CMS Price Transparency Data

Blood test, liver function panel

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $11
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Prisma Health Oconee Memorial Hospital is $11. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 1.35x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$11

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: $102 (1248%)
Insurance Median: $11 (135%)
Cash: $102 (1248% of Medicare)
Ins. Median: $11 (135% 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
Golden Rule Insurance Company [2991] $7 86%
Oxford Health Plans [2992] $7 86%
Tricare $7 86%
UnitedHealthcare $7 - $10 86%
Zzumr-Salt Lake City Ut [3169] $7 86%
Blue Cross Blue Shield $8 - $67 98%
Champva [3049] $8 98%
Cigna $8 - $47 98%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $8 98%
Deseret Mutual Ins Co [3066] $8 98%
Generic Skilled Nursing [3196] $8 98%
Hospice Contracted [1500] $8 98%
Hospice Non Contracted [3190] $8 98%
Humana $8 - $11 98%
Medicare (plans) $8 - $11 98%
Triwest Healthcare Alliance Vcp [902] $8 98%
Va Community Care Network-Vaccn [903] $8 98%
Veterans Administration [3194] $8 98%
Aetna $9 - $124 110%
Healthy Conn Prime-First Choice Vip Care [5300] $9 110%
Healthy Conn Prime-Molina Healthcare [5330] $9 110%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $9 110%
Medicaid / KanCare $10 - $11 122%
First Choice Benefits Mgmt [3074] $11 135%
Workers Comp [600] $11 135%
Ambetter / Centene $15 184%
Bluechoice [810] $36 - $91 441%
Prisma Health Seniorcare Pace - Midlands [5400] $36 441%
Prisma Health Seniorcare Pace-Upstate [5200] $36 441%
Sc Dept Of Corrections [2998] $38 465%
Scdc-Sc Dept Of Corrections [7232] $38 465%
Evernorth Behavioral Contracted [2982] $47 575%
Mvp Health Care [3037] $47 575%
Promise Health Plan Contracted [2401] $55 - $94 673%
Orangeburg Senior Helping Center Pace [5401] $63 771%
Planned Administrators [820] $67 820%
Bob Jones Univ-Pai [821] $94 1151%
Meritain Health Contracted [2200] $100 - $124 1224%
Preferred Administrators Contracted [2839] $110 1346%
Medcost [2940] $116 - $130 1420%
Atlantic Packaging Contracted [4833] $118 1444%
Aps Healthcare System [2981] $126 1542%
Multiplan/Phcs Contracted [2950] $140 1714%
Vsp Vision Care [2986] $141 1726%
First Health Contracted [2952] $146 1787%
Furman Int/Allen University Student [2951] $146 1787%
Quiktrip-First Health [3067] $146 1787%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 298 Memorial Dr, Seneca, SC 29672
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals