CMS Price Transparency Data

Blood test, liver function panel

Facility: St Mary Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $20
  • Cash Discount Price: $144
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at St Mary Medical Center is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 2.45x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$144

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

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: $144 (1763%)
Insurance Median: $20 (245%)
Cash: $144 (1763% of Medicare)
Ins. Median: $20 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Align Senior Care $8 98%
Blue Cross Blue Shield $8 - $99 98%
Cigna $8 - $44 98%
Medicare (plans) $8 - $15 98%
Aetna $9 - $198 110%
Health America Advantra $10 122%
Medicaid / KanCare $10 - $22 122%
Ambetter / Centene $15 184%
Jefferson Health Plan Commercial $15 184%
Oscar $15 184%
Prime Healthcare $15 184%
UnitedHealthcare $15 - $107 184%
Homestead Health Plans Woods Center $16 196%
Group Pension Administrators $18 220%
Reedman Toll $18 220%
Blue Shield - Pa (Highmark) $22 269%
Keystone First $22 269%
Keystone First Chip $22 269%
Pace-Trinity Health $22 269%
Amerihealth $38 465%
Blue Shield - Ca $38 465%
Blue Shield - Id (Regence) $38 465%
Blue Shield - Ny Highmark Western $38 465%
Blue Shield - Wa (Regence) $38 465%
Upmc Health Plan $44 539%
Webtpa $44 539%
Geha $91 1114%
Meritain $198 2424%
Multiplan $200 2448%
Prime Health Services $200 2448%
Galaxy Health Network $211 2583%
Three Rivers Provider Network $211 2583%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals