $330 98%
Ibc $8 98%
Medicare (plans) $8 98%
Philadelphia Va Medical Center $8 98%
Upmc $8 - $412 98%
Aetna $9 - $412 110%
Clover Health Plan $9 110%
Gateway Health Plan $9 - $10 110%
Keystone First $9 110%
Medicaid / KanCare $9 - $412 110%
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 - $412 110%
Us Family Health Plan $9 110%
Elap $12 147%
Keystone Mercy Health Plan $12 147%
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 $70 - $72 857%
Pgm - Regie De L'Assurance Maladie Quebec $95 1163%
Preferred Health Care Eliance $107 1310%
Pgm - Kuwait Defense $144 - $185 1763%
Devon $157 - $185 1922%
Qualcare $157 1922%
Coventry $165 - $210 2020%
Pgm - Chop $165 2020%
Wissahickon Hospice $165 2020%
Healthamerica/Coventry $185 - $202 2264%
Olympus $200 2448%
First Health Global $206 2521%
Urn-Cancer Resource Services $206 2521%
Health Net $247 3023%
Pgm - Royal Embassy Of Saudi Arabia $247 3023%
Pgm - Embassy Of Qatar $268 3280%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $268 3280%
Pgm - Embassy Of The United Emirates/Ipc $288 3525%
Devon Health Services Inc $330 4039%
Health America/Ccn $330 4039%
Intergroup $330 4039%
Pgm - Kuwait Health Division $330 4039%
Pgm - Kuwait Oil $330 4039%
Preferred Care $330 4039%
Commercial Other $412 5043%
Community Behavioral Health $412 5043%
International Pfs $412 5043%
Quest Behavioral Health $412 5043%
United Behavioral Health $412 5043%
Workers Compensation $412 5043%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals