CMS Price Transparency Data

Blood test, liver function panel

Facility: Sanford Clear Lake Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $122
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 14.93x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Sanford Clear Lake Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 14.93x the Medicare baseline. Located in 701 Third Avenue South, Clear Lake, SD.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $118 (1444%)
Insurance Median: $122 (1493%)
Cash: $118 (1444% of Medicare)
Ins. Median: $122 (1493% 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 1493% of the Medicare baseline (a markup of 1393%). 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
Sanford Health Plan Align $76 930%
Security Health Plan $81 991%
Aetna $82 - $129 1004%
Health Partners $82 - $111 1004%
Medicare (plans) $82 1004%
Ucare $82 - $130 1004%
UnitedHealthcare $82 - $124 1004%
Wellmark Sd $82 1004%
Primewest $84 1028%
Sanford Health Plan $103 - $138 1261%
Blue Cross Blue Shield $121 - $137 1481%
Medica $122 - $131 1493%
Wellmark $127 - $129 1554%
Cigna $133 1628%
First Choice Health Network $133 1628%
Healthez $133 1628%
Multiplan $133 1628%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 Third Avenue South, Clear Lake, SD 57226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals