CMS Price Transparency Data

Blood test, liver function panel

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $367
Cash Discount Price: $469
vs. Medicare Baseline: 44.92x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at UPMC Children's Hospital of Pittsburgh is $367. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $469. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 44.92x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$469

Average discount available for prompt cash payment at this facility.

Insurance Median

$367

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: $469 (5741%)

Insurance Median: $367 (4492%)

Cash: $469 (5741% of Medicare)

Ins. Median: $367 (4492% 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 4492% of the Medicare baseline (a markup of 4392%). 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	$7 - $430	86%
Health Plan Of Upper Ohio Valley	$8 - $508	98%
Amerihealth Caritas	$9 - $34	110%
Blue Cross Blue Shield	$9 - $93	110%
Cigna	$9 - $430	110%
Upmc Health Plan	$21 - $68	257%
Health Partners Plans (Jefferson Health Plan)	$35	428%
Highmark Wholecare (Prev Gateway)	$36	441%
UnitedHealthcare	$36 - $367	441%
Geisinger	$37 - $351	453%
Pa Health & Wellness	$37	453%
Intergroup	$508 - $664	6218%
Coventry/First Health	$625	7650%
Saudi Armed Forces	$625	7650%
Health Payors Organization	$664	8127%
Multiplan	$664	8127%
National Provider Network	$703	8605%
Private Health Care Systems	$703	8605%

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 $469.
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 Children's Hospital of Pittsburgh 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.