CMS Price Transparency Data

Blood test, liver function panel

Facility: Children's Hospital of Philadelphia

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $156
Cash Discount Price: $396
vs. Medicare Baseline: 19.09x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Children's Hospital of Philadelphia is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $396. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 19.09x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$396

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $396 (4847%)

Insurance Median: $156 (1909%)

Cash: $396 (4847% of Medicare)

Ins. Median: $156 (1909% 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 1909% of the Medicare baseline (a markup of 1809%). 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
Geisinger Medical Assistance	$12	147%
Highmark Wholecare	$14	171%
Horizon Nj Health	$25	306%
Medicaid / KanCare	$52 - $79	636%
UnitedHealthcare	$52 - $264	636%
Health Partners	$59 - $90	722%
Aetna	$74 - $240	906%
Upmc Medical Assistance	$85 - $131	1040%
Keystone First Chip	$97 - $149	1187%
Keystone Health Plan East	$99 - $152	1212%
Blue Cross Blue Shield	$110 - $192	1346%
Geisinger Health Plan Commercial	$137 - $211	1677%
Jefferson Health Plans	$148 - $227	1812%
Cigna	$156 - $240	1909%
Highmark	$156 - $240	1909%
Qualcare	$172 - $264	2105%
First Health Network	$203 - $312	2485%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$250 - $384	3060%
Private Health Care Systems	$250 - $384	3060%
Choice Care Network	$281 - $432	3439%

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 $396.
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 Children's Hospital of Philadelphia 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.