CMS Price Transparency Data

Blood test, liver function panel

Facility: Baylor Scott & White Medical Center Pflugerville

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 80076
Insurance Median: $91
Cash Discount Price: $150
vs. Medicare Baseline: 11.14x Medicare

The contracted insurance negotiated median rate for a Blood test, liver function panel at Baylor Scott & White Medical Center Pflugerville is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 11.14x the Medicare baseline. Located in 2600 East Pflugerville Parkway, Pflugerville, TX.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $150 (1836%)

Insurance Median: $91 (1114%)

Cash: $150 (1836% of Medicare)

Ins. Median: $91 (1114% 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 1114% of the Medicare baseline (a markup of 1014%). 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
Baylor Scott & White Health Plan	$8 - $107	98%
Humana	$8 - $175	98%
Superior Health Plan	$8 - $45	98%
Triwest	$8	98%
American Health Plan	$9	110%
Corvel	$9	110%
Healthspring	$9	110%
Prime Health Services	$9	110%
Procare Advantage	$9	110%
UnitedHealthcare	$9 - $11	110%
Sedgwick	$12	147%
Blue Cross Blue Shield	$40 - $48	490%
Cigna	$119 - $138	1457%
Aetna	$137	1677%
Midcoast	$137	1677%
Quiktrip	$137	1677%
University Of Mary Hardin-Baylor	$145	1775%
Independent Medical System	$150	1836%
Curative	$162	1983%
First Health	$175	2142%
Healthsmart	$175 - $187	2142%
Private Health Care System	$187	2289%
Three Rivers	$225	2754%

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 $150.
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 Baylor Scott & White Medical Center Pflugerville 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.