CMS Price Transparency Data

Blood test, liver function panel

Facility: Mountain West Medical Center

Billing Code: 80076 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 80076
  • Insurance Median: $145
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 17.75x Medicare
The contracted insurance negotiated median rate for a Blood test, liver function panel at Mountain West Medical Center is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $8.17, this hospital’s rate is 17.75x the Medicare baseline. Located in 2055 North Main Street, Tooele, UT.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$145

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: $121 (1481%)
Insurance Median: $145 (1775%)
Cash: $121 (1481% of Medicare)
Ins. Median: $145 (1775% 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 1775% of the Medicare baseline (a markup of 1675%). 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
Blue Cross Blue Shield $8 - $9 98%
Select Health McR Adv $8 98%
Medicare (plans) $10 122%
Pehp-All Plans $17 208%
Wise/Motivhealth-All Plans $131 1603%
U of Ut-All Plans $131 1603%
Cigna $143 1750%
Dmba-All Plans $146 1787%
Aetna $152 1860%
Select Health-All Other Plans $152 1860%
UnitedHealthcare $156 1909%
Multiplan Primary Network-All Other Plans $160 1958%
Emi-All Plans $172 2105%
Humana $172 2105%
Multiplan Complimentary Network $186 2277%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2055 North Main Street, Tooele, UT 84074
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals