CMS Price Transparency Data

Blood test, liver function panel

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $12
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Hospital Pavia Hato Rey, Inc is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 1.47x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$12

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: $70 (857%)
Insurance Median: $12 (147%)
Cash: $70 (857% of Medicare)
Ins. Median: $12 (147% 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.

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
Mso $7 - $8 86%
First Medical $8 - $16 98%
Medicare (plans) $8 98%
Plan De Salud Menonita $8 - $13 98%
Tricare $9 110%
Triple S $9 - $12 110%
Va $9 110%
Fondo Del Seguro Estado $10 122%
Humana $10 - $17 122%
Ch $11 135%
Mcs $11 - $13 135%
Aarp $12 147%
Acaa $12 147%
Bl $13 159%
Auxilio Salud Plus $14 171%
Mc $14 171%
Prossam $15 184%
Privado $20 245%
Bella Vista $24 294%
Cigna $28 343%
Mapfre $35 428%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Ave Ponce De Leon 435, Hato Rey, PR 00919
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals